Iowa: The "HOME" Waiver Transition Chaos

Iowa’s HOME waiver launch may disrupt IDD billing as prior authorizations fail to migrate, risking payment delays in October 2026.


The Hardship: Replacing the Foundation in Mid-Year

Iowa’s HOME (Hope and Opportunity in Many Environments) Project is set to launch its first phase on October 1, 2026, replacing four of the six existing disability waivers with new age-based "Children and Youth" and "Adults with Disabilities" waivers. While meant to simplify, the transition is anything but.

RCM Insight: Authorization "Black Holes"

For IDD providers, the primary hardship is the authorization migration. As the state shifts from the "Brain Injury" or "Health and Disability" waivers to the "Adults with Disabilities" waiver, many existing Prior Authorizations (PAs) are failing to port over correctly to the MCOs (Molina and Wellpoint). RCM teams should plan for an "Authorization Audit" in September to prevent a total revenue stoppage on October 2.

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