441—82.8(249A) Determination of need for continued stay. For clients not enrolled with a managed care organization, certification of need for continued stay shall be made according to procedures established by the Iowa Medicaid QIO unit. For all clients enrolled with a managed care organization, the managed care organization shall review the Medicaid client’s need for continued care in an ICF/ID at least annually. The managed care organization must submit documentation to the Iowa Medicaid QIO unit for all reviews that indicate a change in the client’s level of care. The Iowa Medicaid QIO unit shall make a final determination for any reviews that indicate a change in the level of care.
This rule is intended to implement Iowa Code section 249A.12.
[ARC 8207B, IAB 10/7/09, effective 12/1/09; ARC 8446B, IAB 1/13/10, effective 2/17/10; ARC 2361C, IAB 1/6/16, effective 1/1/16; ARC 6776C, IAB 12/28/22, effective 2/1/23]