Amendment to Contract Language. The Contract is amended as follows:
Amendment to Contract Language. The Contract is amended as follows:
Revision 1. The document attached to the Contract as Exhibit H is modified by adding the following at the end of the document as new subsection B:
Amendment to Contract Language. The Contract is amended as follows: Name/Principal Address of Agency: Iowa Department of Human Services 0000 X. Xxxxxx Xxx Moines, IA 50319-0114 Agency Billing Contact Name / Address: Xxxx Xxxxxxx 1305 X. Xxxxxx Des Moines, IA 00000-0000 Phone: 000-000-0000 : Xxxx Xxxxxxx Xxxxx Xxxxxxxx 1305 X. Xxxxxx 1305 X. Xxxxxx Des Moines, IA 50319-0114 Des Moines, IA 50319-0114 E-Mail: xxxxxxx@xxx.xxxxx.xx.xx E-Mail: xxxxxxx@xxx.xxxxx.xx.xx
Amendment to Contract Language. The Contract is amended as follows: Name/Principal Address of Agency: Iowa Department of Human Services 0000 X. Xxxxxx Xxx Moines, IA 50319-0114 Agency Billing Contact Name / Address: Xxxxx X. Xxxx 0000 X. Xxxxxx Xxx Moines, IA 00000-0000 Phone: 000-000-0000 Xxxxx X. Xxxx Xxxxx Xxxxxxxx 0000 X. Xxxxxx 0000 X. Xxxxxx Des Moines, IA 50319-0114 Xxx Xxxxxx, XX 00000-0000 E-Mail: xxxxx@xxx.xxxxx.xx.xx E-Mail: xxxxxxx@xxx.xxxxx.xx.xx New enrollees shall be auto-assigned to a Contractor in accordance with the auto-assignment process set forth in Section 7.2.3. Information shall be provided to new enrollees in accordance with Section 8.2.1
Amendment to Contract Language. The Contract is amended as follows:
Revision 1. This amendment adds subsection (b) to contract section 3.06, which states, The MA Health Plan shall submit a monthly DSNP Health Plan Enrollment File to the State on or before the 10th day of each month via Secure File Transfer Protocol (SFTP).
Amendment to Contract Language. The Contract is amended as follows:
Revision 1: Contract Title that reads “The Dental Wellness Plan for the Iowa Wellness and Marketplace Choice Plan”, is hereby amended to read as follows: Revision 2: Section 1.3.4.2, Payment Methodology, first sentence that reads “The Contractor shall be paid a monthly capitation payment of $22.66 per Enrollee per month for the time period of May 1, 2014 through June 30, 2015”, is hereby amended to read as follows:
Amendment to Contract Language. The Contract is amended as follows: Beginning December 1, 2020, the Agency will exclude from the capitation rates the costs associated with COVID 19 vaccine administration services. Contractor shall continue to provide coverage for COVID 19 vaccine administration services. The Agency will reimburse the Contractor on a retrospective basis for such claims using the Medicare payment methodology and rates for the same services and consistent with IL No. 2207-MC-FFS-CVD (the “IL”). However, payments to Contractor under this provision shall be limited to the lower of (1) what Medicare would have paid for the same services for a Medicare eligible individual and consistent with the IL, or (2) the Contractor’s actual out-of-pocket payments for such services. All invoices for reimbursement under this paragraph must be submitted no later than 12 months from the date of service. All adjustments made to invoices shall be submitted to the Agency within 90 days from the date of the invoice being adjusted and must be backed by claim level detail sufficient to support the invoice.
Amendment to Contract Language. The Contract is amended as follows: Revision 1 Section 3.2.6.8.3.1 is amended to read as follows:
3.2.6.8.3.1.1 Carve out Iowa Medicaid managed care prescriptions and other products from the 340B program. If this methodology is chosen, the Contractor shall ensure that the entity: (i) uses only non-340B drugs, vaccines, and diabetic supplies for all Iowa Medicaid managed care enrollees served; (ii) only bills the Contractor for drugs, vaccines, and diabetic supplies purchased outside the 340B program; (iii) does not bill the Contractor for drugs, vaccines, or diabetic supplies purchased through the 340B program; and (iv) consults the Iowa Medicaid Managed Care Pharmacy Identification for assistance in identifying Medicaid managed care enrollees.
Amendment to Contract Language. The Contract is amended as follows:
Revision 1. The following dual eligible enrollment categories are added to include: Specified Low-Income Medicare Beneficiary (SLMB)only: An individual entitled to Medicare Part A, has income that exceeds 100% FPL but less than 120% FPL, and resources do not exceed the maximum allowed by the SSI program for subsidy eligibility. SLMB individuals are eligible for Medicaid payment of Medicare Part B premium. Categories of SLMBs covered by this Agreement are. SLMB Only do not qualify for any additional Medicaid benefits. Qualifying Individual (QI) means an individual entitled to Medicare Part A, has income at least 120% FPL but less than 135% FPL, and resources that do not exceed the maximum allowed by the SSI program for subsidy eligibility, and not otherwise eligible for Medicaid benefits. QI individuals are eligible for Medicaid payment of Medicare Part B premium. Qualified Disabled and Working Individual (QDWI) means an individual who is under 65 years of age, has lost Medicare Part A benefits due to a return to work, but is eligible to enroll in and purchase Medicare Part A. The individual’s income may not exceed 200% FPL and resources may not exceed twice the SSI resource limit. The individual may not be otherwise eligible for Medicaid. QDWIs are eligible only for Medicaid payment of the Part A premium.
Revision 2. Appendix A of the Contact is hereby deleted and replaced with the attached Appendix A.
Amendment to Contract Language. The Contract is amended as follows: Name/Principal Address of Agency: Iowa Department of Human Services 0000 X. Xxxxxx Xxx Moines, IA 50319-0114 Agency Billing Contact Name / Address: Xxxx Xxxxxxx 1305 X. Xxxxxx Des Moines, IA 00000-0000 Phone: 000-000-0000 Xxxx Xxxxxxx 0000 X. Xxxxxx Xxx Moines, IA 50319-0114 Xxxxx Xxxxxxxx 0000 X, Xxxxxx Xxx Xxxxxx, XX 00000-0114 E-Mail: xxxxxxx@xxx.xxxxx.xx.xx E-Mail: xxxxxxx@xxx.xxxxx.xx.xx New enrollees shall be auto-assigned to a Contractor in accordance with the auto-assignment process set forth in Section 7.2.3. Information shall be provided to new enrollees in accordance with Section 8.2.1 Due to planning for staffing and operations for Iowa Total Care implementation, the Agency will provide the Contractor a projected July 2019 minimum enrollment no later than November 1, 2018.
