The documents we hold show no Iowa license for non-medical home care: Iowa Medicaid, part of the Department of Health and Human Services (HHS), enrolls waiver providers, and home health agencies must be Medicare-certified to take part in Iowa Medicaid. Most Medicaid members are in IA Health Link, run by three health plans: Iowa Total Care, Molina Healthcare of Iowa and Wellpoint Iowa. On October 1, 2026, Iowa plans to replace four waivers with the new Adults with Disabilities and Children and Youth waivers, and new rates start for attendant care and home maintenance support.
Red means act now, amber means read it this month, grey is for the record.
Iowa Medicaid is revalidating all enrolled providers over two years, in phases. Once you get your notice, you have about 30 days to finish. The letter applies to fee-for-service enrollment.
Iowa HHS plans to replace the Health and Disability, Children's Mental Health, AIDS/HIV and Physical Disability waivers with two age-based waivers on October 1, 2026. Attendant care, nursing and home health aide services are not offered on the Children and Youth waiver; children get them through EPSDT (Iowa Care for Kids). The Elderly, Intellectual Disability and Brain Injury waivers stay for now.
Under 2026 House File 2782, rates increase from October 1, 2026 for Attendant Care (S5125) and Skilled Attendant Care (S5125 U3) on six waivers, Home Maintenance Support (S5130) on the AIDS/HIV, Elderly and Health and Disability waivers, and Elderly Waiver assisted living (T2031).
Chapters 73 (managed care), 77 (who may enroll), 78 (covered services), 79 (provider policies), 83 (waivers) and 90 (case management) were amended throughout. Chapter 77 lists who may provide attendant care and home maintenance. The enrollment rule 79.15 was changed again by an emergency rule on Aug. 10, 2026.
CDAC is now Attendant Care and Skilled Attendant Care; homemaker and chore are now Home Maintenance Support. Iowa Medicaid stopped enrolling individual CDAC providers; members chose agency attendant care or the Consumer Choices Option.
Dates taken from the rules and notices as we read them.
They replace the Health and Disability, Children's Mental Health, AIDS/HIV and Physical Disability waivers.
Codes S5125, S5125 U3, S5130 and T2031; amounts are on the Iowa Medicaid Fee Schedules webpage.
Members switch at their annual reassessment or when services change.
About 30 days to finish once you are notified.
Every state follows the same outline, so you always know where to look. Open a section for the detail.
Sometimes two official documents say different things. Here is what we went with, why, and what each document says, so you can judge for yourself.
The rule took effect July 1, 2026. The HCBS manual chapter was last revised in 2022.
The state rule is newer (July 1, 2026), but the Elderly Waiver approved by CMS in January 2026 adds community businesses on purpose. Check with Iowa Medicaid Provider Services before enrolling as a community business for this service.
The informational letter is a formal notice with an effective date. The general FAQ was written before home health EVV started and is out of date.
The informational letter has a date and an effective date. The home health FAQ is undated. Ask your health plan if this affects you.
The 2024 informational letter reports a CMS-approved waiver change. The manual (2022) and the handbook (2015) are older.
The informational letter (2024) is newer than the manual chapter (revised 2022) and says the attestation is no longer required.
Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Not that we found.
None of the documents we hold sets up a state license for non-medical home care. To be paid by Medicaid, you enroll with Iowa Medicaid as a waiver provider. For attendant care, community businesses qualify if they have all necessary licenses and permits and send proof of current liability and workers' compensation coverage (441-77.35(7)).
Check the rule and your waiver.
The state rule lists Medicare-certified home health agencies and agencies with a local public health services contract (441-77.35(1)). The Elderly Waiver approved in January 2026 also adds community businesses. The documents disagree, so check with Iowa Medicaid Provider Services before enrolling as a community business for this service.
Yes.
Home health agencies may take part in Iowa Medicaid if they are certified for Medicare and, unless exempt, have a surety bond (441-77.10). Waiver home health aide and nursing providers must also be Medicare-certified agencies.
Managed care attendant care, home maintenance and home health.
For IA Health Link members, EVV covers waiver codes S5125, S5130, T1019 and home health aide and nursing codes, and home health care services since January 1, 2024. Iowa Medicaid does not require EVV for fee-for-service members. CareBridge is free; another vendor must link to CareBridge, and claims not sent through CareBridge are denied.
Yes.
Iowa's EVV FAQ says live-in caregivers are not excluded, because EVV applies by service code. Assisted living and residential care facility shift workers are the exception for personal care, and they may not opt out for home health care services.
Criminal and abuse registry checks.
Before hiring, request a Department of Public Safety criminal history check and HHS child and dependent adult abuse checks, or use the single contact repository. If a record turns up, HHS's record check evaluation system decides whether you may hire the person. You may hire someone provisionally after a third-party preliminary check only in the cases 135C.33 allows. Tell applicants about the checks and get a signed acknowledgment.
Yes.
Iowa Code 235B.3 names in-home homemaker-home health aides as mandatory reporters. They must report to HHS within 24 hours and also tell the person in charge. Within one month of hire, give them a statement of the reporting rules. They must complete the core abuse training within six months and every three years.
On some waivers.
Since November 1, 2023, spouses and parents of minors may be considered as paid caregivers for attendant care, supported community living and Consumer Choices Option services on the AIDS/HIV, Brain Injury, Health and Disability, Intellectual Disability and Physical Disability waivers (IL 2588). Older manuals still say no. On the planned Children and Youth waiver, parents who give attendant care to their children will have to enroll as a provider with a home health agency, according to HHS's December 2025 HOME update.
Three plans.
IA Health Link plans are Iowa Total Care, Molina Healthcare of Iowa and Wellpoint Iowa. Most Medicaid members must enroll in a plan (441-73.3). Iowa Total Care was awarded a new contract starting July 1, 2025.
The program ended.
Iowa Medicaid stopped enrolling individual CDAC providers on July 1, 2025, and processed their claims through dates of service Dec. 31, 2025. Members chose agency attendant care or the Consumer Choices Option. Former individual providers could move to employment with an agency.
The official link for each document. Our own dated copies will sit next to them, so a document is still here when a state moves its website.
69 documents — showing the newest 25