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News for Iowa Health Care Association members and their employees May 8, 2018
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Payment and Reimbursement
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IHCA meets with DHS to address payment concerns
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Last week, IHCA staff met with leadership from IME and their contractor Myers and Stauffer to discuss several areas important to membership. These areas include:

NSGO State Plan Amendment (SPA)
DHS received a letter back from CMS on April 30, 2018 denying the SPA. This was following the second letter from IME that answered questions CMS had asked after the state's initial submission. The basic theme of the denial letter was that Iowa's request was being denied because of a lack of supporting documentation of how the program was going to run and how the payments were going to flow. This language was not included in legislation and, therefore, was not included in the SPA submission. Next steps could potentially include more prescriptive language in 2019 that could assist in pushing this forward.

Utilization Data
Since the transition to managed care, the availability of data has become hard to come by. IHCA expressed that this information had always been available before and that it was used to track days/units for our members. During this meeting, Director Randol seemed receptive to the idea of making this available once again.

MCO Issues
IHCA again made DHS aware of the ongoing issues providers are experiencing surrounding claims. Samples were shared explaining what was happening routinely to providers which is making collection of monies owed more difficult that it has ever been. IHCA has representation on the DHS Process Improvement Working Group where providers are able to discuss difficulties in the managed care system. On the Process Improvement Working Group webpage you can find the group's workplan. If you have examples of issues you are experiencing that are on this list, reach out to Brandon Hagen at IHCA and he will share them with DHS.

MCO Request for Proposal
Two bidders, Iowa Total Care (Centene) and Trusted Health Plan, submitted their intent to help run Iowa’s Medicaid program. The Department originally estimated the notice of intent to award would be published on or around May 1, 2018. This date has since been pushed back to approximately May 21, 2018.

Hospice Pass-Through for Room and Board
IHCA has been working with the department on discussions to remove the room and board pass through and allow nursing facility providers to bill IME or the MCOs directly for these services. Per HF 2309, DHS has created a working group to continue the discussions of moving this forward and put the options into a legislative report. The first of these meetings will be held on May 15. 
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Education Calendar
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NW District Meeting & Education, May 8, 2018, 10:00 a.m.-12:00 p.m., Storm Lake
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SNF Medicare Review, May 9, 2018, West Des Moines
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NE District Meeting & Education, May 10, 2018, 10:00 a.m.-12:00 p.m., Cedar Falls
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Medicaid HCBS Elderly Waiver Review, May 16, West Des Moines
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Assisted Living Nurses Conference, May 17, West Des Moines
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SE District Meeting & Education, May 22, 2018, 10:00 a.m.-12:00 p.m., West Liberty
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SW District Meeting & Education, May 24, 2018, 10:30 a.m.-12:30 p.m., Atlantic
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Nursing Facility Reimbursement Conference, May 31, West Des Moines
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LTC Medical Directors, Medical Practitioners & Pharmacists Conference, June 1-2, West Des Moines
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Activity Professionals Workshop, June 14, Des Moines (See corrected date)
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Summer Quarterly Education Conference, June 20, Des Moines
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LTC Dietary Conference, June 26, West Des Moines
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Assisted Living Management Certification, Online program
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Online Dementia Care Training and Individual Certification Program
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Click on the event link to learn more about each educational offering and to register. If you have additional questions, contact Georgene Olson at 800.422.3106.

West Des Moines area hotel discounts for IHCA members.

Map to the IHCA Education Center, 1775 90th Street, West Des Moines, IA.

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This newsletter contains confidential information and is intended only for IHCA, ICAL and ICHC membership. Dissemination, distribution or copying the contents of this email beyond this group is strictly prohibited. 

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