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Medicaid Reimbursement Changes

June 09, 2016

Last week, Governor Branstad took action on the fiscal year 2017 Health and Human Services (HHS) budget bill, which includes funding for Iowa's Medicaid program. In doing this, the governor line-item vetoed a provision of the bill that would have prohibited DHS for implementing a $13 million rate cut that was originally proposed by Governor Branstad in January.

Effective July 1, 2016 this line-item veto removes the enhanced primary care physician rate introduced in2014 and allows DHS to implement a new payment policy for Medicare cross-over claims, capping Medicaid coverage if the Medicare primary payment exceeds the Medicaid fee schedule for that procedure.