On Thursday, March 12, IHCA held its monthly Home Care Provider Update Call to discuss important developments in home health and home care. Conversation covered the OASIS E-2 system, changes to patient care measures and surveys, key bills moving through state legislature, Spring Conference announcements and medication error reporting and denials.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Ankeny, Iowa City, Eldridge, Newton, Hiawatha, Harlan and Clarinda.
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IHCA continues to review the Iowa Administrative Bulletin for potential impacts to long-term care providers. The March 4 issue includes a proposed rule from the Iowa Department of Health and Human Services outlining procedures for record check evaluations. These will be used to determine employment eligibility for individuals with certain criminal convictions or founded abuse findings in health care settings and related training programs.
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The National Council of State Boards of Nursing (NCSBN) is seeking qualified nurses to serve on item writing and review panels for the NCLEX-PN and NCLEX-RN exams, which are designed to assess the knowledge and skills needed for safe, entry-level nursing practice. The influence of post-acute nursing is essential to the applicability of the NCLEX exam for nurses. Participation allows nurses to influence the exam’s applicability, contribute to the profession, earn continuing education credit and network nationally and internationally. Volunteer opportunities are held in Chicago, with travel expenses covered.
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CMS has officially published the final versions of the OASIS E-2 data set, OASIS E-2 manual and OASIS E-2 Q&A documents. OASIS-E2 is scheduled for implementation on April 1, 2026. Minor differences between the drafted and the finalized data set include typo corrections, a revised definition and a citation addition.
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More than 50 long-term care leaders gathered at the Iowa Capitol last week for IHCA Day on the Hill, presented by Martin Bros. Distributing Co., Inc., to meet with legislators and advocate for the profession. Members shared how policy decisions impact residents, staff and communities while highlighting IHCA’s 2026 priorities, including workforce solutions, home- and community-based services and sustainable funding for long-term care. The event provided an important opportunity for policymakers to hear directly from providers delivering care across Iowa.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Burlington, Ankeny, Montrose, Iowa City, Waterloo, Eldridge, Council Bluffs, Denison, Cedar Rapids and Urbandale.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Ankeny, Red Oak, Glenwood, Eldridge and Dubuque.
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The Iowa Department of Health and Human Services (DHHS) has announced free competency-based training (CBT) opportunities for Iowa long-term services and supports providers. Upcoming sessions will address service documentation and monitoring best practices as well as early and periodic screening, diagnostic and treatment (EPSDT) requirements, with content tailored to providers, direct support professionals and case managers. All trainings will be recorded and made available through the agencies’ online training archive and Learning Management System.
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Several key bills affecting long-term care providers and IHCA members have advanced in the 2026 Iowa legislative session, including measures related to Medicaid elderly waiver services, certified medication aides, claims payment and audits, guardianship, property tax, Certificate of Need and rural access. These proposals could impact operations, workforce capacity, reimbursement and access to care across skilled nursing, assisted living and other care settings. IHCA continues to monitor and engage with lawmakers to support policies that strengthen the workforce, improve provider sustainability and ensure high-quality care for Iowans.
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Home health agencies are evaluated on their ability to prevent hospitalizations during care and for 31 days after discharge through the Potentially Preventable Hospitalization (PPH) and Discharge to Community Post-Acute Care measures. Agencies can improve performance by strengthening case management, enhancing patient and caregiver education, promoting timely communication, optimizing medication management and incorporating strategic touch points, including post-discharge follow-up. Provider Insights has provided a script for post-discharge check-in calls to assist in identifying risks after discharge.
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IHCA’s Spring Conference, presented by BCG, will be held March 25–26 at The Meadows Events & Conference Center in Altoona. Sessions will focus on leadership, workforce, compliance, reimbursement and quality improvement, with up to 10.0 contact hours available for a range of care professionals. Limited rooms remain at Prairie Meadows Hotel, with an additional room block available at the Comfort Inn Altoona across the street.
