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Iowa Wellness Plan

State: Iowa
Waiver Authority:
1115
Status: Approved

Waiver Dates

Approval: 07/27/2017
Effective: 01/01/2017
Expiration: 12/31/2024

Supporting Documents

Approved Application(s) and Related Documents

Date Title
Date   05/24/2023 Title   Demonstration Approval (PDF, 4.72 MB)
Date   02/04/2022 Title   Risk Mitigation Approval (PDF, 187.34 KB)
Date   01/27/2022 Title   CMS COVID-19 Approval (PDF, 214.25 KB)
Date   12/22/2016 Title   Fact Sheet (PDF, 53.2 KB)

Administrative Record

Date Title
Date   10/02/2023 Title   CMS Approval - Healthy Behaviors and Premiums Protocol (PDF, 136.75 KB)
Date   09/29/2023 Title   CMS Approved COVID-19 CHIP Evaluation Design (PDF, 286.89 KB)
Date   09/12/2023 Title   Dental Wellness Plan Healthy Behaviors Protocol (PDF, 210.74 KB)
Date   08/21/2023 Title   Healthy Behaviors Protocol (PDF, 221.52 KB)
Date   07/21/2023 Title   CMS Accepted Summative Evaluation Report (PDF, 2.12 MB)
Date   06/23/2023 Title   CMS Approved Evaluation Design – Updated (PDF, 4.46 MB)
Date   05/24/2023 Title   Approved Monitoring Protocol (PDF, 643.6 KB)
Date   05/24/2023 Title   CMS Approved EandC Monitoring Protocol (Part A) Workbook (XLSX, 210.14 KB)
Date   04/07/2023 Title   IA Risk Mitigation approved Evaluation Design (PDF, 675.22 KB)
Date   03/16/2022 Title   Iowa’s COVID-19 Amendment Technical Corrections Letter (PDF, 405.72 KB)
Date   02/14/2022 Title   State Acceptance of Managed Care Risk Mitigation COVID-19 amendment (PDF, 205.44 KB)
Date   02/11/2022 Title   COVID Amendment Acceptance Letter (PDF, 245.37 KB)
Date   12/29/2021 Title   Quarterly Monitoring Report – July-September 2021 (PDF, 329.5 KB)
Date   12/07/2021 Title   Ending Healthy Behaviors for the Dental Wellness (PDF, 85.53 KB)
Date   08/30/2021 Title   Quarterly Monitoring Report – April – June 2021 (PDF, 987.17 KB)
Date   08/04/2021 Title   CMS Approved Implementation Plan (PDF, 692.52 KB)
Date   08/04/2021 Title   Retroactive Eligibility Waiver Implementation Plan Approval (PDF, 5.7 MB)
Date   07/14/2021 Title   Iowa Wellness Plan Amendment STC Technical Corrections (PDF, 4.12 MB)
Date   07/02/2021 Title   Iowa Wellness Plan Amendment STC Acceptance Letter (, 4.34 KB)
Date   06/24/2021 Title   Demonstration Approval (PDF, 560.02 KB)
Date   06/23/2021 Title   CMS Approved Evaluation Design (, 228.34 KB)
Date   06/23/2021 Title   CMS Approved Monitoring Protocol (Part A) (XLSX, 143.36 KB)
Date   06/23/2021 Title   CMS Approved Monitoring Protocol (Part B) (PDF, 285.76 KB)
Date   05/25/2021 Title   Iowa Wellness Plan Quarterly Report January – March 2021 (PDF, 973.88 KB)
Date   03/30/2021 Title   Fourth Quarter & Annual Report – January – December 2020 (PDF, 1.58 MB)
Date   03/30/2021 Title   State Annual Report – January-December 2020 (PDF, 1.58 MB)
Date   03/26/2021 Title   CMS Completeness Letter- Iowa Wellness Plan Amendment (PDF, 117.73 KB)
Date   02/25/2021 Title   State Dental Amendment Application (PDF, 247.99 KB) View Comments
Date   02/12/2021 Title   CMS Letter to State (PDF, 38.76 KB)
Date   12/04/2020 Title   Iowa Wellness Plan Quarterly Report July – September 2020 (PDF, 940.4 KB)
Date   09/16/2020 Title   Iowa Letter for Nursing Facility Pass Through Payment and Lawful Permanent Resident Pregnant Women Questions (PDF, 351.68 KB)
