The SSDC Iowa Medicaid Supplement Drug Rebate Agreement utilized by the state to enter into a rebate agreement with a drug manufacturer has been revised and must be authorized by CMS.

This State Plan Amendment clarifies Medicaid reimbursement for inpatient hospital care provided to Indian Health Service and Tribal 638 providers.

Increase PMIC maximum rate to 1034 of the statewide weighted average for SFY 2010. Transition out-of-state placements to in-state and allow for Third Party Liability payments from other insurers for SFY 2011. Implement 100% cost reimbursement with cost settlement for state-owned PNIC.

These changes implement a temporary reduction (for the remainder of SFY 2010) in the pharmacy dispensing fee from $4.57 to $4.34 and implements a new permanent methodology for the determination of the EAC for specialty drugs at AWP minus 17% as opposed to the non-specialty BAC of AWP minus 12%.

Reductions in payment rates and changes in payment standards for inpatient hospital and NFs related to across the board budget cuts made by the Governor.

Reductions in fee schedule payments to providers, per across the board budget cuts made by the Governor.

This is a technical amendment to correct a previous technical error in regard to this page. It is being submitted.

Reduction in payments to providers, per-across-the-board budget cuts made by the Governor.

CHIPPRA 2009 gave states the option to use express lane procedures for determining Medicaid eligibility for children. SF 389 requires IA DHS to implement this option. DHS has chosen to rely on information from the IA Supplemental Nutrition Food Assistance Program eligibility to determine Medicaid eligibility for children under 19 who are not current Medicaid members.

Increases the resource limits for QMB, SLMB and QI. Adds Qualified Individuals (QIs) to Attachment 26-A. Uses current language for specified Low Income Medicare Beneficiaries (SLMB) in Attachment 2.2-A, and Re-numbers 28 to 29 and 29 to 30 in Attachment 2.2-A.