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Title 5: Centrally Administered Programs Page 73 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Approval of hawk-i Coverage Revised July 3, 2009 Required Services Each participating health and dental plan may have requirements in order for services to be paid. These may include but are not limited to: ♦ Use of participating providers. ♦ Prior approval. ♦ Limits on the frequency or amount that can be paid. Effective Date of Coverage Legal reference: 441 IAC 86.5 For children determined eligible for the hawk-i program from an initial hawk-i or Medicaid application, the effective date of coverage is the first day of the month following the month in which the application is filed, regardless of the day of the month the application is filed.

1. A valid hawk-i application is received June 30. The earliest date hawk-i coverage can begin is July 1. 2. A valid hawk-i application is received July 1. The earliest date hawk-i coverage can begin is August 1. For children determined eligible for the hawk-i program from a referral from Medicaid, the effective date of coverage is: ♦ The first day of the month after Medicaid eligibility is lost, regardless of the date of the referral, in order to ensure that there is no break in coverage when Medicaid was canceled, or ♦ The first day of the month following the month of application when Medicaid was denied.

1. A hawk-i referral from Medicaid is received May 23. The Medicaid end date for the children is May 31. The earliest date hawk-i coverage can begin is June 1. 2. A hawk-i referral from Medicaid is received July 7. The Medicaid end date for the children is May 31. The earliest date hawk-i coverage can begin is June 1. 3. A hawk-i referral from Medicaid is received May 12. The Medicaid application date on the denial is March 29. The earliest date hawk-i can begin is April 1.