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Title 8: Medicaid Page 4 Iowa Department of Health and Human Services Employees’ Manual Chapter A: Administration Overview Revised January 13, 2023 Definitions “MAC” means the MAGI-related mothers and children coverage group to pregnant women, infants under age one, and to children who have not reached age 19. “MAGI” means the modified adjusted gross income. “MAGI-exempt” describes Medicaid coverage groups for MAGI-related special populations who are exempt from the income test. “MAGI-related” describes Medicaid coverage groups for pregnant women, children under 19, parents and caretakers, and the adult population (IHAWP).whose eligibility criteria are derived from the MAGI tax-based methodology determination. “Managed care organization” or “MCO” means an organization that provides members with comprehensive health care services, including physical, behavioral, and long term care services and supports. MCOs make these services available to the member for a fixed monthly rate (capitation payment) that is paid by Medicaid. “Medicaid for Kids with Special Needs” or “MKSN” means a medical coverage group for children with disabilities. “Medical Assistance Advisory Council” or “MAAC” means the group that advises the Department about health and medical care services and participates in policy development. The MAAC is composed of representatives from: ▪ Provider groups. ▪ The General Assembly. ▪ The Department of Public Health. ▪ Consumers. ▪ The public. Legal reference: 42 CFR 431.12, 441 IAC 79.7(249A)) “Medical institution” means: ▪ Acute care hospitals ▪ Psychiatric institutions, including: • State mental health institutes (MHIs) • Psychiatric hospitals • Psychiatric medical institutions for children (PMICs) ▪ Long-term care facilities, including: • Nursing facilities (NFs) • Nursing facilities for people with mental illness (ICF/MI) • Hospital-based or non-hospital-based skilled nursing facilities (SNFs) • Intermediate care facilities for persons with an intellectual disability (ICF/IDs) Residential care facilities (RCFs) are not medical institutions and are not Medicaid providers.