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Iowa Medicaid

Pharmacy Resources

Medicaid Provider Enrollment

Iowa Medicaid recognizes pharmacists as providers, paying for services on the Medical Benefit, effective July 1, 2020.
Iowa Medicaid and the Managed Care Organizations (MCOs) will recognize claims retroactive to July 1, 2020 – SO LONG AS PROVIDER ENROLLMENT IS COMPLETE IN 2021 (before 12/31/2021). For Iowa Total Care, any newly contracted pharmacist will fall under the policy which is a prospective effective date of 30 days after signature on contract.

MCO Pharmacy Reference Grid - Quick access to contact and policy information for both of the contracted MCOs. (Updated 09/2023) (Member login required)

MCO Issue-Resolution

IPA regularly communicates with both MCOs in the state, as well as staff at the Iowa Medicaid Enterprise. We meet quarterly with the Iowa Medicaid Director, Liz Matney, and have the opportunity to relay issues at all levels. If your pharmacy is experiencing any issues related to Medicaid or the MCOs, please contact Emmeline Paintsil, and IPA will assist you to seek resolution. You can also submit feedback through this form.

Additional Resources