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Code · Iowa · Chapter 249A — Medical Assistance

249A.28 Hospital directed payment — prohibition of pass-through on non-Medicaid payors.

83 words·~1 min read·/ia/chapter-249a-medical-assistance/249a-28·

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A hospital participating in the hospital directed payment program pursuant to 42 C.F.R. §438.6 shall not knowingly pass on the directed payment increase for health care services provided to non-Medicaid payors, including as a fee or rate increase. If a hospital violates this section, the hospital shall not receive the directed payment but shall instead only be reimbursed the hospital base reimbursement rate for health care services provided under the medical assistance program for one year from the date the violation is discovered.
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