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IHCA’s Day on the Hill on March 4 will bring long-term care leaders to the Iowa Capitol to meet directly with legislators and share how policy decisions impact residents, tenants, patients, staff and communities across Iowa. This event, sponsored by Martin Bros. Distributing Co., Inc., plays a key role in advancing IHCA’s advocacy priorities during the legislative session. Please RSVP by this Friday, Feb. 27, to secure your spot.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Waterloo, Iowa City, Eldridge, Council Bluffs, Wilton, Oskaloosa, Coralville, Bettendorf, Urbandale, DeWitt, Marion and Ankeny.
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Skilled nursing facilities, assisted living communities and ID/DD centers must maintain a respiratory protection program to comply with OSHA and CMS requirements, ensuring employee and resident safety from airborne hazards. AHCA/NCAL and MCA Consulting are offering a comprehensive Respiratory Protection Plan toolkit and training, including customizable templates, forms and videos to help providers achieve compliance. The resource is being offered via a discounted three-year subscription, giving facilities everything needed to meet federal respiratory protection and emergency preparedness standards.
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Iowa officials, including Gov. Kim Reynolds, announced the launch of the new Health Care Professional Incentive Program, backed by nearly $8 million in first-year funding to recruit and retain medical professionals in high-need and rural counties. The program offers income bonuses or federal student loan repayment to eligible health care providers who commit to working in underserved areas for up to five years full-time or seven years part-time. The initiative consolidates five previous state incentive programs into one streamlined effort to strengthen Iowa’s health care workforce pipeline and improve access to care. The application deadline is March 31, 2026.
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CMS has updated the MLN Booklet titled, "Medicare Billing: CMS 1450 & 837I." The updated guidance has added COVID-19 vaccinations to its roster billing options. More information about roster billing can be found on the CMS website.
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IHCA’s Day on the Hill on March 4 will bring long-term care leaders to the Iowa Capitol to meet directly with legislators and share how policy decisions impact residents, tenants, patients, staff and communities across Iowa. This event, sponsored by Martin Bros. Distributing Co., Inc., plays a key role in advancing IHCA’s advocacy priorities during the legislative session. Members are encouraged to RSVP by Feb. 27 and review IHCA’s 2026 Legislative + Policy Agenda in advance.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Winterset, Ankeny, Murray, Webster City, Fairfield, Spencer, Fredericksburg, Newton, Eldridge, Cedar Rapids, Harlan, Allison, Dubuque, Waterloo and Iowa City.
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IHCA is monitoring the Jan. 21 and Feb. 4 Iowa Administrative Bulletin for items that may impact members, with several adopted rule updates from the Department of Inspections and Appeals tied to the state’s Red Tape Review (Executive Order 10). The updates include repromulgated chapters and new standards for health care facility audits, elder group homes, assisted living programs and adult day services, specifically addressing certification processes, incident investigations and medication handling.
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Iowa Department of Health and Human Services (DHHS) is seeking public comments through this Friday, Feb. 13, on a proposal to redesign its Medicaid HCBS waiver system under the HOME project, replacing six disability-based waivers with two new waivers (Children and Youth, and Adults with Disabilities) while keeping the Elderly Waiver. The redesign aims to simplify the system, better match services to individual needs and support people with disabilities in living at home rather than in institutions. The transition would occur in phases starting in late 2026, with all changes subject to CMS approval after the public comment process.
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Iowa Medicaid and Iowa Department of Health and Human Services (DHHS) have announced the FFY 2025 SUPPORT Act reporting survey, which collects data on providers’ compliance with required Prescription Drug Monitoring Program (PDMP) checks before prescribing controlled substances to most Medicaid members. The survey supports Iowa’s annual Medicaid Drug Utilization Review reporting to CMS and applies to prescribing practices from October 2024 through September 2025. Providers must complete the survey by March 31, 2026.
