This text of Iowa § 231.44 (Utilization of resources — assistance and advocacy related to long-term services and supports under the Medicaid program) is published on Counsel Stack Legal Research, covering Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
and supports under the Medicaid program.
1.The office of long-term care ombudsman may utilize its available resources to provide
assistanceandadvocacyservicestoeligiblerecipients, orthefamiliesorlegalrepresentatives
of such eligible recipients, of long-term services and supports provided through the Medicaid
program. Such assistance and advocacy shall include but is not limited to all of the following:
a.Assisting recipients in understanding the services, coverage, and access provisions and
their rights under Medicaid managed care.
13 HEALTH AND HUMAN SERVICES — AGING AND DISABILITY SERVICES, §231.46
b.Developing procedures for the tracking and reporting of the outcomes of individual
requests for assistance, the obtaining of necessary services and supports, and other aspects
of the serv
Free access — add to your briefcase to read the full text and ask questions with AI
and supports under the Medicaid program.
1. The office of long-term care ombudsman may utilize its available resources to provide
assistanceandadvocacyservicestoeligiblerecipients, orthefamiliesorlegalrepresentatives
of such eligible recipients, of long-term services and supports provided through the Medicaid
program. Such assistance and advocacy shall include but is not limited to all of the following:
a. Assisting recipients in understanding the services, coverage, and access provisions and
their rights under Medicaid managed care.
13 HEALTH AND HUMAN SERVICES — AGING AND DISABILITY SERVICES, §231.46
b. Developing procedures for the tracking and reporting of the outcomes of individual
requests for assistance, the obtaining of necessary services and supports, and other aspects
of the services provided to eligible recipients.
c. Providing advice and assistance relating to the preparation and filing of complaints,
grievances, and appeals of complaints or grievances, including through processes available
under managed care plans and the state appeals process, relating to long-term services and
supports under the Medicaid program.
2. A representative of the office of long-term care ombudsman providing assistance and
advocacy services authorized under this section for an individual, shall be provided access
to the individual, and shall be provided access to the individual’s medical and social records
as authorized by the individual or the individual’s legal representative, as necessary to carry
out the duties specified in this section.
3. A representative of the office of long-term care ombudsman providing assistance and
advocacy services authorized under this section for an individual, shall be provided access to
administrative records related to the provision of the long-term services and supports to the
individual, as necessary to carry out the duties specified in this section.
4. The office of long-term care ombudsman and representatives of the office, when
providing assistance and advocacy services under this section, shall be considered a health
oversight agency as defined in 45 C.F.R. §164.501 for the purposes of health oversight
activities as described in 45 C.F.R. §164.512(d). Recipient information available to the office
of long-term care ombudsman and representatives of the office under this subsection shall
be limited to the recipient’s protected health information as defined in 45 C.F.R. §160.103 for
the purpose of recipient case resolution. When providing assistance and advocacy services
under this section, the office of long-term care ombudsman shall act as an independent
agency, and the office of long-term care ombudsman and representatives of the office
shall be free of any undue influence that restrains the ability of the office or the office’s
representatives from providing such services and assistance. The office of long-term care
ombudsman shall adopt rules applicable to long-term care ombudsmen providing assistance
and advocacy services under this section to authorize such ombudsmen to function in a
manner consistent with long-term care ombudsmen under the federal Act.
5. For the purposes of this section:
a. “Institutional setting” includes a long-term care facility, an elder group home, or an
assisted living program.
b. “Long-term services and supports” means the broad range of health, health-related,
and personal care assistance services and supports, provided in both institutional settings
and home and community-based settings, necessary for older individuals and persons with
disabilities who experience limitations in their capacity for self-care due to a physical,
cognitive, or mental disability or condition.