Iowa Proposed Rules on Managed Care Organization (MCO) Quality and Home Health Low Utilization Payment Adjustment (LUPA)
Iowa Medicaid Enterprise (IME), the Medicaid agency in Iowa, released proposals impacting UnityPoint Health and UnityPoint at Home. As Medicaid patients are a growing segment of our care delivery, we monitor these rules to assure adequate reimbursement and operational flexibility. The 2021 Iowa Medicaid Managed Care Quality Assurance System proposal serves as a guidance document to oversee Iowa’s Medicaid MCOs and to explore the use of clinical outcomes-based research to inform a set of performance measures. As a care provider for Medicaid members, UnityPoint Health encourages quality measurement to be consistent, support MCO accountability, and promote a transition to value-based care. In terms of the Home Health LUPA rules, these are based upon legislative action from the prior session. Fair rates are needed to sustain home health services regardless of where a member resides. Reimbursement up to the LUPA rate identified by the federal government supports moving appropriate care to the community and home that accelerated under the COIVD-19 pandemic.
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For more information on Federal advocacy, legislative, policy and regulatory issues of impact to UnityPoint Health, please contact Cathy Simmons, executive director of government & external affairs for UnityPoint Health or Stephanie Collingwood, government & external affairs specialist.