IHA Today

IHA Today

By Joah Hogan|
|April 10, 2023

April 8, 2023

CMS issues 2024 Medicare Advantage final rule
The Centers for Medicare and Medicaid Services issued a final rule increasing oversight of Medicare Advantage plans and better aligns them with traditional Medicare. The 2024 Medicare Advantage final rule ensures beneficiaries have access to medically necessary health care services and protects beneficiaries from inappropriate delays and denials of coverage. Updates include:

  • Addressing gaps in behavioral health services.
  • Establishing additional health-plan utilization-management oversight processes.
  • Implementing Inflation Reduction Act provisions making prescription drugs more affordable.
  • Making changes to Medicare Advantage star ratings to address social determinants of health.
  • Requiring Medicare Advantage plans to provide culturally and linguistically appropriate services.
  • Streamlining prior-authorization processes.
  • Tightening marketing rules to protect beneficiaries from misleading advertisements.

IHA submitted earlier comments to CMS about the initial proposed rule. IHA supported the provisions outlined above, but expressed concern about changes to the legal standard for identifying overpayment. The proposed legal-standard changes were not codified in the final regulation.


Iowa Medicaid clarifies continuous-coverage unwind
Iowa Medicaid announced members will not automatically lose coverage because of the COVID-19 public health emergency unwind. Most members will need to renew their coverage, but renewal dates are different.

Health care providers are encouraged work with members to ensure they retain their health coverage by:

  • Looking for mail from the Iowa Department of Health and Human Services, Iowa Medicaid or Iowa Health Link and completing and returning requested documents.
  • Updating their contact information with Iowa HHS and their managed care organizations.
  • Contacting Iowa Medicaid Member services at 855-889-7985 with questions.

An Iowa Medicaid unwind toolkit with approved language is available for providers who wish to connect with their members about the continuous-coverage requirement unwind.


Mercy Iowa City announces new president and CEO
Tom Clancy, MBA, Ph.D., RN, has been appointed president and CEO of Mercy Iowa City by its board of trustees. Dr. Clancy is the chair of the hospital’s board and worked at the hospital in the 1990s as a nurse.

He previously served as clinical professor and associate dean at the University of Minnesota School of Nursing and was responsible for facilitating corporate and community partnerships. During his time in Minnesota, he facilitated the development of nurse-managed clinics and faculty practices, health care consultation in information technology, process workflow, computer simulation, modeling and big data.


Register for HRSA's rural emergency hospital webinar
The Health Resources and Services Administration and the National Academy for State Health Policy is hosting a one-hour webinar about the new rural emergency hospital designation. Webinar participants will learn about the requirements of the designation. Representatives from the Kansas Hospital Association and the Michigan Center for Rural Health also will share their experiences implementing the new designation in their states.

The Understanding Medicare’s New Rural Emergency Hospital Designation webinar is scheduled from noon-1 p.m. Monday, April 10.

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