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Iowa Wellness Plan

State: Iowa
Waiver Authority:
1115
Status: Pending

Waiver Dates

Approval: 12/10/2013
Effective: 01/01/2014
Expiration: 07/31/2025

Supporting Documents

Pending Application(s) and Related Documents

Date Title
06/06/2025 Pending Application (PDF, 3.93 MB) View/Submit Comments
05/22/2025 Pending Application - Extension Application (PDF, 49.51 MB) View/Submit Comments
06/26/2024 Pending Application (PDF, 18.71 MB) View/Submit Comments

Approved Application(s) and Related Documents

Date Title
06/25/2025 Monitoring Redesign Overlay Letter (PDF, 6.96 MB)
06/18/2025 CMS Temporary Extension Approval (PDF, 200.83 KB)
12/10/2024 CMS Temporary Extension Approval (PDF, 282.71 KB)
05/24/2023 Demonstration Approval (PDF, 4.72 MB)

Administrative Record

Date Title
06/12/2025 CMS Completeness Letter (PDF, 144.5 KB)
04/30/2025 CMS Approved COVID-19 Risk Mitigation Final Report (PDF, 397.77 KB)
03/11/2025 Quarterly Monitoring Report (Part A) January 2024 - March 2024 (XLSX, 174.45 KB)
03/11/2025 Quarterly Monitoring Report (Part A) July 2024 - September 2024 (XLSX, 174.45 KB)
03/11/2025 Quarterly Monitoring Report (Part B) January 2024 - March 2024 (PDF, 383.84 KB)
03/11/2025 Quarterly Monitoring Report (Part B) July 2024 - September 2024 (PDF, 383.63 KB)
03/05/2025 Letter from State (PDF, 110.28 KB)
01/07/2025 CMS Approved COVID-19 CHIP Aging Out Final Report (PDF, 506.32 KB)
07/11/2024 CMS Completeness Letter (PDF, 149.92 KB)
05/30/2024 Quarterly Monitoring Report (Part A) April – June 2023 (XLSX, 168.85 KB)
05/30/2024 Quarterly Monitoring Report (Part B) April – June 2023 (PDF, 339.08 KB)
05/24/2024 Quarterly Monitoring Report (Part A) April – June 2022 (XLSX, 148.72 KB)
05/24/2024 Quarterly Monitoring Report (Part A) January - March 2022 (XLSX, 148.1 KB)
05/24/2024 Quarterly Monitoring Report (Part A) January – March 2023 (XLSX, 149.49 KB)
05/24/2024 Quarterly Monitoring Report (Part A) July – September 2022 (XLSX, 147.93 KB)
05/24/2024 Quarterly Monitoring Report (Part A) October - December 2021 (XLSX, 148.62 KB)
05/24/2024 Quarterly Monitoring Report (Part A) October – December 2022 (XLSX, 146.01 KB)
05/24/2024 Quarterly Monitoring Report (Part B) April – June 2022 (PDF, 367.19 KB)
05/24/2024 Quarterly Monitoring Report (Part B) January - March 2022 (PDF, 362.05 KB)
05/24/2024 Quarterly Monitoring Report (Part B) January – March 2023 (PDF, 365.72 KB)
05/24/2024 Quarterly Monitoring Report (Part B) July – September 2022 (PDF, 389.39 KB)
05/24/2024 Quarterly Monitoring Report (Part B) October - December 2021 (PDF, 362.4 KB)
05/24/2024 Quarterly Monitoring Report (Part B) October – December 2022 (PDF, 364.62 KB)
10/02/2023 CMS Approval - Healthy Behaviors and Premiums Protocol (PDF, 136.75 KB)
09/29/2023 CMS Approved COVID-19 CHIP Evaluation Design (PDF, 286.89 KB)
09/12/2023 Dental Wellness Plan Healthy Behaviors Protocol (PDF, 210.74 KB)
08/21/2023 Healthy Behaviors Protocol (PDF, 221.52 KB)
07/21/2023 CMS Accepted Summative Evaluation Report (PDF, 2.12 MB)
06/23/2023 CMS Approved Evaluation Design – Updated (PDF, 4.46 MB)
05/24/2023 Approved Monitoring Protocol (PDF, 643.6 KB)
05/24/2023 CMS Approved EandC Monitoring Protocol (Part A) Workbook (XLSX, 210.14 KB)
04/07/2023 IA Risk Mitigation approved Evaluation Design (PDF, 675.22 KB)
03/16/2022 Iowa’s COVID-19 Amendment Technical Corrections Letter (PDF, 405.72 KB)
02/14/2022 State Acceptance of Managed Care Risk Mitigation COVID-19 amendment (PDF, 205.44 KB)
02/11/2022 COVID Amendment Acceptance Letter (PDF, 245.37 KB)