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IHCA’s Day on the Hill on March 4 will bring long-term care leaders to the Iowa Capitol to meet directly with legislators and share how policy decisions impact residents, tenants, patients, staff and communities across Iowa. This event, sponsored by Martin Bros. Distributing Co., Inc., plays a key role in advancing IHCA’s advocacy priorities during the legislative session. Members are encouraged to RSVP by Feb. 27 and review IHCA’s 2026 Legislative + Policy Agenda in advance.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Ankeny, Forest City, Waterloo, Roland, Denver, Algona, Denison, Davenport and Parkersburg.
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Registration is now open for IHCA’s Spring Conference, presented by BCG, taking place March 25–26 in Altoona. This two-day event will offer practical, Iowa-specific education across leadership, workforce, compliance, reimbursement and quality, with up to 10.0 contact hours available for a wide range of long-term care professionals. The discounted hotel room rate is available through Feb. 27.
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The SING system received an overdue upgrade, going live on Jan. 25, with the old platform set to sunset on Feb. 28. Members must use the new SING portal for results, which are only available for 30 days, and access requires setting up an OKTA account through their agency admin. The old system remains available only for retrieving past submissions, and organizations are advised to download all necessary results before the deadline.
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IHCA’s Day on the Hill on March 4 will bring long-term care leaders to the Iowa Capitol to meet directly with legislators and share how policy decisions impact residents, tenants, patients, staff and communities across Iowa. This event, sponsored by Martin Bros. Distributing Co., Inc., plays a key role in advancing IHCA’s advocacy priorities during the legislative session. Members are encouraged to RSVP by Feb. 27 and review IHCA’s 2026 Legislative + Policy Agenda in advance.
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IHCA encourages members to attend upcoming legislative town halls as a practical way to support grassroots advocacy and connect directly with elected officials. These local forums provide an opportunity to share real-world perspective on how legislation impacts long-term care and reinforce IHCA’s 2026 priorities. Upcoming events include town halls and legislative forums in Ankeny, Sumner, Emmetsburg, Ida Grove, Dubuque, Storm Lake and Nashua.
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The Iowa Insurance Division’s Senior Health Insurance Information Program (SHIIP) reminds Iowans of upcoming Medicare deadlines, including the March 31, 2026, deadline to make changes during the Medicare Advantage Open Enrollment Period. Iowans affected by cancelled Medicare Advantage or Part D plans have until Feb. 28, 2026, to enroll in new coverage, with some eligible for guaranteed issue Medigap policies. SHIIP offers free, confidential counseling to help beneficiaries understand their options and make informed decisions.
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Join IHCA on March 10 for Documentation Reimagined – How AI is Reshaping Home Health Operations. This webinar will explore how artificial intelligence (AI) can improve home health documentation and workflows. The one-hour session will explore AI-driven strategies to reduce clinician burden, enhance accuracy and support regulatory compliance. Attendees will gain practical insights to boost operational efficiency, clinician satisfaction and patient care outcomes, as well as earn 1.0 contact hour.
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OSHA has two key injury and illness recordkeeping compliance deadlines for 2026. Employers must post the OSHA Form 300A (Summary of 2025 Work-Related Injuries and Illnesses) by Feb. 1, 2026, and keep it posted through April 30, 2026. Required data must also be submitted electronically through OSHA’s Injury Tracking Application by March 2, 2026, depending on establishment size and industry. OSHA and AHCA/NCAL resources are available to help long-term care providers determine coverage and complete recordkeeping and reporting requirements.
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CMS has launched a new online form that allows providers to submit beneficiary-focused complaints about Medicare Advantage (MA) plans directly to CMS. Submitted complaints are routed through the CMS Health Plan Management System for review and tracking, without being sent to the MA plans themselves. AHCA supports this new provider-initiated complaint process and encourages providers to use it to report ongoing access and care-delivery issues, helping CMS identify systemic problems and improve plan oversight.
