The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2543-MC-FFS: Amerigroup Iowa, Inc. Rebranding to Wellpoint Iowa, Inc.
Also in Iowa, on January 3, 2024, Wellpoint released Clinical UM Guideline (Guideline #CG-DME-42) regarding the use of continuous glucose monitoring devices (CGMs). Also review the Iowa Administrative Code and Department of Human Services Medical Equipment and Supply Dealer Provider Manual for related information; see pages 39-40. Please contact the following for assistance: Angela Dillon or Joely Anderson.
Also in Iowa, in response to complaints by Iowa pharmacies, Andria Seip, Senior Health Policy Specialist, Iowa Insurance Division, sent a memo on January 4, 2024, to PBMs (Pharmacy Benefit Managers) licensed in the state that contracts requiring reimbursement models using “effective rates” are considered prohibited under Iowa Code section 510B.8C.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.