Medicaid/CHIP Data Requirements in Iowa
Subtopic | Statute/Regulation | Description |
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Medicaid medical records maintenance by providers (including retention period, storage, and other recordkeeping requirements) | Community mental health centers, I.A.C. r. 441-78.16 | Community mental health centers States that Iowa’s Medicaid program will approve payments for reasonable and necessary services provided... |
Discharge and Transfer, I.A.C. r. 441-81.5 | Discharge and Transfer Requires nursing facility administrators to notify the Department of Human Services when a Medicaid member requests a... | |
Maintenance of records, I.A.C. r. 441-79.3 | Maintenance of records by providers of service Requires Medicaid providers to maintain financial and medical records and to make these records... | |
Participating Health and Dental Plans, I.A.C. r. 441-86.15 | Participating Health and Dental Plans Establishes requirements for health and dental plans that wish to participate in Iowa’s CHIP... | |
Pharmaceutical Case Management Services, I.A.C. r. 441-78.47 | Pharmaceutical Case Management Services Permits physicians and pharmacists to provide pharmaceutical case management services to Medicaid... | |
Records and Reports, I.A.C. r. 441-73.18 | Records and reports Requires managed care organizations that provide Medicaid services to maintain clinical records in compliance with state... | |
Records and Reports, I.A.C. r. 441-88.9 | Records and Reports, Requires Prepaid Health Organizations (PHPs) to comply with the Medicaid records standards codified in Iowa Admin.... | |
Records I.A.C. r. 441-81.9 | Records. Establishes record keeping requirements for nursing facilities that provide Medicaid services. These requirements address the... | |
Responsibilities of Hospitals, I.A.C. r. 441-85.6 | Responsibilities of Hospitals Requires psychiatric hospitals that provide Medicaid services to maintain medical and fiscal records. Specifies... | |
Screening Centers, I.A.C. r. 441-78.18 | Screening Centers States the circumstances in which Iowa’s Medicaid program will approve payments to screening centers. Requires... |
Access to Medicaid data (by patients, providers, and government agencies) | Confidentiality of records, Iowa Code ยง 217.30 | Confidentiality of records -- report of recipients. Specifies the information regarding Department of Human Services program... |
Mandatory reporting by Medicaid providers (cost/utilization information) | Determination of Payment Rate, I.A.C. r. 441-86.6 | Financial and Statistical report and Determination of Payment Rate Requires nursing facilities to submit a Financial and Statistical... |
Health Home Services Providers, I.A.C. r. 441-77.47 | Health Home Services Providers Establishes qualifications for health home services providers’ participation in Iowa’s Medicaid... |
Quality reporting by Medicaid providers (cross post to care coordination/care management (chronic disease management; sharing information across providers; enrollee participation) | Grievance Procedures, I.A.C. r. 441-88.8 | Grievance Procedures Requires prepaid health plans (PHPs) to establish grievance procedures and to obtain the Department of Human Services... |
Grievances, I.A.C. r. 441-73.15 | Grievances Requires managed care organizations that provide Medicaid services to establish procedures for handling nonclinical grievances.... | |
Quality assurance, I.A.C. r. 441-73.24 | Quality Assurance Requires managed care organizations that provide Medicaid services to implement a systems for quality assurance and... | |
Written Record, I.A.C. r. 441-73.16 | Written record Requires managed care organizations to maintain records of received grievances and their disposition and report these records... |
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