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Effective Feb. 1, Iowa Total Care will conduct quarterly reviews of Home- and Community-Based Services (HCBS) provider documentation as part of ongoing service monitoring. Community-based case managers will review records during member visits to ensure services are delivered as outlined in each member’s person-centered service plan. Providers must have relevant documentation available, including service plans, logs, medication records, financial documents and incident reports.
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CMS is transitioning the CLIA program to a fully electronic system, meaning nursing homes that perform lab testing must switch to paperless notifications, fee coupons and certificates by March 1, 2026. After that date, paper CLIA fee coupons and paper certificates will no longer be issued (with exceptions for CLIA-exempt states or state licensure). Facilities can opt in by notifying their state agency in writing or by completing the CMS-116 form to receive electronic notifications and certificates via email.
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IHCA is monitoring the Dec. 24 and Jan. 7 Iowa Administrative Bulletin for items that may impact members, with several newly noticed Iowa Medicaid and waiver-related rule updates tied to the state’s Red Tape Review (Executive Order 10). The updates include proposed changes to waiver services, payment methods, provider policies and conditions of participation, managed care and covered services, along with an adopted rule increasing the State Supplementary Assistance personal needs allowance from $50 to $55.
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The 2026 Iowa legislative session is underway, and IHCA is advocating at the Capitol for policies that support long-term care providers across the state. IHCA’s priorities include strengthening the CNA and CMA workforce pipeline, improving access to care through a more sustainable Home- and Community-Based Services (HCBS) Elderly Waiver and securing funding to support critical long-term care services. To connect directly with legislators on these issues, mark your calendar for IHCA Day on the Hill, happening March 4, 2026.
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As we kick off 2026, IHCA President and CEO Brent Willett reminds members that work in long-term care isn’t a tragedy — it’s a calling that requires resilience, skill and professionalism. He reaffirms IHCA’s commitment to elevating the work of providers and advocating for the fairness, respect and recognition the profession has earned.
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Effective Jan. 1, 2026, all Wellcare (Medicare) prior authorization requests for certain services will transition from Evolent to Wellcare, with no changes to Iowa Total Care (Medicaid) processes. Affected services include advanced and cardiac imaging, therapies, select surgeries, oncology services and interventional pain management, with all requests required to be submitted through Wellcare’s secure provider portal.
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As part of Iowa Total Care's ongoing work to improve the prior authorization (PA) process for both providers and members, Iowa Total Care is sharing some important updates to their PA requirements. Their goal is to reduce administrative burden, simplify submission and approval processes and facilitate timely access to appropriate, high-quality care. Code changes will become effective on April 1, 2026.
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Iowa Medicaid and Iowa Department of Health and Human Services (DHHS) have announced upcoming updates to Home- and Community-Based Services (HCBS) waiver service names, procedure codes and Attendant Care forms, effective Jan. 1, 2026. The changes affect multiple waivers, including AIDS/HIV, Brain Injury, Elderly, Intellectual Disabilities and Physical Disability, and will align service names and codes with updated Medicaid fee schedules. Providers are encouraged to review the implementation guidance and prepare their systems in advance, as a revised Attendant Care form will also be released to support Electronic Visit Verification (EVV) and documentation requirements.
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As 2026 approaches, Home Health Value-Based Purchasing (HHVBP) measures continue to evolve, with performance from multiple years influencing future payment adjustments. Provider Insights’ 2026 HHVBP comparison sheet helps agencies understand how 2024 and 2025 performance data connect to updated measures taking effect in 2026, providing a clear, at-a-glance view to support planning and compliance.
