ARC 9067C - Iowa Administrative Rules

Adopted and Filed

Early and periodic screening, diagnosis, and treatment, ch 84

Untitled document

ARC 9067C

HUMAN SERVICES DEPARTMENT[441]

Adopted and Filed

Rulemaking related to early and periodic screening, diagnosis, and treatment

The Department of Health and Human Services hereby rescinds Chapter 84, “Early and Periodic Screening, Diagnosis, and Treatment,” Iowa Administrative Code, and adopts a new chapter with the same title.

Legal Authority for Rulemaking

This rulemaking is adopted under the authority provided in Iowa Code chapter 249A.

State or Federal Law Implemented

This rulemaking implements, in whole or in part, Iowa Code section 249A.32B and 42 CFR 441.56.

Purpose and Summary

This rulemaking is in response to Executive Order 10. Under the Red Tape Review, the Department eliminated restrictive terms and made other minor, nonsubstantive changes. This chapter defines and structures the early and periodic screening, diagnosis, and treatment services provided under the Medicaid program to eligible children under the age of 21. As further described in these rules, services include physical and mental health screenings (including hearing and vision), laboratory tests, immunizations, and health education. Services are provided in compliance with federal regulations at Title 42, Part 441, Subpart B, as amended to August 1, 2024.

Public Comment and Changes to Rulemaking

Notice of Intended Action for this rulemaking was published in the Iowa Administrative Bulletin on January 8, 2025, as ARC 8710C. A public hearing was held on the following date(s):

●January 28, 2025

●January 29, 2025

No one attended the public hearings. One public comment was received. As a result, one change from the Notice has been made to add laboratories to the list of qualified providers in rule 441—84.3(249A).

Adoption of Rulemaking

This rulemaking was adopted by the Department on March 14, 2025.

Fiscal Impact

This rulemaking has no fiscal impact to the State of Iowa.

Jobs Impact

After analysis and review of this rulemaking, no impact on jobs has been found.

Waivers

Any person who believes that the application of the discretionary provisions of this rulemaking would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 441—Chapter 6.

Review by Administrative Rules Review Committee

The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rulemaking by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rulemaking at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

Effective Date

This rulemaking will become effective on June 1, 2025.

The following rulemaking action is adopted:

ITEM 1.Rescind 441—Chapter 84 and adopt the following new chapter in lieu thereof:

CHAPTER 84

EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT

441—84.1(249A) Definitions.

“Diagnosis” is the determination of the nature of physical or mental disease or abnormality.

“Interperiodic screen” means a screen that occurs between the times stated in the periodicity schedule in 441—subrule 78.18(3).

“Screening” is the use of quick, simple procedures to sort out apparently well persons from those who may have a disease or abnormality and to identify those in need of more definitive study. These services will be provided in accordance with reasonable standards of medical and dental practice.

441—84.2(249A) Eligibility. All persons eligible for medical assistance under age 21 are eligible for early and periodic screening, diagnosis, and treatment.

441—84.3(249A) Screening services. Screening services shall be provided in accordance with 42 CFR §441.56 as amended to August 1, 2024, and may be done by a screening center or other qualified providers. Other qualified providers are physicians, advanced registered nurse practitioners, rural health centers, federally qualified health centers, laboratories, clinics, and dentists.

441—84.4(249A) Referral.

84.4(1) The availability of early and periodic screening will be discussed with the payee for any Medicaid-eligible child under the age of 21 at the time of application and periodically thereafter in compliance with federal regulations at Title 42, Part 441, Subpart B, as amended to March 29, 2022.

84.4(2) Screening will be offered to each eligible individual according to the periodicity schedule in 441—subrule 78.18(3) when screening has been accepted, or on at least an annual basis when screening has been rejected. Interperiodic screens may be furnished when medically necessary to determine whether a child has a physical or mental illness or condition that may require further assessment, diagnosis, or treatment.

441—84.5(249A) Follow up. Follow-up services will be provided when a referral for screening was accepted, but 60 days have elapsed and no screening examination has been performed, and when a screening examination discloses a possible abnormal condition and a referral was made for further diagnosis or treatment and such diagnosis or treatment has not been received within a period of 60 days from the date of the screening examination.

These rules are intended to implement Iowa Code section 249A.4.

[Filed 3/14/25, effective 6/1/25]

[Published 4/2/25]

EDITOR’S NOTE: For replacement pages for IAC, see IAC Supplement 4/2/25.