May 16, 2019 | Issue 6 | Volume 4
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IA Health Link Updates
A new manged care organization (MCO), Iowa Total Care, is joining the IA Health Link program on July 1, 2019, and UnitedHealthcare is leaving no sooner than June 30, 2019. Amerigroup Iowa will continue to provide coverage.
Open Choice continues for members through September 30, 2019. Members have until June 18, 2019 to submit a MCO choice for coverage effective July 1, 2019.
Continuity of Care
The Department of Human Services (DHS) is taking extra measures to ensure continuity of care for Medicaid members during the transition.
When a member switches MCOs, all prior authorizations will be honored for 90 days.
If a member is receiving Home- and Community-Based Services, their service plan will be honored until a new assessment is completed and a new plan is developed with the member and their team.
DHS also is working to maintain member relationships with their case managers. The Department is working with the MCOs to provide information about where case managers are employed if a member requests that information. In the coming weeks, members will be able to contact IME Member Services or their MCO to find out where their case manager is employed. During the Open Choice Period, a member will be able to switch MCOs based on where their case manager is employed. The Department is working with the MCOs to ensure that a member stays with their case manager if they so choose.
Mailing
DHS has started sending letters to members impacted by UnitedHealthcare's upcoming departure. Affected members primarily include those who were tentatively assigned to UnitedHealthcare as part of the March redistribution, or have recently chosen UnitedHealthcare. Members will be sent a notice letting them know that UnitedHealthcare is no longer an option.
Town Hall Meetings
Medicaid Director Mike Randol has been holding town hall meetings across the state over the last week to talk with members and providers about the MCO transition and the extra measures DHS is taking to ensure continuity of care. A town hall meeting will be held in Davenport on May 16, 2019 and in Ottumwa on May 24, 2019. Complete details on the town halls is available on the
DHS website.
Provider Training Events
The IME and the MCOs continue to hold training sessions across the state throughout the month of May to provide updates regarding the Medicaid program. Details on provider training can be found in
Informational Letter 2011-MC-FFS.
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Public Comment Period to Extend the Iowa Wellness Plan Demonstration Waiver
DHS will hold two public hearings on the renewal of the 1115 Iowa Wellness Plan Demonstration Waiver, which is set to expire December 31, 2019. DHS intends to request extension of this waiver for an additional five years.
Hearings offer an opportunity for the public to provide written or verbal comments about the Iowa Wellness Plan Demonstration Waiver extension. All comments will be summarized and taken into consideration prior to submission to the Centers for Medicare and Medicaid Services (CMS). Hearings will be held at the following dates, times and locations:
Tuesday, May 21, 2019
1:30 p.m. - 2:30 p.m.
Hoover State Office Building
A-Level, Conference Room 7
1305 E. Walnut St., Des Moines, IA 50319
Conference Line Available: 1-866-685-1580 / Code: 000-999-0232
Wednesday, May 22, 2019
12:00 p.m. - 1:00 p.m.
Coralville Public Library
Meeting Room A
1401 5th St., Coralville, IA 52241
Conference Line Available: 1-866-685-1580 / Code: 000-999-0232
Written comments may be addressed to Anna Ruggle, DHS, Iowa Medicaid Enterprise, 611 Fifth Avenue, Des Moines, IA 50309. Comments may also be sent to the attention of DHS, Iowa Health and Wellness Plan at:
aruggle@dhs.state.ia.us through June 10, 2019.
The Iowa Wellness Plan was created to provide comprehensive health care coverage to low-income, uninsured Iowans ages 19 to 64. During the initial two waiver periods, the innovative design of the Iowa Wellness Plan has demonstrated success in meeting key State goals. The State seeks to continue its success with the program and requests an extension of all current federal waivers.
The only modification requested is a technical change to the special terms and conditions to align with current program operations for retroactive eligibility. Specifically, as implemented by DHS effective for applications received on or after July 1, 2018, in accordance with Iowa Senate File 2418, a period of up to three months of retroactive eligibility is provided for applicants who are residents of a nursing facility at the time of Medicaid application and are otherwise Medicaid-eligible.
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DHS Now Accepting Medicaid Premiums Online
Iowa Health and Wellness Plan members and Dental Wellness Plan members that receive a monthly billing statement in the mail, can now pay their premiums online.
Payments may only be made from your checking or savings account. Once you submit your payment information, a receipt will be made for your records.
The ClickPay website does not require you to create an account to make a payment. However, you'll need to enter your statement number, Member ID and the last 4 digits of your Social Security Number to make a payment. (The statement number is located on the front of the statement, in the upper-right-hand corner.)
Once you enter the required information you will be transferred to a secure bank site: U.S. Bank, to complete your transaction. U.S. Bank processes the premiums for DHS; you do not need to have a U.S. Bank account to pay your contribution online.
The ClickPay online payment option is not available for Hawki or Medicaid for Employed People with Disabilities members.
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Changing Managed Care Organizations
Remember, members
requesting to change their Managed Care Organization (MCO) due to 'Good Cause,' f
irst must contact their current MCO to go through their grievance process for resolution. If the issue has not been resolved following the decision of the grievance, the member may call Iowa Medicaid Member Services at 1-800-338-8366. The final decision for disenrollment will be determined by DHS. For more information click here.
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Provider Tools and Resources:
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Providers are Encouraged to Verify Eligibility
The Eligibility and Verification Information System (ELVS) line is very busy during the first of the month. The
ELVS web portal is another option for providers in lieu of calling the ELVS line but each provider must enroll through the Electronic Data Interchange Support Services (EDISS). The ELVS web portal allows for multiple eligibility checks and batch submission, where as the ELVS phone system only allows for one at a time.
Login ID and password may be obtained through EDISS by submitting the following
Access Request Form to EDISS or calling EDISS at 1-800-967-7902.
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Provider Resource Pages
Comprehensive provider resource pages are available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. View them below:
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Informational Letters
Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website
here
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These letters communicate important policies and procedures for providers and their administrative staff.
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1-800-600-4441
1-800-464-9484
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1-800-454-3730
1-833-404-1061
1-888-650-3462
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Dental Wellness Plan Contacts
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1-888-472-2793
1-855-247-6262
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1-888-472-1205
1-855-856-6262
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 IA Health Link Success Stories
IA Health Link is a managed care program that works to make sure members get the health care that they need. Click the
image above to read success stories.
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611 Fifth Ave., Des Moines, IA 50309
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Copyright © 2019. All Rights Reserved.
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