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Title 5: Centrally Administered Programs Page 4 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) General Administration Revised August 20, 2010 Responsibilities of the Department Responsibilities of the Department Legal reference: 441 IAC 1.3(2)“c” The chief of the Bureau of Adult and Children’s Medical Programs of the Iowa Medicaid Enterprise within the Department of Human Services (DHS) is the administrator of the hawk-i program. Under the direction of the hawk-i Board, DHS is responsible for: ♦ Planning and developing the scope, content, and priorities of the hawk-i program within present and anticipated available funding. ♦ Interpreting and ensuring compliance with federal and state law and regulations. ♦ Writing manual. ♦ Administering contracts for: • Third-party administration, • Health and dental coverage, • Outreach services, and • Quality performance measures. ♦ Developing administrative rules regarding: • Eligibility criteria and procedures • Covered services • Other program policies Responsibilities of the hawk-i Third-Party Administrator Legal reference: 441 IAC 86.13(514I) The Department contracts with a third-party administrator (TPA). The primary role of the TPA is to provide customer service, determine eligibility for the hawk-i program, and manage the enrollment of eligible children into participating health and dental plans. The TPA will process and track the accurate disposition of all applications received and maintain ongoing enrollment in accordance with the procedures and rules established by the Department and adopted by the hawk-i Board.