Iowa Code » Chapter 249A — MEDICAL ASSISTANCE
Iowa Code

Iowa Code § 249A.2 (2026)

Definitions

✓ current as of July 2026
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As used in this chapter:

1. “Department” means the department of health and human services.

2. “Director” means the director of health and human services.

3. “Discretionary medical assistance” means mandatory medical assistance or optional medical assistance provided to medically needy individuals whose income and resources are in excess of eligibility limitations but are insufficient to meet all of the costs of necessary medical care and services, provided that if the assistance includes services in institutions for mental diseases or intermediate care facilities for persons with an intellectual disability, or both, for any group of such individuals, the assistance also includes for all covered groups of such individuals at least the care and services enumerated in Tit. XIX of the federal Social Security Act, section 1905(a), paragraphs (1) through (5), and (17), as codified in 42 U.S.C. §1396d(a), paragraphs (1) through (5), and (17), or any seven of the care and services enumerated in Tit. XIX of the federal Social Security Act, section 1905(a), paragraphs (1) through (24), as codified in 42 U.S.C. §1396d(a), paragraphs (1) through (24).\n\nTue Dec 09 22:20:22 2025 Iowa Code 2026, Chapter 249A (116, 3) 3 MEDICAL ASSISTANCE, §249A.3\n\n 4. “Family investment program” means the family investment program eligibility requirements under chapter 239B, except to the extent federal law requires application of the eligibility requirements under chapter 239, Code 1997, as in effect on July 16, 1996.

5. “Group health plan cost sharing” means payment under the medical assistance program of a premium, a coinsurance amount, a deductible amount, or any other cost sharing obligation for a group health plan as required by Tit. XIX of the federal Social Security Act, section 1906, as codified in 42 U.S.C. §1396e.

6. “Mandatory medical assistance” means payment of all or part of the costs of the care and services required to be provided by Tit. XIX of the federal Social Security Act, section 1905(a), paragraphs (1) through (5), (17), (21), and (28), as codified in 42 U.S.C. §1396d(a), paragraphs (1) through (5), (17), (21), and (28).

7. “Medical assistance” or “Medicaid” means payment of all or part of the costs of the care and services made in accordance with Tit. XIX of the federal Social Security Act and authorized pursuant to this chapter.

8. “Medical assistance program” or “Medicaid program” means the program established under this chapter to provide medical assistance.

9. “Medicare cost sharing” means payment under the medical assistance program of a premium, a coinsurance amount, or a deductible amount for federal Medicare as provided by Tit. XIX of the federal Social Security Act, section 1905(p)(3), as codified in 42 U.S.C. §1396d(p)(3).

10. “Optional medical assistance” means payment of all or part of the costs of any or all of the care and services authorized to be provided by Tit. XIX of the federal Social Security Act, section 1905(a), paragraphs (6) through (16), (18) through (20), (22) through (27), and (29), as codified in 42 U.S.C. §1396d(a), paragraphs (6) through (16), and (18) through (20), (22) through (27), and (29).

11. “Overpayment” means any funds that a provider receives or retains under the medical assistance program to which the person, after applicable reconciliation, is not entitled. To the extent the provider and the department disagree as to whether the provider is entitled to funds received or retained under the medical assistance program, “overpayment” includes such funds for which the provider’s administrative and judicial review remedies under 441 IAC ch. 7 and chapter 17A have been exhausted. For purposes of repayment, an overpayment may include interest in accordance with section 249A.41.

12. “Provider” means an individual, firm, corporation, association, or institution which is providing or has been approved to provide medical assistance to recipients under this chapter.

13. “Recipient” means a person who receives medical assistance under this chapter.

14. “Retained life estate” means any of the following:

a. A life estate created by the recipient or recipient’s spouse, in which either the recipient or the recipient’s spouse held any interest in the property at the time of the creation of the life estate.

b. A life estate created for the benefit of the recipient or the recipient’s spouse in property in which either the recipient or the recipient’s spouse held any interest in the property within five years prior to the creation of the life estate. [C62, 66, 71, 73, 75, 77, 79, 81, §249A.2] 83 Acts, ch 96, §157, 159; 84 Acts, ch 1297, §2; 89 Acts, ch 104, §1; 90 Acts, ch 1039, §15; 91 Acts, ch 107, §11; 91 Acts, ch 158, §1, 2; 93 Acts, ch 54, §5; 96 Acts, ch 1129, §113; 97 Acts, ch 41, §25; 2002 Acts, ch 1086, §1, 21; 2010 Acts, ch 1061, §180; 2012 Acts, ch 1019, §96; 2013 Acts, ch 24, §2; 2013 Acts, ch 138, §62 – 64; 2023 Acts, ch 19, §796 Referred to in §135D.2, 239.1, 249B.1, 249F.1, 633C.1 \n

