Approved State Directed Payment Preprints

Uniform dollar increase and Minimum Fee Schedule for home and community-based services and behavioral health outpatient services established by the state for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $374.7 Million.

Uniform percentage increase for physician and professional services provided at qualifying Iowa state-owned or operated professional services practices as defined in the Medicaid State Plan for rating periods covering July 1, 2025 through June 30, 2026,incorporated in the capitation rates through a separate payment term amount of up to$136,779,796.

Quality Payment/Pay for Performance (Category 2 APM, or similar) for Certified Community Behavior Health Center’s (CCBHC) services for rating periods covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $3,695,094.83.

Uniform increases established by the state for inpatient and outpatient services provided by all in-state hospitals for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$3.9 billion.

Uniform percentage increase for dental services for the rating period covering January 1,2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $63,373,184.

Minimum Fee Schedule for Integrated Community Wellness Centers for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $49,874,341.00.

Integrated Care Incentive proposal for non-state, public hospitals for the rating periods covering January 2, 2025 to December 31, 2027, incorporated in the capitation rates through a separate payment term of up to $148.8 million for January 1, 2025 - December31, 2025; $148.8 million for the January 1, 2026 – December 31, 2026; and $148.8million for January 1, 2027 – December 31, 2027.

Minimum Fee Schedule established by the state for eligible non-state government owned nursing facilities for actual utilization of services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $5,650,000.

The Hospital Quality Incentive proposal for the rating period covering January 1, 2025through December 31, 2027, incorporated in the capitation rates through a separate payment term of up to $160.8 million for January 1, 2025 – December 31, 2025; $160.8million for January 1, 2026 – December 31, 2026; and $160.8 million for January 1, 2027–December 31, 2027.

The Performance Improvement Initiative for Professional Services proposal for the rating period covering January 1, 2025, through December 31, 2027, incorporated in the capitation rates through a separate payment term of up to $75 million for January 1, 2025–December 31, 2025; $75 million for January 1, 2026 – December 31, 2026; and $75million for January 1, 2027 – December 31, 2027.