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                                                                                 Center for Connected Health Policy

           Iowa


           Medicaid Program:  Iowa Medicaid Enterprise (IME)

           Program Administrator:  IA Dept. of Human Services

           Regional Telehealth Resource Center:
           Great Plains Telehealth Resource and Assistance Center
           University of Minnesota/Institute for Health Informatics
           330 Diehl Hall
           505 Essex Street S.E.
           Minneapolis, MN 55455
           (888) 239-7092
           www.gptrac.org


            STATE LAW/REGULATIONS                              MEDICAID PROGRAM
            Definition of telemedicine/telehealth

            “Telemedicine means use of a telecommunications    No reference found.
            system for diagnostic, clinical, consultative, data, and
            educational services for the delivery of health care
            services or related health care activities by licensed
            health care professionals, licensed medical
            professionals, and staff who function under the direction
            of a physician, a licensed health care professional, or
            hospital, for the purpose of developing a
            comprehensive, statewide telemedicine network or
            education.”

            Source: IA Admin. Code, 751 7.1(8D) (2012).
            Live Video Reimbursement
            No reference found.                                No reference found.

            Store and Forward Reimbursement
            No reference found.                                No reference found.
            Remote Patient Monitoring Reimbursement

            No reference found.                                No reference found.
            Email/Phone/FAX

            No reference found.                                No reference found.
            Online Prescribing
             Pharmacists are prohibited from dispensing prescription  No reference found.
             drugs if the pharmacist knows or should have known
             that the prescription was issued solely on the basis of
             an Internet-based questionnaire, an Internet-based
             consult, or a telephone consult, and was completed
             without a pre-existing patient-provider relationship.

             Source: IA Admin. Code, 657 8.19(124,126,155A) (2012).

             A physician must be physically present with a woman at

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

             the time an abortion-inducing drug is provided.

             Source: IA Admin. Code, 653 13.10.
            Consent
            No reference found.                                No reference found.

            Location
            No reference found.                                No reference found.
            Cross-State Licensing

            No reference found.                                No reference found.
            Private Payers

            No reference found.                                No reference found.
            Site/Transmission Fee
            No reference found.                                No reference found.

            Miscellaneous
                                                               Iowa contracts with Magellan Health Services to
                                                               manage the Iowa Plan for Behavioral Health.  The
                                                               delivery of psychiatric evaluation and medication
                                                               management via webcam/video/audio to Iowa Plan
                                                               Medicaid members is available through the Iowa Plan.

                                                               Members must consent to using telehealth.

                                                               Members must have an in-person intake at the
                                                               provider’s location, where the option of telehealth is
                                                               discussed.

                                                               Source: Iowa Plan for Behavioral Community Reinvestment.
                                                               Magellan of Iowa.  http://www.magellanofiowa.com/for-providers-
                                                               ia/community-reinvestment.aspx (accessed Jul. 18, 2014)

                                                               Source:  Telehealth Psychiatric Service Standards.  Magellan
                                                               Behavioral Care of Iowa.
                                                               http://www.magellanofiowa.com/media/740191/telehealth_service
                                                               _standards_addendum_jan2014.pdf (accessed Jul. 18, 2014).

                         Comments:    A letter from the Department of Human Services addressed to the Elderly Waiver
                         Interim Committee and posted on the Iowa legislature’s website indicates that Iowa Medicaid will
                         pay for otherwise covered medical services if rendered via telemedicine and if the standard in the
                         medical community would support rendering those services via telemedicine.  CCHP has reached
                         out to Iowa Medicaid staff, who have confirmed this practice in Iowa Medicaid, stating that a service
                         rendered via telemedicine must meet the general provisions for Medicaid covered services outlined
                         in 441 Iowa Administrative Code 79.9(2).  However, Iowa Medicaid has not published an official
                         telehealth policy.

                         State of Iowa, Department of Human Services.  Letter to the Elderly Waiver Interim Committee regarding Follow up
                         Information to hearing.  (December 29,
                         2008), https://www.legis.iowa.gov/DOCS/LSA/IntComHand/2009/IHPAF026.PDF (accessed Jan. 7, 2015).




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                                                                                 Center for Connected Health Policy

                         Iowa conducted a pilot program in 1997-2000 to study the cost-effectiveness of providing telehealth
                         services to Medicaid patients.  Few providers participated in the program, and the study found that it
                         was not cost effective.

                         Office for the Advancement of Telehealth, Telemedicine Reimbursement Report,   p. 31-32 (Oct. 2003) (accessed on
                         Jul. 18, 2014).











































































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