02/04/2022 Risk Mitigation Approval (PDF, 187.34 KB)
01/27/2022 CMS COVID-19 Approval (PDF, 214.25 KB)
12/29/2021 Quarterly Monitoring Report – July-September 2021 (PDF, 329.5 KB)
12/07/2021 Ending Healthy Behaviors for the Dental Wellness (PDF, 85.53 KB)
08/30/2021 Quarterly Monitoring Report – April – June 2021 (PDF, 987.17 KB)
08/04/2021 CMS Approved Implementation Plan (PDF, 692.52 KB)
08/04/2021 Retroactive Eligibility Waiver Implementation Plan Approval (PDF, 5.7 MB)
07/14/2021 Iowa Wellness Plan Amendment STC Technical Corrections (PDF, 4.12 MB)
07/02/2021 Iowa Wellness Plan Amendment STC Acceptance Letter (, 4.34 KB)
06/24/2021 Demonstration Approval (PDF, 560.02 KB)
06/23/2021 CMS Approved Evaluation Design (, 228.34 KB)
06/23/2021 CMS Approved Monitoring Protocol (Part A) (XLSX, 143.36 KB)
06/23/2021 CMS Approved Monitoring Protocol (Part B) (PDF, 285.76 KB)
05/25/2021 Iowa Wellness Plan Quarterly Report January – March 2021 (PDF, 973.88 KB)
03/30/2021 Fourth Quarter & Annual Report – January – December 2020 (PDF, 1.58 MB)
03/30/2021 State Annual Report – January-December 2020 (PDF, 1.58 MB)
03/26/2021 CMS Completeness Letter- Iowa Wellness Plan Amendment (PDF, 117.73 KB)
02/25/2021 State Dental Amendment Application (PDF, 247.99 KB) View Comments
02/12/2021 CMS Letter to State (PDF, 38.76 KB)
12/04/2020 Iowa Wellness Plan Quarterly Report July – September 2020 (PDF, 940.4 KB)
09/16/2020 Iowa Letter for Nursing Facility Pass Through Payment and Lawful Permanent Resident Pregnant Women Questions (PDF, 351.68 KB)
08/29/2020 Quarterly Report April-June 2020 (PDF, 910.63 KB)
05/13/2020 Quarterly Report January- March 2020 (PDF, 656.18 KB)
03/30/2020 Iowa Wellness Plan Annual Report (PDF, 1.04 MB)
12/11/2019 Iowa STC Acceptance Letter (PDF, 2.81 MB)
11/19/2019 Quarterly Report July- September 2019 (PDF, 975.67 KB)
11/15/2019 CMS Approval - Extension Request (PDF, 2.57 MB)
10/30/2019 Iowa Extension Request (PDF, 1.34 MB)
10/15/2019 Iowa Extension Request (PDF, 2.71 MB)
09/16/2019 Proposed Special Terms and Conditions Changes Letter (PDF, 164.81 KB)
09/09/2019 Quarterly Report April-June 2019 (PDF, 875.86 KB)
08/19/2019 Quarterly Report July-September 2018 (PDF, 463.09 KB)
08/02/2019 Letter of Intent to Review Special Terms and Conditions (PDF, 140.61 KB)
07/17/2019 Quarterly Report January-March 2019 (PDF, 716.69 KB)
07/03/2019 CMS Completeness Letter (PDF, 170.76 KB)
06/20/2019 Iowa Extension Application (PDF, 3.92 MB) View Comments
05/23/2019 Iowa Wellness Plan Annual Report 2018 (PDF, 457.61 KB)
05/17/2019 Quarterly Report January-March 2018 (PDF, 582.07 KB)
05/02/2019 Quarterly Report April-June 2018 (PDF, 622.63 KB)
09/25/2018 Iowa Wellness Plan Retroactive Eligibility Exemption CMS Response Letter (PDF, 171.91 KB)
09/04/2018 Iowa Wellness Plan Retroactive Eligibility Exemption Letter (PDF, 384 KB)
04/11/2018 IA Wellness Plan Annual Report 2017 (PDF, 249.47 KB)
12/04/2017 Quarterly Report July - September 2017 (12/4/2017) (PDF, 389.11 KB)
11/08/2017 State Acceptance Letter (11/08/2017) (PDF, 1.71 MB)
10/27/2017 CMS Amendment Approval (PDF, 352.51 KB)
09/01/2017 Quarterly Report April – June 2017 (9/1/2017) (PDF, 815.15 KB)
08/23/2017 State Acceptance Letter (8/23/17) (PDF, 323.14 KB)
08/07/2017 CMS Completeness Letter (08/07/2017) (PDF, 100.65 KB)
08/02/2017 Iowa Wellness Plan Amendment Request (8/2/17) (PDF, 2.43 MB) View Comments
07/27/2017 Iowa Wellness Plan Amendment Approval (7/27/17) (PDF, 350.34 KB)
06/01/2017 Quarterly Report January – March 2017 (6/1/2017) (PDF, 411.79 KB)
05/10/2017 CMS Completeness Letter (05/10/2017) (PDF, 99.23 KB)
