Iowa Admin. Code r. 441-7.14
Current through Register Vol. 47, No. 11, December 11, 2024
(1) If the contested case hearing presiding officer's proposed decision is favorable to an enrollee in a Medicaid appeal, the department must promptly make corrective payments retroactive to the date an incorrect action was taken, and, if appropriate, provide for admission or readmission of an individual to a facility. If the presiding officer reverses a decision of a managed care organization to deny, limit, or delay services that were not furnished while the appeal was pending, the managed care organization must authorize or provide the disputed services promptly and as expeditiously as the enrollee's health condition requires, but no later than 72 hours from the date the managed care organization receives notice reversing the determination.(2) Unless there is contravening federal or state law, all final decisions shall be put into effect within seven days of the issuance of the final decision.Iowa Admin. Code r. 441-7.14
ARC 0487C, lAB 12/12/12, effective 2/1/2013Amended by IAB March 11, 2020/Volume XLII, Number 19, effective 4/15/2020Adopted by IAB May 29, 2024/Volume XLVI, Number 25, effective 7/3/2024