Iowa Admin. Code r. 441-79.6
Current through Register Vol. 47, No.14, January 8, 2025
Providers of medical and health care wishing to participate in the program shall execute an agreement with the department on Form 470-2965, Agreement Between Provider of Medical and Health Services and the Iowa Department of Human Services Regarding Participation in Medical Assistance Program.
Exception: Dental providers are required to complete Form 470-3174, Addendum to Dental Provider Agreement for Orthodontia, to receive reimbursement under the early and periodic screening, diagnosis, and treatment program.
In these agreements, the provider agrees to the following:
This rule is intended to implement Iowa Code section 249A.4.
Iowa Admin. Code r. 441-79.6