441—88.44 (249A) Eligible providers.
	 88.44(1) Specialties allowed. Providers shall be allowed to contract with the department to provide patient management to enrolled recipients as long as the provider:
	  a.   	 Is a licensed doctor of medicine or osteopathy or an advanced registered nurse practitioner licensed pursuant to Iowa Code chapter 152 and possessing evidence of certification pursuant to board of nursing rules under 655—Chapter 7 in a specialty area listed in paragraph 88.44(1)“d.”
	  b.   	 Is otherwise eligible to enroll as an Iowa Medicaid provider.
	  c.   	 Is a provider in good standing with the Medicaid agency as defined in subrule 88.45(1).
	  d.   	 Is practicing in one of the following specialties in the medical services area:
	 (1) 	 Family practice.
	 (2) 	 General practice.
	 (3) 	 Pediatrics.
	 (4) 	 Internal medicine.
	 (5) 	 Obstetrics and gynecology.
	 88.44(2) Clinic or group practice participation. A provider may participate as an individual practitioner or as a partner or employee of a clinic or group practice. The clinic or group shall be the contractor. Federally qualified health centers and rural health clinics that employ providers in the specialties specified in subrule 88.44(1) may contract. However, each provider participating within the clinic, group, federally qualified health center, or rural health clinic shall sign and be bound by the terms of the clinic or group contract as if the provider was in individual practice.
	 88.44(3) Exceptions. Other providers licensed as doctors of medicine or osteopathy or as advanced registered nurse practitioners may request exception to subrule 88.44(1) for specific individual patients in accordance with the procedures set forth in this subrule.
	  a.   	 If the request is being made in order to allow a different type of specialist to be a patient manager, or to allow a provider practicing outside the recipient’s medical service area to serve the recipient, the provider shall make a written request to the department.
	 (1) 	 The request shall identify the provider by name, address, telephone number, specialty, and Medicaid provider number, indicating the practice location, or date of application to be a Medicaid provider. The request shall specify the members in question and state agreement to provide primary care and patient management as specified in subrule 88.45(2) to those members.
	 (2) 	 If the request comes initially from the recipients as specified in paragraph 88.46(2)“c,” the department shall contact the provider in question to offer the provider the opportunity to request the exception.
	  b.   	 Rescinded IAB 11/10/93, effective 11/1/93.
	  c.   	 Rescinded IAB 11/10/93, effective 11/1/93.
	  d.   	 The managed health care review committee shall consider the request and respond within ten working days of receipt of the request. If the request is approved, a contract will be forwarded to the physician and procedures for contracting with a physician as specified in rule 441—88.45(249A) shall be followed.
	  e.   	 The following factors shall be taken into account when considering the physician’s request:
	 (1) 	 Mutual agreement between physician and patient regarding the arrangement.
	 (2) 	 Existence of an already established physician-patient relationship.
	 (3) 	 Transportation barriers, if requesting a patient manager outside the medical service area.
	 (4) 	 Customary practice by the specialist to provide primary care.
	 (5) 	 A new medical condition which necessitates the proposed physician-patient relationship.