State Member Stacy Malone
State Member-
Stacy Malone replied to the discussion State Preclusion List? (PCA bad actors) in the forum State Only Forum 2 years ago
Reply to State Preclusion List? (PCA bad actors)
Iowa sanctions these providers and they are then added to the state sanction list which is posted externally on a monthly basis.
-
Stacy Malone replied to the discussion Self Disclosures in the forum State Only Forum 2 years ago
Iowa only posts disciplinary actions that have been taken against a provider. We post Probations, Participation Suspensions and Terminations. If they self-disclosed and then fail to submit the overpayment, we would sanction them and then they would go on the list after their appeal rights had expired.
-
Stacy Malone replied to the discussion Referrals to MFCU in the forum State Only Forum 2 years ago
This is the form Iowa uses. Kimee Pierson designed it. We will be updating it with our new HHS logo and adding a third MCO to the form. We also include a Companion Guide for the MCOs to use. All of the referrals come to PI and we determine if the allegations are credible. If so, then we submit the form and all of the documentation to the MFCU.
-
Stacy Malone replied to the discussion Preclusion list in the forum State Only Forum 3 years ago
In Iowa, our MFCU will prosecute these individuals if the theft involved a Medicaid member. Regardless if they are enrolled or not, we terminate them from participation so that they are on the sanction list; therefore, they would not be allowed to enroll.