05/05/2017 Iowa Wellness Plan Fourth Quarter and Annual Report 2016 (5/5/2017) (PDF, 468.77 KB)
05/01/2017 Iowa Wellness Plan Amendment Request (5/1/2017) (PDF, 427.09 KB) View Comments
12/13/2016 Quarterly Report July - September 2016 (12/13/2016) (PDF, 326.42 KB)
11/23/2016 Iowa Wellness Plan Extension Approval (11/23/2016) (PDF, 653.3 KB)
09/30/2016 Quarterly Report April - June 2016 (09/30/2016) (PDF, 323.64 KB)
07/12/2016 Quarterly Report January - March 2016 (07/12/2016) (PDF, 304.17 KB)
06/20/2016 Iowa Wellness Plan Demonstration Extension Request (PDF, 654.6 KB) View Comments
06/14/2016 CMS Completeness Letter (06/14/2016) (PDF, 91.62 KB)
05/31/2016 CMS Approval - NEMT Waiver Extension (05/31/2016) (PDF, 621.64 KB)
03/01/2016 Iowa Dental Wellness Plan Interim Report March 2016 (PDF, 1.66 MB)
03/01/2016 Iowa Healthy Behaviors Interim Report March 2016 (PDF, 600.82 KB)
03/01/2016 Iowa IWP NEMT Report March 2016 (PDF, 590.09 KB)
02/23/2016 CMS Technical Corrections - Feb 2016 (PDF, 1.25 MB)
02/04/2016 Non-emergency Medical Transportation Waiver Temporary Extension (02/04/2016) (PDF, 91.75 KB)
02/01/2016 Iowa IWP Q4 2015 Quarterly Report (02/01/2016) (PDF, 3.41 MB)
01/01/2016 Special Terms and Conditions (01/01/2016) (PDF, 527.08 KB)
12/31/2015 Iowa Health and Wellness Plan Evaluation Interim Report (PDF, 3.43 MB)
12/24/2015 CMS Amendment Approval (12/24/2015) (PDF, 593.4 KB)
10/30/2015 Iowa IWP Q3 2015 Quarterly Report (10/30/2015) (PDF, 2.91 MB)
09/17/2015 CMS Completeness Letter (09/17/2015) (PDF, 99.07 KB)
09/03/2015 State Amendment Application (09/03/2015) (PDF, 237.8 KB) View Comments
07/31/2015 CMS Amendment Approval (07/31/2015) (PDF, 631.65 KB)
07/30/2015 IWP Quarterly Report Apr-June 2015 (07/30/2015) (PDF, 2.91 MB)
06/09/2015 CMS Completeness Letter (06/09/2015) (PDF, 91.55 KB)
05/29/2015 State Amendment Application - Non-Emergency Medical Transportation (NEMT) (05/29/2015) (PDF, 968.24 KB) View Comments
05/04/2015 IWP Quarterly Report Jan-Mar 2015 (05/04/2015) (PDF, 2.77 MB)
02/02/2015 Current Approval (02/02/2015) (PDF, 577.65 KB)
01/20/2015 Amendment Approval Letter (01/20/2015) (PDF, 55.14 KB)
01/01/2015 Quarterly Report October - December 2014 (1/1/2015) (PDF, 2.89 MB)
10/30/2014 Quarterly Report July - September 2014 (10/30/2014) (PDF, 3.76 MB)
09/29/2014 Dental Wellness Plan Approval (09/29/2014) (PDF, 3.59 MB)
09/23/2014 Pending Application (09/23/2014) (PDF, 201.74 KB) View Comments
09/19/2014 Complete Letter (09/19/2014) (PDF, 64.73 KB)
07/30/2014 Quarterly Report April - June 2014 (07/30/2014) (PDF, 7.09 MB)
06/04/2014 Approval Letter (06/04/2014) (PDF, 71.49 KB)
05/01/2014 Amendment Request Letter (05/01/2014) (PDF, 222.13 KB)
04/30/2014 Iowa IWP Q1 2014 Quarterly Report (04/30/2014) (PDF, 28.88 MB)
02/26/2014 Letter Issuing Technical Corrections (02/26/14) (PDF, 73.25 KB)
01/01/2014 Special Terms and Conditions (01/01/14-12/31/16 Amended 12/30/13) (PDF, 98.44 KB)
01/01/2014 Special Terms and Conditions (01/01/14-12/31/16 Amended 12/30/13) (PDF, 99.5 KB)
01/01/2014 Special Terms and Conditions (01/01/14-12/31/16) (PDF, 77.56 KB)
12/30/2013 Letter of Approval to Amend Demo (12/30/13) (PDF, 40.45 KB)
12/30/2013 Waiver List 12/30/13 (PDF, 32.45 KB)
12/30/2013 Waiver List 12/30/13 (01/01/14-12/31/16 Amended 12/30/13) (PDF, 33.34 KB)
12/10/2013 Demo Approval Letter (12/10/13) (PDF, 307.95 KB)
12/10/2013 Waiver List 12/10/13 (PDF, 29.42 KB)
08/31/2013 1115 Waiver App (August 2013) (PDF, 753.35 KB)
Public Comments (PDF, 162.77 KB)
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