(i.e., HCBS Elderly and/or Physically Disabled Adult Waivers)
IA HCBS Waiver for Persons w/Physical Disabilities for physically disabled individuals ages 18-64 yrs
Types of Technology Reimbursed/Definition (i.e., Personal Emergency Response System (PERS), Medication Dispensing, Home Telehealth, Remote Monitoring, etc.)
PERS Service: Personal emergency response system is an electronic device that transmits a signal to a central monitoring station to summon assistance in the event of an emergency when the consumer is alone. The required components are: an in home medical communications transmitter and receiver; a remote potable activator, a central monitoring station with backup systems staffed by trained attendants at all times, current data files at the central monitoring station containing response protocols and personal, medical and emergency information for each consumer.
PERS Installation: A unit of service is a onetime installation fee or one month of service, maximum units per state fiscal year shall be one initial installation and 12 months of service. The initial onetime fee has an upper limit and the ongoing monthly fee has an upper limit. The individuals’ plan of care will address how the consumer health care needs are being met. Services must be authorized in the service plan The Iowa Department of Human Services, service worker will monitor the plan.
Reimbursement Rates
PERS Service: $39.00 - $47.40/month
PERS Installation - $39.00 - $60.96 (one-time)
IA HCBS Elderly (for older individuals ages 65 - no max)
Types of Technology Reimbursed/Definition (i.e., Personal Emergency Response System (PERS), Medication Dispensing, Home Telehealth, Remote Monitoring, etc.)
PERS Service: (same as above definition)
The case manager/service worker, consumer or the consumer’s, should inform Providers of the ERS representative as soon as possiblewhen the service is no longer needed.
Reimbursement Rates
PERS Service: $37.56 - $47.40/month
PERS Installation: $48.29 - (one-time)
Durable Medical Equipment for Home Health Providers (available in above waivers and others)
Types of technology reimbursed/definition (i.e., Personal Emergency Response System (PERS), Medication Dispensing, Home Telehealth, Remote Monitoring, etc.)
Automated medication dispensers (A9280): Prior authorization is required for automated medication dispensers. Approval will be granted when prescribed for members who meet all of the following conditions:
- The member is taking two or more medications prescribed more than once per day.
- The availability of a caregiver is limited or non-existent.
- The member has a diagnosis indicating cognitive impairment or age-related factors that affect the ability to remember to take medications.
- Less costly alternatives such as medisets and telephone reminders have failed.
Reimbursement Rates
Automated Medication Dispenser: Rate requires prior approval with negotiated price
Telephone monitoring (S5185) services may be allowed when:
- The medications prescribed and the member’s condition necessitate that the medication be taken at a certain time to avoid complications, and
- The member lives alone or others living in the member’s home are unable to provide assistance, andThe member has no other services coming into the home or the frequency is insufficient.
Reimbursement Rates
Telephone Monitoring: Rate requires prior approval and are manually priced.
Blood Pressure Monitors:Blood pressure monitors are covered when ordered for a condition or disease that warrants in-home monitoring daily to weekly and recording with review by the physician on a regular basis. Examples include polycystic renal disease, renal failure, cardiac defects, and medications that create hypertension or hypotension. Monitors are also covered when prescribed for any member who has end-stage renal disease and the equipment is appropriate for home use (coverage differs from Medicare).
Reimbursement Rates
Blood Pressure Monitoring: $48.88/month
Iowa Reimbursement Policy Notes: During 2011 rules will be implemented which will expand coverage of PERS under the HCBS waivers to include personal locator systems.