Director Liz Matney
Continuous Coverage Unwind
- There has been quite a bit of national coverage on this
- IME is still awaiting guidance from CMS. There may be some adjustments made to the unwind. IME did anticipate higher rate of disenrollments in the first few months, as that is when the folks who were flagged as potentially ineligible were disenrolled.
- Please encourage clients to re-enroll during the 90 day grace period so they have no coverage gap. This is preferable than going through an appeals process.
IME is aware of the back up in services that we are facing for behavioral health and crisis services. They know that folks are in emergency departments sitting and waiting for more appropriate placements. IMW is working to put together a solution-focused roundtable where they hope get a start on an action plan.
Data Dashboard for Medicaid is live on the Iowa HHS website
https://hhs.iowa.gov/Iowa-Medicaid-dashboard
Update on the continuous coverage unwind - Anna Casteel
They are working to figure out how to reach folks better.
Folks who lost coverage in the early months are beginning to re-apply.
IME is working to reduce the wait time at the Call Center.
There is STILL time to get renewal forms in. HHS wants folks to get their renewal forms completed and turned in so they don’t have a coverage gap.
Outreach:
MCOs are sending text messages, letters, post cards, and visiting members to get word out about renewals.
Pharmacy outreach – attaching information to prescriptions bags for those with Medicaid as their insurance.
NON-MAGI – those who need long-term services and supports. Maintaining coverage is very critical for these folks. If a client says that an MCO is coming out to check on an individual – that is likely true. They are actually doing this.
Open Choice Forms - Joanne Bush
Two open choice periods going on right now:
- 7-1-23 to 9-30-23. There is a 90 day period for all Medicaid enrollees to switch to a different MCO. After 9-30-23, one would have to have “cause” to change their MCO. Request can be made as late as 9-30-23.
- Molina has a 90 day period, where out-of network providers, will be reimbursed as in-network FFS rate for all providers
- Dental Open Choice Period: If you are already enrolled for 12 months, you have an opportunity to change your Medicaid Dental Plan so from 6-19 until 9-30 enrollees can change their Dental Plan, if you they like.
Some providers have a contract with Molina, but aren’t yet credentialed. So they aren’t showing up on provider lists yet, but should be in-network by 9-30-23.
Rate Increases -- Rebecca Curtiss
$13M increase from the legislature for FY 24
The rate increases were based on 2022 rates.
Find links to the Informational Letters Here
See Informational Letter No 2484-MC-FFS
for
Medicaid Payment Rates for Substance Use Providers
See
INFORMATIONAL LETTER NO. 2500-MC-FFS
for
Rate Increases for Psychologists, Social Workers and Behavioral Health providers
54.91 % increase
30+ procedure codes
Fee Schedule will be uploaded in about 2 weeks
INFORMATIONAL LETTER NO. 2500-MC-FFS
Community Mental Health Centers - Medicaid Rate Increases
18.2% rate increase
90834-HO was excluded from the rate increase because the current rate is actually higher than it would have been with the increase.
INFORMATIONAL LETTER NO. 2496-MC-FFS
Medicaid Rate PMICs Informational Letter
$3 Million
Increase to $464.95 per diem rate
Improve access and enhance services for children and youth.
There is a survey link in the IL – if you work at a PMIC, please complete the survey.
In General:
Rate increases will go back July 1 – but still waiting for CMS approval.
IME is going ahead of pay at this rate without CMS approval as they are feeling very confident that it will be approved – they want to get money out as quickly as possible.
If you are billing at the higher amount, they will automatically reprocess you request.
If you billed below the new rate, you will have to ask it be reprocessed. Be sure to bill at the Usual and customary – the higher rate.
It will take all the MCOs about 30 days to get the new rates uploaded.
IME is working with claims processing unit to get new rates uploaded onto website, so the new rates will be on the website in about two weeks.
Contracted rates from 2022 were the rates that were used to calculate the new rates.
The HOME Project (Hope and Opportunity in many Environments)
Community Based services redesign
Will be having townhall meetings (Home town conversations) – dates and locations will be official announced soon.
To be held in Oct. and Nov. 2023
Sioux City, Spencer, Fort Dodge Council Bluffs, Des Moines, Osceola, Oskaloosa, Marshalltown, Cedar Rapids, Dubuque, Waterloo, Burlington
virtual event in Nov.
Jennifer Steenblock – Red Tape review
Medicaid has oversight on 31 Chapters of Iowa Administrative Code. All rules be reviewed December 26, some will need to be reviewed more quickly.
Please send in your suggestions and questions about what needs to be struck, added, or made more clear:
medicaidrules@dhs.ia.state.us
Director Matney really wants assistance with this project to clean things up and make things more flexible and workable for the system.
Provider services Medicaid annual training this fall - Kera Oestreich
Virtual and in-person options. There will be an informational letter coming out.
10-9 through 10-19
Tues. 10-10 Council Bluffs
Thurs. 10-12 Mason City
Mon. 10-16 Des Moines
Thurs. 10-19 Dubuque
Escalation pathways information
has been updated to include Molina – will be placed on website.