ARC 9852C

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Additional information Add-ons to the base amount Advance directives Ambulatory surgical centers Appeal by provider of care Audit or review of clinical and fiscal records by the department Audit or review procedures Basis for service requirements for specific services Basis of reimbursement of specific provider categories Beneficiary advisory council Billing for patient transfers and readmissions Calculation of blended base amount Calculation of Iowa-specific weights and case-mix index Calculation of statewide base APC rate Calculation of the hospital-specific base APC rates Civil monetary penalties and interest Claim submission Components Contractual rate Copayment by member Corrections Cost outlier payment policy Cost-based reimbursement Cost-reporting requirements Council Covered DRGs Definition Definitions Dentists Determination of final payment rate amount Determination of inpatient admission Disagreement with audit or review findings Disagreement with sampling results Documentation Drugs Education about false claims recovery Eligibility and payment Enforcement Established providers Expenses, staff support, and technical assistance Fee schedule Fee schedules Financial (fiscal) records Finding and order for repayment Graduate medical education and disproportionate share fund Grounds for sanctions HCBS retrospectively limited prospective rates Health care access assessment inflation factor Home- and community-based general rate criteria Home health services Hospital billing Imposition and extent of sanction Independent laboratories Indian health facilities Inflation factor Inflation factors, rebasing, and recalibration Inpatient admission after outpatient services Iowa Medicaid review Limit on payments Limitations and application of limitations on payment Maintenance of records by providers of service Maintenance requirement Medicaid advisory council Medical (clinical) records Medicare crossover claims Membership New providers Nondiscrimination on the basis of handicap Nonpayment for preventable conditions Non-state-owned teaching hospital disproportionate share payment Notice of violation Notice to third parties Officers Outlier payment policy Outpatient hospital services Outpatient reimbursement for hospitals Payment for anesthesia services Payment for outpatient hospital services Payment for primary care services Payment reduction for services rendered in facility settings Payment to critical access hospitals Payment to out-of-state hospitals Pharmaceutical case management (PCM) services reimbursement Physicians Policy requirements Preadmission, preauthorization or inappropriate services Preadmission, preauthorization, or inappropriate services Preliminary report of audit or review findings Procedures Prohibition against factoring Prohibition against reassignment of claims Prospective cost-related Prospective rates for established providers Prospective rates for new providers Provider enrollment Provider participation agreement Purpose Rate adjustments for hospital mergers Rate determination based on cost reports Reasonable charges for services, supplies, and equipment Rebasing Recommendations Reevaluation request Rehabilitation agencies Reimbursement for community mental health centers (CMHCs) Reimbursement for hospice services Reimbursement for hospitals Reimbursement for translation and interpretation services Reimbursement of Medicare crossover claims Report and return of identified overpayment Reporting requirements Requests for preadmission review Requests for preprocedure surgical review Requests for prior authorization Requirements for prescribing controlled substances Responsibilities, duties and meetings Retrospective adjustment for critical access hospitals Retrospective adjustments Retrospective cost-related Retrospectively adjusted prospective rates Retrospectively limited prospective rates Review of Iowa prescription monitoring program database Reviews and audits Rural hospital disproportionate share payment Sanctions Scope of sanction Services covered by DRG payments Services delivered in the emergency room State-owned teaching hospital disproportionate share payment Suspension or withholding of payments Terminated home health agencies Tiered rates Types of reimbursement