Iowa Admin. Code r. 441-83.25 - Redetermination

A complete redetermination of eligibility for elderly waiver services shall be done at least once every 12 months.

A redetermination of continuing eligibility factors shall be made when a change in circumstances occurs that affects eligibility in accordance with rule 441-83.22 (249A). A redetermination shall contain the components listed in rule 441-83.27 (249A).

(1) The IME medical services unit or the member's managed care organization shall be responsible for annual redetermination of the level of care.
(2) The managed care organization must submit documentation to the IME medical services unit for all reassessments, performed at least annually, which indicate a change in the member's level of care. The IME medical services unit shall make a final determination for any reassessments which indicate a change in the level of care. If the level of care reassessment indicates no change in level of care, the member is approved to continue at the already established level of care.

Notes

Iowa Admin. Code r. 441-83.25
Amended by IAB January 06, 2016/Volume XXXVIII, Number 14, effective 1/1/2016

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