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On Thursday, Dec. 11, IHCA hosted its monthly Home Care Provider Update Call to discuss the most recent changes for the home health and home care profession. The main discussion focused on CMS's final rule for home health payments, which included changes to rates, quality reporting and implementation of a new Outcome and Assessment Information Set (OASIS) E2 system. The conversation ended with updates on Low Utilization Payment Adjustment (LUPA) rates and survey delays.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. The bi-weekly areas of note found in the Nov. 12, Nov. 26 and Dec. 10 issues of the Iowa Administrative Bulletin include regulatory analyses related to Medicaid waiver services, conditions of participation for providers of medical and remedial care, adopted and filed rule related to conditions of eligibility, newly noticed rules related to assisted living programs, health care facility audits, adult day care and more.
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IHCA’s new on-demand webinar, "Home Health Final Rule 2026 – What You Need to Know," features expert insights from home health consultant Annette Lee of Provider Insights on the key provisions of the CY 2026 Home Health Final Rule. The webinar covers reimbursement and quality reporting changes, offers practical implementation guidance and is approved for 1.0 contact hour for administrators and nurses.
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The Iowa Medicaid Long-Term Services and Supports (LTSS) team, in partnership with the managed care organizations, invite you to join for a special Home- and Community-Based Services (HCBS) Enabling Technology Town Hall held tomorrow, Dec. 11, at 2:30 p.m.
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Iowa Medicaid has released the Home Health Low Utilization Payment Adjustment (LUPA) rates effective July 1, 2025. These updated rates apply to home health services delivered under the state Medicaid program for the current fiscal year.
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Iowa Medicaid and the Iowa Department of Health and Human Services (DHHS) recently released an amended informational letter (IL) 2711 on Dec. 9, 2025. This serves as an amendment to the original IL 2711, published on Nov. 14, 2025. The updates include correcting the citation for Iowa Administrative Code and adding a link to the Telecommunication Technology Guide. The effective date of the IL remains the same.
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IHCA will host a webinar next Wednesday, Dec. 10, led by home health consultant Annette Lee, to review the newly released 2026 Home Health Final Rule. The session will cover changes to reimbursement, quality reporting and compliance requirements, offering practical guidance to help agencies prepare for implementation. The webinar will offer 1.5 contact hours for administrators and nurses.
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On Nov. 28, CMS issued the calendar year (CY) 2026 Home Health Prospective Payment System Rate and Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Updates Final Rule. CMS has also released a fact sheet accompanying the final rule, along with a fact sheet addressing durable medical equipment competitive bidding provisions. The overall impact of the rule is an estimated -1.3% ($220 million) decrease in payments relative to CY 2025. This is in comparison to a proposed -6.4% ($1.135 billion) decrease in payments relative to CY 2025.
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CMS has issued notices to home health agencies that did not meet Home Health Quality Reporting Program requirements for the CY 2026 annual payment update, with notifications posted in iQIES on Nov. 26, 2025. Medicare administrative contractors will also send follow-up letters, and non-compliant agencies may request reconsideration by Jan. 6, 2026. CMS reminds providers that reconsideration requests must be under 20 MB and cannot contain any protected health information.
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Iowa Medicaid and Iowa Department of Health and Human Services (DHHS) have issued IL 2717 outlining annual fraud- and abuse-prevention submission requirements for providers or entities receiving $5 million or more in Medicaid payments during a federal fiscal year. Eligible providers must maintain specific written policies and submit the required Attestation of Compliance form (470-5506) by Jan. 31, 2026. Failure to comply may result in sanctions, including suspension or termination from the Iowa Medicaid program.
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CMS has approved a one-year temporary extension and amendment of the "Iowa Wellness Plan" section 1115 demonstration. This approval allows the state to continue operating the demonstration through 2026 and sunsets the waiver of non-emergency medical transportation on Dec. 31, 2026.
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Iowa Medicaid has announced the release of the 2025 Home- and Community-Based Services (HCBS) Provider Quality Self-Assessment questionnaire, which is due Jan. 31, 2026. All HCBS waiver and habilitation providers enrolled for the services listed in this article are required to complete this annual HCBS Provider Quality Self-Assessment. Failure to submit by Jan. 31, 2026, will jeopardize an organization’s Medicaid enrollment, including managed care contracts, and may result in a sanction of payment suspension.
