This request removes language that limits reimbursement for public hospitals to no more than cost.

Proposes to remove the final settlement process language for non-state-government-owned and state-government-operated hospitals that limits the reimbursement to no more than cost for outpatient hospital services.

This request removes language that limits reimbursement for public nursing facilities to no more than cost.

This request modifies inpatient hospital reimbursement for implementation of a hospital provider tax (quality assurance assessment fee).

Establishes the tribal consultation process the State of Iowa will follow to inform and seek advice from all federally recognized Native American Tribes and Indian Health Programs within the State of Iowa.

To adjust the method used for determining the cost-effectiveness of health insurance plans when determining if the State will pay premiums for private insurance under the Health Insurance Premium Payment (HIPP) under Section 1906 of the Act. Previously Iowa had allowed deemed cost effectiveness under certain criteria. This SPA eliminates the deemed cost effectiveness criteria so that the cost effectiveness of each plan must be considered individually against the cost effectiveness formula. This criterion had originally been added to the State Plan with TN #96-07.

The State is attesting that it will establish a Medicaid Recovery Audit Contractor (RAC) program as required by the Affordable Care Act.

Change inpatient hospital reimbursement methodology for Native American members to the inpatient hospital per diem (excludes physician/practitioner services). Inpatient for all other members will continue to be paid on the DRG methodology.

Which proposes to amend outpatient hospital reimbursement methodology for IHS providers.

HF 649, as authorized by the Iowa General Assembly, restored the 5% payment reduction applied to PMIC reimbursement on December 1, 2009.