Iowa Admin. Code r. 17-8.7

Current through Register Vol. 47, No. 5, September 4, 2024

Rule 17-8.7 - Managed care ombudsman program

(1) The office of the long-term care ombudsman may provide advocacy and assistance to eligible recipients, or the families or legal representatives of such eligible recipients, of long-term services and supports provided through the Medicaid program who are receiving services in a long-term care facility or under one of the home- and community-based services waivers.

(2) Representatives of the office of long-term care ombudsman providing an individual with assistance and advocacy services authorized under Iowa Code section 231.44 shall be provided access to the individual and to the individual's medical, social and administrative records related to the provision of the long-term services and supports to the individual, as authorized by the individual or the individual's legal representative, as necessary to carry out the duties specified by Iowa Code section 231.44.

(3) The office of long-term care ombudsman and representatives of the office, when providing assistance and advocacy services under Iowa Code section 231.44, shall be considered a health oversight agency as defined in 45 CFR §164.501 for the purposes of health oversight activities described in 45 CFR §164.512(d). Recipient information available to the office of long-term care ombudsman and representatives of the office under this subrule shall be limited to the recipient's protected health information as defined in 45 CFR §160.103 for the purpose of recipient case resolution.

Iowa Admin. Code r. 17-8.7

ARC 8489B, lAB 1/27/10, effective 1/7/10; ARC 8939B, lAB 7/14/10, effective 7/1/10

Rescinded by IAB July 9, 2014/Volume XXXVII, Number 1, effective 8/13/2014

Amended by IAB January 15, 2020/Volume XLII, Number 15, effective 2/19/2020