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Iowa Medicaid is aligning with the requirements for the coordination of benefits to ensure when a member has both Medicaid and commercial insurance (primary payer), Medicaid is the payor of last resort. Payments cannot exceed the Medicaid allowable amount or the amount paid by commercial insurance. This is known as the Lesser of Logic. This policy is effective for claims received by managed care organizations (MCOs) and dental plans on or after Dec. 1, 2025. Implementation for Fee-For-Service claims will occur at a later date and additional guidance will be provided. This logic has been applied to Medicare claims since July 1, 2017, and will be extended to commercial claims received on or after Dec. 1, 2025, for claims received by MCOs and dental plans.
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Join IHCA for its Home Health Final Rule 2026 - What You Need to Know webinar on Dec. 10, led by IHCA’s home health consultant, Annette Lee of Provider Insights. While CMS has not yet released the final rule, we expect it soon. Annette will break down the key provisions, highlight changes to reimbursement and quality reporting and explain what agencies need to know to prepare for implementation. This webinar is approved for 1.5 contact hours for administrators and nurses.
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A recently passed continuing resolution restores Medicare telehealth flexibilities for home health and hospice face-to-face (FTF) encounters through Jan. 30, 2026, retroactive to Oct. 1, 2025, preventing denials during the shutdown period. The law also renews funding for Medicare hospice surveys, halts an additional 4% sequestration cut by waiving Statutory PAYGO through 2026, and stabilizes VA and TriCare funding so claims from the shutdown period can be paid.
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IHCA's November Home Care Provider Update Call last week covered the government shutdown resolution and its impact on telehealth services, hospice surveys and payment rules. Discussion focused on the timing of payment rule releases and Low Utilization Payment Adjustment (LUPA) rate adjustments for home health providers in Iowa, including implementation challenges and concerns about claim processing. The group also addressed the acuity add-on program's implementation issues and explored ways to improve the system and support providers in its effective use.
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The One Big Beautiful Bill Act introduces major Medicaid changes that will significantly affect Iowa’s long-term care providers, including reduced retroactive coverage beginning in 2027, more frequent eligibility redeterminations and new asset and home equity limits in 2028. While the law delays the federal staffing mandate, it also adjusts how states can finance Medicaid, creating additional operational and administrative considerations for providers. Facilities will need to prepare for shorter coverage windows, increased renewal activity and upcoming eligibility rule changes.
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Iowa Medicaid’s new guidance establishes that, beginning Dec. 1, 2025, telehealth services billed with POS codes 02 or 10 will receive reduced reimbursement to account for the lower cost of virtual care compared to in-person visits. Providers must ensure services are on the approved telehealth list and billed with the correct POS code, with fee-for-service implementation details to be issued later. The Iowa Department of Health and Human Services (DHHS) and the MCOs have provided contact information for questions and additional support.
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Iowa Medicaid’s new policy requires certain medications to be dispensed in 90-day supplies beginning Dec. 1, 2025, with a single dispensing fee and one copay per 90-day fill. Beneficiaries in long-term care facilities, residential programs and medically needy populations are excluded, and pharmacists may use an override code when medically appropriate. A full list of affected medications is available on the Preferred Drug List website.
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IHCA is seeking member feedback through its 2025 Member Satisfaction Survey to help guide future initiatives in education, communication and member support. Members are encouraged to complete the short, 15-minute survey by this Friday, Nov. 14, using the link that corresponds with their sector. The results will help IHCA enhance the value and effectiveness of its programs and services.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. IHCA is actively reviewing the new regulatory analyses and plans to make requests for modifications as necessary and communicate out important changes as they become finalized. The bi-weekly areas of note found in the Oct. 15 and Oct. 29 issues of the Iowa Administrative Bulletin include regulatory analyses related to adult day care, assisted living programs and Certificate of Need, as well as a newly noticed rule related to personal needs allowance.
