A complete redetermination of eligibility for the health and
disability waiver shall be completed at least once every 12 months or when
there is significant change in the person's situation or condition.
A redetermination of continuing eligibility factors shall be
made in accordance with rules
441-76.7 (249A) and
441-83.2 (249A). A
redetermination shall include verification of the existence of a current
service plan meeting the requirements listed in rule
441-83.7 (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. 441-83.5
ARC 0757C, IAB
5/29/2013, effective 8/1/2013
Amended by
IAB
January 06, 2016/Volume XXXVIII, Number 14, effective
1/1/2016