Date   08/29/2020 Title   Quarterly Report April-June 2020 (PDF, 910.63 KB)
Date   05/13/2020 Title   Quarterly Report January- March 2020 (PDF, 656.18 KB)
Date   03/30/2020 Title   Iowa Wellness Plan Annual Report (PDF, 1.04 MB)
Date   12/11/2019 Title   Iowa STC Acceptance Letter (PDF, 2.81 MB)
Date   11/19/2019 Title   Quarterly Report July- September 2019 (PDF, 975.67 KB)
Date   11/15/2019 Title   CMS Approval - Extension Request (JSON, 338 B)
Date   10/30/2019 Title   Iowa Extension Request (PDF, 1.34 MB)
Date   10/15/2019 Title   Iowa Extension Request (PDF, 2.71 MB)
Date   09/16/2019 Title   Proposed Special Terms and Conditions Changes Letter (PDF, 164.81 KB)
Date   09/09/2019 Title   Quarterly Report April-June 2019 (PDF, 875.86 KB)
Date   08/19/2019 Title   Quarterly Report July-September 2018 (PDF, 463.09 KB)
Date   08/02/2019 Title   Letter of Intent to Review Special Terms and Conditions (PDF, 140.61 KB)
Date   07/17/2019 Title   Quarterly Report January-March 2019 (PDF, 716.69 KB)
Date   07/03/2019 Title   CMS Completeness Letter (PDF, 170.76 KB)
Date   06/20/2019 Title   Iowa Extension Application (PDF, 3.92 MB) View Comments
Date   05/23/2019 Title   Iowa Wellness Plan Annual Report 2018 (PDF, 457.61 KB)
Date   05/17/2019 Title   Quarterly Report January-March 2018 (PDF, 582.07 KB)
Date   05/02/2019 Title   Quarterly Report April-June 2018 (PDF, 622.63 KB)
Date   09/25/2018 Title   Iowa Wellness Plan Retroactive Eligibility Exemption CMS Response Letter (PDF, 171.91 KB)
Date   09/04/2018 Title   Iowa Wellness Plan Retroactive Eligibility Exemption Letter (PDF, 384 KB)
Date   04/11/2018 Title   IA Wellness Plan Annual Report 2017 (PDF, 249.47 KB)
Date   12/04/2017 Title   Quarterly Report July - September 2017 (12/4/2017) (PDF, 389.11 KB)
Date   11/08/2017 Title   State Acceptance Letter (11/08/2017) (PDF, 1.71 MB)
Date   10/27/2017 Title   CMS Amendment Approval (PDF, 352.51 KB)
Date   09/01/2017 Title   Quarterly Report April – June 2017 (9/1/2017) (PDF, 815.15 KB)
Date   08/23/2017 Title   State Acceptance Letter (8/23/17) (PDF, 323.14 KB)
Date   08/07/2017 Title   CMS Completeness Letter (08/07/2017) (PDF, 100.65 KB)
Date   08/02/2017 Title   Iowa Wellness Plan Amendment Request (8/2/17) (PDF, 2.43 MB) View Comments
Date   07/27/2017 Title   Iowa Wellness Plan Amendment Approval (7/27/17) (PDF, 350.34 KB)
Date   06/01/2017 Title   Quarterly Report January – March 2017 (6/1/2017) (PDF, 411.79 KB)
Date   05/10/2017 Title   CMS Completeness Letter (05/10/2017) (PDF, 99.23 KB)
Date   05/05/2017 Title   Iowa Wellness Plan Fourth Quarter and Annual Report 2016 (5/5/2017) (PDF, 468.77 KB)
Date   05/01/2017 Title   Iowa Wellness Plan Amendment Request (5/1/2017) (PDF, 427.09 KB) View Comments
Date   12/13/2016 Title   Quarterly Report July - September 2016 (12/13/2016) (PDF, 326.42 KB)
Date   11/23/2016 Title   Iowa Wellness Plan Extension Approval (11/23/2016) (PDF, 653.3 KB)
Date   09/30/2016 Title   Quarterly Report April - June 2016 (09/30/2016) (PDF, 323.64 KB)
Date   07/12/2016 Title   Quarterly Report January - March 2016 (07/12/2016) (PDF, 304.17 KB)
Date   06/20/2016 Title   Iowa Wellness Plan Demonstration Extension Request (PDF, 654.6 KB) View Comments
Date   06/14/2016 Title   CMS Completeness Letter (06/14/2016) (PDF, 91.62 KB)
Date   05/31/2016 Title   CMS Approval - NEMT Waiver Extension (05/31/2016) (PDF, 621.64 KB)
