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Title 8: Medicaid Page 24 Iowa Department of Health and Human Services Employees’ Manual Chapter A: Administration Appeals Revised January 13, 2023 Reimbursement After Appeal Decisions Bills That Cannot Be Reimbursed Legal reference: 441 IAC 75 (Rules in Process) Medical bills cannot be reimbursed if a person or agency paid the bill and the member does not have to repay the money. Examples of this type of situation are when: ▪ The member receives insurance payments. ▪ The member receives a legal settlement and the settlement designates funds for medical bills. ▪ A provider refunds the member and bills Medicaid. Medical bills for the member that are paid by county relief agencies cannot be reimbursed if: ▪ The member is repaying the county. ▪ The provider refunds the agency and bills Medicaid. Reimbursement Process Members and county agencies use form 470-2224, Verification of Paid Medical Bills, to file a claim. When the form is returned to the IM worker with necessary documentation, the IM worker ▪ Completes section II of the form according to instructions in 6-Appendix, and ▪ Submits the form with original signatures to the interim assistance reimbursement coordinator at the Iowa Medicaid Enterprise (IME) within 60 days. Payment is issued from Iowa Medicaid Enterprise. When the county agency paid the provider, reimbursement is made directly to the agency. When the member (or someone acting on the member’s behalf) paid the provider directly, reimbursement is made directly to the member. A Medically Needy member can choose whether to receive reimbursement or to allow the bills to be applied to spenddown. However, reimbursement is not made unless the spenddown has been met. Explain the options to Medically Needy members. Property Tax Relief Legal reference: Iowa Code Chapters 425 and 427 Iowa law provides certain low-income residents with: ▪ Relief on tax payments for real property through tax suspension and property tax credit. ▪ Rent reimbursement. It is to a member’s advantage to file for both a tax suspension and a tax credit. A tax suspension means the taxes do not have to be paid until the property is transferred. A tax credit reduces or eliminates the amount of tax to be paid when the property is transferred.