HCBS Providers

Under the home- and community-based services program, Medicaid provides services to keep eligible people out of institutions. The state must be able to show that these services do not cost the Medicaid program more than providing care in an institution. If the state demonstrates this for a specified population, the federal government may agree to waive some federal requirements for eligibility and for amount, duration, and scope of services. Thus, these programs are referred to as Medicaid �waivers.�

To be eligible for home- and community-based waiver services, a consumer must meet various requirements. These include requiring the level of care otherwise provided in an institution, and requiring and receiving at least one service quarterly.

The consumer chooses to receive services at home. Enrolled consumers are eligible to receive regular Medicaid services.

To enroll as a HCBS Provider you would need to complete the enrollment process. Please click the following Iowa Medicaid Enterprise Provider Services enrollment link to access the required document to enroll as a provider for HCBS. (All documents are in pdf format and need Acrobat reader)

• Instructions and checklist to complete Enrollment Form
• Provider Enrollment Form
• Requirement to be a HCBS Provider

List of Waiver Types

1. Ill and Handicapped Waiver
2. Mental Retardation Waiver
3. Elderly Waiver
4. Aids/ HIV Waiver
5. Brain Injury Waiver
6. Physical Disability waiver
7. Children's Mental Health
   

MediPASS Providers

Certain Medicaid recipients are required to enroll in the managed health care option known as MediPASS (Medicaid Patient Access to Service System). These recipients select or are assigned to a primary care physician, advanced registered nurse practitioner, rural health center, or federally qualified health center that serves as their patient manager.

The patient manager is responsible for providing all primary care, for referring the recipient to other levels of care, and for coordinating and monitoring necessary medical care. An agreement in addition to the regular Medicaid agreement is required.

To enroll as a MediPASS Provider you should be a Iowa Medicaid Provider and complete MediaPASS Provider Agreement. Please select by clicking required document that would help in the enrollment process. (All documents are in pdf format and need Acrobat reader)

• Instructions and checklist to complete Provider Agreement
• MediPASS Provider Agreement
• Procedure Guide for Patient Manager

Specialty Types for MediPASS

All Other Providers

A "health care provider" is a person who is trained and licensed to provide health care authorized to practice in the State and performing within the scope of their practice as defined under State Law. Also, a place that is licensed to provide health care authorized to practice in the State and performing within the scope of their practice as defined under State Law. A person, agency, department, unit, subcontractor, or other entity that delivers a health-related service, whether for payment or as an employee of a governmental or other entity. Examples include hospitals, laboratory, clinics, free clinics, community health centers, private practitioners, the local health department, anyone who delivers medical etc

To enroll as a Medicaid Provider you would need to complete the enrollment process. Please select by clicking the provider type from the list and other required document that would help in the enrollment process. (All documents are in pdf format and need Acrobat reader).

• Instructions and checklist to complete Enrollment Form
• Provider Enrollment Form
• Requirement to be a Medicaid Provider

List of Provider Types

• Acute Hospitals
• Advanced Registered Nurse Practitioners
• Ambulance Services
• Ambulatory Surgical Centers
• Area Education Agencies
• Audiologists and Hearing Aid Dealers
• Birth Centers
• Case Managers
• Chiropractors
• Community Mental Health Centers
• Dentists
• Family Planning Clinics
• Federally Qualified Health Centers
• Health Maintenance Organizations
• Home Health Agencies
• Hospices
• Independent Laboratories
• Infant and Toddler Services
• Intermediate Care Facilities for the Mentally Retarded (ICF/MR)
• Lead Investigation Agencies
• Local Education Agencies
• Maternal Health Centers
• Medical Equipment and Supply Dealers
• Nursing Facilities
• Occupational Therapists and Speech Therapists
• Optometrists and Opticians
• Orthopedic Shoe Dealers
• Patient Managers
• Pharmacies
• Physical Therapists
• Physicians
• Podiatrists
• Psychiatric Medical Institutions for Children (PMICs)
• Psychologists
• Rehabilitation Agencies
• Rehabilitation Services for People with Chronic Mental Illness
• Rehabilitative Treatment Services
• Rural Health Clinics
• Screening Centers
• Transportation to Receive Medical Care