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The Iowa Department of Health and Human Services (DHHS) has released an updated version of form 470-2115 – Authorization to Disclose Personal Health Information (PHI) Form for Eligibility Verification Purposes. This form replaces the previous version of form 470-2115 – Authorization for the Department to Release Information. Effective immediately, any prior versions of form 470-2115 on file that have not yet expired cannot be honored for the release of information. Facilities and individuals must use the new form to authorize the release of information to Iowa DHHS. Providers should ensure they are using the updated form moving forward to avoid delays in eligibility verification or information requests.
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On Nov. 10, Iowa Total Care released an updated Provider News Alert regarding prior authorization (PA) requirements, originally published on Nov. 3. The revised alert includes key updates regarding additional details on behavioral health PA requirements, inclusion of a new maternal health item and code changes effective Feb. 1, 2026. Aside from these updates, the information remains consistent with the version previously issued. Providers are encouraged to review the full alert carefully to ensure compliance with the updated effective date and new requirements.
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Iowa Total Care announced updates to its prior authorization (PA) requirements effective Nov. 3, 2025, aimed at reducing administrative burden and improving access to care. The revisions include removing certain PA requirements, standardizing rules across service categories and markets and refining criteria for services. Providers are encouraged to review the updated code list and contact their provider relations specialist with any questions.
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IHCA is seeking member feedback through its 2025 Member Satisfaction Survey to help guide future initiatives in education, communication and member support. Members are encouraged to complete the short, 15-minute survey by Friday, Nov. 14, using the link that corresponds with their sector. The results will help IHCA enhance the value and effectiveness of its programs and services.
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IHCA's eight-part Dementia Care On-Demand Training Series is crafted to address the multifaceted aspects of dementia care, encompassing not only the medical and cognitive dimensions but also the emotional, social and ethical considerations that play a vital role in providing holistic care. This training series provides the tools and insights needed to create a supportive and enriching environment for individuals with dementia, fostering dignity, respect and a sense of well-being and is approved for 8.0 contact hours for nurses, activity professionals, social services staff, environmental services staff, department heads, administrators, assisted living managers and home health professionals.
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The Q1 2025 home care (HC) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa agencies. Please share this report with the individuals at your organization involved with managing survey success, as it is a helpful resource when planning for future surveys.
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Medicare's open enrollment period is here! Visit Medicare.gov/plan-compare now through Dec. 7 to compare all your coverage options.
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IHCA has provided a breakdown of how the federal government shutdown impacts survey activity across different care settings. Please review the relevant section(s) for your organization. All providers are encouraged to stay proactive and compliant during this period to avoid future enforcement complications.
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On Oct. 1, 2025, CMS released QSO-26-01 regarding contingency plans related to state survey and certification activities in the event of a federal government shutdown. IHCA consultant Annette Lee of Provider Insights has provided an explanation and analysis regarding impacts to home health.
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IHCA has been made aware of delays affecting providers and Medicaid beneficiaries in the completion of level of care assessments conducted by Telligen. We have been in contact with the Iowa Department of Health and Human Services (DHHS) regarding this issue. DHHS has confirmed that it is aware of the backlog and is monitoring assessment completion rates on a weekly basis. To help address the delays, all assessments with due dates prior to July 1, 2025, will be conducted virtually. This protocol will be applied consistently across all waiver types and assessment categories.
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Iowa Department of Inspections, Appeals and Licensing (DIAL) has expanded virtual options for the written portion of the CNA competency exam, adding a second online pathway beyond the one launched in June 2025. Nurse aide candidates — regardless of training program location — can now register and complete the written exam from home or work. The skills evaluation remains in person at approved sites for now, with DIAL exploring remote skills testing; IHCA will share updates when available.
