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LeadingAge Iowa is a statewide membership organization of non-profit providers of aging services and supports and the champion for advancement and innovation in aging services. Our mission is to be the voice, support and connector for non-profit members and the people they serve. Our membership is diverse, representing the spectrum of non-profit long-term support and service providers including skilled nursing, assisted and independent living, PACE, home health, adult day, respite, hospice and home delivered meals.  Our members serve over 25,000 older adults in Iowa each day.

Amerigroup Payment Delays

Late last week IASN and LAI started to hear from a few members regarding non-payment of claims for Amerigroup, particularly related to August and even some July claims.  Amerigroup has shared that they experienced processing issues related to the information transfer from UnitedHealthcare.  As a result, Amerigroup has a lot of projects underway to resolve these issues.  As of October 4, Amerigroup indicated that July problems have been resolved and payment should be forthcoming as soon as this week.  As of August 7, Amerigroup reported that August claims that have been pending are now going through their system for payment.

 

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Iowa Announces OSA Due to PDPM

DHS/IME released Informational Letter 2049-MC-FFS regarding the new Optional State Assessment (OSA) requirement. Due to the Centers for Medicare and Medicaid Services (CMS) implementation of the Patient-Driven-Payment-Model (PDPM), which is effective October 1, 2019, all unscheduled Prospective Payment System (PPS) assessments (with the exception of the 5-day) will be retired. To fill this gap in assessments, CMS has created an OSA as a way for nursing facilities (NFs) to report changes in resident status, consistent with individual state case-mix rules so that Medicaid payments are not adversely impacted when PDPM is implemented. The State of Iowa (DHS/IME) is adopting the OSA which will also be effective October 1, 2019.

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