Date   03/01/2016 Title   Iowa Dental Wellness Plan Interim Report March 2016 (PDF, 1.66 MB)
Date   03/01/2016 Title   Iowa Healthy Behaviors Interim Report March 2016 (PDF, 600.82 KB)
Date   03/01/2016 Title   Iowa IWP NEMT Report March 2016 (PDF, 590.09 KB)
Date   02/23/2016 Title   CMS Technical Corrections - Feb 2016 (PDF, 1.25 MB)
Date   02/04/2016 Title   Non-emergency Medical Transportation Waiver Temporary Extension (02/04/2016) (PDF, 91.75 KB)
Date   02/01/2016 Title   Iowa IWP Q4 2015 Quarterly Report (02/01/2016) (PDF, 3.41 MB)
Date   01/01/2016 Title   Special Terms and Conditions (01/01/2016) (PDF, 527.08 KB)
Date   12/31/2015 Title   Iowa Health and Wellness Plan Evaluation Interim Report (PDF, 3.43 MB)
Date   12/24/2015 Title   CMS Amendment Approval (12/24/2015) (PDF, 593.4 KB)
Date   10/30/2015 Title   Iowa IWP Q3 2015 Quarterly Report (10/30/2015) (PDF, 2.91 MB)
Date   09/17/2015 Title   CMS Completeness Letter (09/17/2015) (PDF, 99.07 KB)
Date   09/03/2015 Title   State Amendment Application (09/03/2015) (PDF, 237.8 KB) View Comments
Date   07/31/2015 Title   CMS Amendment Approval (07/31/2015) (PDF, 631.65 KB)
Date   07/30/2015 Title   IWP Quarterly Report Apr-June 2015 (07/30/2015) (PDF, 2.91 MB)
Date   06/09/2015 Title   CMS Completeness Letter (06/09/2015) (PDF, 91.55 KB)
Date   05/29/2015 Title   State Amendment Application - Non-Emergency Medical Transportation (NEMT) (05/29/2015) (PDF, 968.24 KB) View Comments
Date   05/04/2015 Title   IWP Quarterly Report Jan-Mar 2015 (05/04/2015) (PDF, 2.77 MB)
Date   02/02/2015 Title   Current Approval (02/02/2015) (PDF, 577.65 KB)
Date   01/20/2015 Title   Amendment Approval Letter (01/20/2015) (PDF, 55.14 KB)
Date   01/01/2015 Title   Quarterly Report October - December 2014 (1/1/2015) (PDF, 2.89 MB)
Date   10/30/2014 Title   Quarterly Report July - September 2014 (10/30/2014) (PDF, 3.76 MB)
Date   09/29/2014 Title   Dental Wellness Plan Approval (09/29/2014) (PDF, 3.59 MB)
Date   09/23/2014 Title   Pending Application (09/23/2014) (PDF, 201.74 KB) View Comments
Date   09/19/2014 Title   Complete Letter (09/19/2014) (PDF, 64.73 KB)
Date   07/30/2014 Title   Quarterly Report April - June 2014 (07/30/2014) (PDF, 7.09 MB)
Date   06/04/2014 Title   Approval Letter (06/04/2014) (PDF, 71.49 KB)
Date   05/01/2014 Title   Amendment Request Letter (05/01/2014) (PDF, 222.13 KB)
Date   04/30/2014 Title   Iowa IWP Q1 2014 Quarterly Report (04/30/2014) (PDF, 28.88 MB)
Date   02/26/2014 Title   Letter Issuing Technical Corrections (02/26/14) (PDF, 73.25 KB)
Date   01/01/2014 Title   Special Terms and Conditions (01/01/14-12/31/16 Amended 12/30/13) (PDF, 98.44 KB)
Date   01/01/2014 Title   Special Terms and Conditions (01/01/14-12/31/16 Amended 12/30/13) (PDF, 99.5 KB)
Date   01/01/2014 Title   Special Terms and Conditions (01/01/14-12/31/16) (PDF, 77.56 KB)
Date   12/30/2013 Title   Letter of Approval to Amend Demo (12/30/13) (PDF, 40.45 KB)
Date   12/30/2013 Title   Waiver List 12/30/13 (PDF, 32.45 KB)
Date   12/30/2013 Title   Waiver List 12/30/13 (01/01/14-12/31/16 Amended 12/30/13) (PDF, 33.34 KB)
Date   12/10/2013 Title   Demo Approval Letter (12/10/13) (PDF, 307.95 KB)
Date   12/10/2013 Title   Waiver List 12/10/13 (PDF, 29.42 KB)
Date   08/31/2013 Title   1115 Waiver App (August 2013) (PDF, 753.35 KB)
Date   Title   Public Comments (PDF, 162.77 KB)
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