441—82.7 (249A) Initial approval for ICF/ID care.
	 82.7(1) Referral through targeted case management. Persons seeking ICF/ID placement shall be referred through targeted case management. The case management program shall:
	  a.   	 Identify appropriate service alternatives;
	  b.   	 Inform the person of the alternatives; and
	  c.   	 Refer a person without appropriate alternatives to the department.
	 82.7(2) Approval of placement by department.
	  a.   	 Within 30 days of receipt of a referral, the department shall:
	 (1) 	 Approve ICF/ID placement;
	 (2) 	 Offer a home- or community-based alternative; or
	 (3) 	 Refer the person back to the targeted case management program for further consideration of service needs.
	  b.   	 Once ICF/ID placement is approved, the eligible person, or the person’s representative, is free to seek placement in the facility of the person’s or the person’s representative’s choice.
	 82.7(3) Approval of level of care. Medicaid payment shall be made for ICF/ID care upon certification of need for this level of care by a licensed physician of medicine or osteopathy and approval by the Iowa Medicaid enterprise (IME) medical services unit. The IME medical services unit shall review ICF/ID admissions and transfers only when documentation is provided which verifies a referral from targeted case management that includes an approval by the department.
	 82.7(4) Appeal rights. Notice of adverse action and right to appeal shall be given in accordance with 441—Chapter 7.
This rule is intended to implement Iowa Code section 249A.12 as amended by 2012 Iowa Acts, Senate File 2336, section 58.
[ARC 8207B, IAB 10/7/09, effective 12/1/09; ARC 8446B, IAB 1/13/10, effective 2/17/10; ARC 0191C, IAB 7/11/12, effective 7/1/12]