1.Program Definition and Services
Home Health Services (HHS) in Iowa provide in-home medical services by Medicare-certified home health agencies. Services include:
- Skilled nursing care
- Home health aide services
- Physical therapy
- Occupational therapy
- Speech-language therapy
- Medical social services
2. Regulations
Home Health Services are governed by:
- Iowa Administrative Code (IAC) 441-78.9 for home health agencies
- Federal regulations set by the Centers for Medicare and Medicaid Services (CMS)
3. Licensing or Certification
Providers must be Medicare-certified home health agencies to participate in the Medicaid program
4. Responsible State Agency
The Iowa Department of Health and Human Services (HHS) oversees Home Health Services programs.
5. Application Process
Providers must enroll through the Iowa Medicaid Enterprise (IME) Provider Enrollment Unit to become Medicaid providers for Home Health Services
6. Required Documentation
Required documentation includes:
- Completed provider enrollment application
- IRS Form W-9 (signed and dated)
- Iowa State Medicaid Approval Letter and NPI Number
- Copy of General/Professional Liability Insurance ($1M/$3M)
- Medicare certification documentation
7. Timeline for Approval
The exact timeline for approval is not specified in the provided information.
8. Pre-Application Process
There is no specific pre-application process mentioned.
9. Pre-Application Training
No mandatory pre-application training is mentioned.
10. Additional Notes
- A physician must certify the medical need for HHS through a face-to-face encounter
- The physician must review and sign the HHS plan of care every 60 days
- Services are reimbursed per visit based on the low utilization payment adjustment (LUPA) methodology
- Members do not need to be homebound to receive HHS services
- As of February 11, 2025, there were 18,078 home health beneficiaries in Iowa
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