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IHCA’s October Home Care Provider Update Call last week focused on recent developments affecting home health and home care providers, particularly the Rural Health Transformation (RHT) Program and its initiatives to expand access to care in rural Iowa. Discussion centered on three key home health initiatives: transitional coaching, technology integration such as remote patient monitoring, and funding decisions expected by mid-November. Annette Lee of Provider Insights also provided updates on star rating reports, value-based purchasing changes and training opportunities, underscoring the role of accurate data and staff engagement in improving quality outcomes.
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IHCA continues to track issues of importance to members, including the subjects mentioned in the Iowa Administrative Bulletin that is released every two weeks. The bi-weekly areas of note found in the Sept. 17 and Oct. 1 issues of the Iowa Administrative Bulletin include regulatory analyses related to personal needs allowance, investigatory authority and procedures of the Medicaid Fraud Control Unit and newly noticed rules related to Medicaid enrollment, personal needs allowance and more.
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Thank you to those who joined us at IHCA's 2025 Convention and Trade Show! CEUs from this event have now been uploaded to your IHCA profile. Please take some time to verify that you received credit for all of the sessions you attended. If you find that you are missing any certificates, please send a list of the sessions that are missing to
[email protected].
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IHCA will host a one-hour webinar, "Time to Lead – Prioritizing What Matters," this Friday, Oct. 3, with leadership expert Jerald Cosey. The session will equip long-term care leaders with tools to manage the “firefighting” cycle, prioritize strategic goals and build a resilient leadership mindset. Sponsored by Brighton Consulting Group, the webinar is approved for 1.0 contact hour and will be available on-demand after the live session.
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The Blueprint for OASIS Accuracy Workshop, held next Monday and Tuesday, will offer two days of comprehensive training on OASIS-E1 coding, based on the most current CMS guidance. Designed for clinicians, supervisors, educators and quality staff, the workshop uses real patient scenarios and group discussions to strengthen coding accuracy, compliance and data quality. The program is approved for 14.0 contact hours for nurses and social workers. Participants may also register separately for the COS-C Exam, which provides certification for expertise in OASIS data collection and accuracy.
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The flexibility allowing telehealth for face-to-face (FTF) encounters in home health and hospice expired yesterday, Sept. 30, 2025. As of now, CMS has not indicated any plans to extend this waiver. All FTF encounters for home health and hospice were to be completed by Sept. 30, 2025, to be eligible for telehealth. Going forward, FTF encounters must return to in-person visits, regardless of the start of care or recertification timing.
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The Preliminary CY 2025 Annual Performance Reports (CY 2025 APRs) for the expanded Home Health Value-Based Purchasing (HHVBP) Model have been published in the Internet Quality Improvement and Evaluation System (iQIES).
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Effective Oct. 1, 2025, Iowa Total Care has provided a list of manufacturers that will be terminated from the Medicaid Drug Rebate Program (MDRP) and will no longer be covered. For additional information regarding the MDRP changes please email the Iowa Total Care pharmacy team at
[email protected].
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The September skilled nursing facility (SNF) survey trend report is now available on the IHCA website. This report is a member-only resource that provides listings of the most frequently cited tags and regulatory outcomes from Iowa facilities. Please share this report with the individuals at your facility involved with managing survey success, as it is a helpful resource when planning for future surveys. Congratulations to the IHCA SNF member facilities that recently achieved a deficiency-free recertification survey!
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IHCA's on-demand Cybersecurity Essentials Series, sponsored by CLA, will help you fortify your digital fortress by focusing on cybersecurity hygiene, ransomware resilience and defending against business email compromise. Attendees will learn to identify online behaviors that can lead to increased exposure, identify common threats, gain insights into the latest ransomware threat landscape and develop and refine incident response plans. This on-demand course is approved for 3.0 contact hours for activity professionals, dietary staff, social services, nurses, department heads, administrators and assisted living managers.
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