Notes of Decisions
Cited in 13 cases (1 in the last 5 years), 1985–2023 · leading case: In the Matter of the Est. of Arnold Melby, Iowa, 841 N.W.2d 867 (Iowa 2014).
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In the Matter of the Est. of Arnold Melby, Iowa, 841 N.W.2d 867 (Iowa 2014). · cites it 36× “Recognizing the general assembly defined “medical assistance,” “additional medical assistance,” and “discretionary medical assistance” separately in section 249A.2, and observing section 249A.”
Robert F. Colwell, Jr. v. Iowa Dep't of Human Servs., 923 N.W.2d 225 (Iowa 2019). · cites it 4× “§ 249A.2. Webster's defines "individual" as "a single human being as contrasted with a social group or institution.”
Mosher v. Dep't of Inspections & Appeals, Health Facilities Div., 671 N.W.2d 501 (Iowa 2003). · cites it 2× “2 See Iowa Code §§ 249A.2(1), .3. In one of these rules, DHS defines “abuse” to include the exploitation of a “resident” by “a nursing facility employee.”
Exceptional Persons, Inc. New Choices, Inc. Handicapped Dev. Ctr. Life Works Cmty. Servs. Candeo, Vocational Dev. Ctr., Inc., Healthy Connections, Inc. & Krysilis, Inc. v. Iowa Dep't of Human Servs., 878 N.W.2d 247 (Iowa 2016). · cites it 2× “Iowa Code § 249A.2(7) (2015). IDHS is responsible for managing the Medicaid program in Iowa.”
Health Mgmt. Sys., Inc. Ex Rel. Iowa Dep't of Human Servs. v. Laughead, 696 N.W.2d 312 (Iowa 2005). · cites it 4× “Iowa Code § 249A.2(11) (2003). The amended version of section 249A.”
Sunrise Ret. Cmty., Friendship Haven, Presbyterian Vill., Rose Vista Home, Longview Home, United Presbyterian Home, Riceville Cmty. Rest Home, Hubbard Care Ctr., & Happy Siesta Care Ctr. v. Iowa Dep't of Human Servs., 833 N.W.2d 216 (Iowa 2013). · cites it 2× “4(9) directs DHS to adopt rules for determining the method and level of reimbursement for all medical and health services specified in section 249A.2 after considering the following goals: a.”
Iowa Dep't of Human Servs. v. Cmty. Care, Inc., 861 N.W.2d 868 (Iowa 2015). · cites it 2× “§§ 2-7 (codified at Iowa Code §§ 249A.2(11), .39-.43). The legislation further provided: Overpayment — emergency relief.”
Meyers v. Reagan, 776 F.2d 241 (8th Cir. 1985). “§ 1396d(a)(ll); Iowa Code § 249A.2(6). “Related services” includes professional assistance for individuals with speech, hearing, and language disorders.”
Exceptional Persons, Inc., New Choices, Inc., Handicapped Dev. Ctr., Lifeworks Cmty. Servs., Candeo, Vocational Dev. Ctr., Inc., Nishna Prods., Inc., & Krysilis, Inc. v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2014). · cites it 4× “The director is also required to: Adopt rules pursuant to chapter 17A in determining the method and level of reimbursement for all medical and health services referred to in section 249A.2, subsection 1 or 7, after considering all of the following: a.”
Lois Noll & Leonard Noll v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2017). · cites it 2× “4(1) (requiring director of department to determine “the broadest range of eligible individuals to whom assistance may effectively be provided”); 249A.3 (prescribing eligibility rules). The statute authorizes the department to “[a]dopt rules pursuant to chapter 17A [the Iowa…”
EerieAnna Good & Carol Beal v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2019). · cites it 2× “See Iowa Code § 249A.2(7) (“‘Medical assistance’ or ‘Medicaid’ means payment of all or part of the costs of the care and services made in accordance with Tit.”
Mark J. Den Hartog v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2023). · cites it 2× “” See Iowa Code § 249A.2. However, a commonly accepted definition is “to institute and pursue a criminal action against (a person).”
Show all 13 citing cases →
— Iowa Code § 249A.2(1) — 2 cases
Mosher v. Dep't of Inspections & Appeals, Health Facilities Div., 671 N.W.2d 501 (Iowa 2003). “2 See Iowa Code §§ 249A.2(1), .3. In one of these rules, DHS defines “abuse” to include the exploitation of a “resident” by “a nursing facility employee.”
Lois Noll & Leonard Noll v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2017). “4(1) (requiring director of department to determine “the broadest range of eligible individuals to whom assistance may effectively be provided”); 249A.3 (prescribing eligibility rules). The statute authorizes the department to “[a]dopt rules pursuant to chapter 17A [the Iowa…”
— Iowa Code § 249A.2(11) — 3 cases
Health Mgmt. Sys., Inc. Ex Rel. Iowa Dep't of Human Servs. v. Laughead, 696 N.W.2d 312 (Iowa 2005). “Iowa Code § 249A.2(11) (2003). The amended version of section 249A.”
Iowa Dep't of Human Servs. v. Cmty. Care, Inc., 861 N.W.2d 868 (Iowa 2015). “§§ 2-7 (codified at Iowa Code §§ 249A.2(11), .39-.43). The legislation further provided: Overpayment — emergency relief.”
Amended June 15, 2015 Iowa Dep't of Human Servs. v. Cmty. Care, Inc. (Iowa 2015).
— Iowa Code § 249A.2(12) — 1 case
Robert F. Colwell, Jr. v. Iowa Dep't of Human Servs., 923 N.W.2d 225 (Iowa 2019). “§ 249A.2. Webster's defines "individual" as "a single human being as contrasted with a social group or institution.”
— Iowa Code § 249A.2(3) — 1 case
Robert F. Colwell, Jr. v. Iowa Dep't of Human Servs., 923 N.W.2d 225 (Iowa 2019). “§ 249A.2. Webster's defines "individual" as "a single human being as contrasted with a social group or institution.”
— Iowa Code § 249A.2(6) — 1 case
Meyers v. Reagan, 776 F.2d 241 (8th Cir. 1985). “§ 1396d(a)(ll); Iowa Code § 249A.2(6). “Related services” includes professional assistance for individuals with speech, hearing, and language disorders.”
— Iowa Code § 249A.2(7) — 3 cases
In the Matter of the Est. of Arnold Melby, Iowa, 841 N.W.2d 867 (Iowa 2014). “Recognizing the general assembly defined “medical assistance,” “additional medical assistance,” and “discretionary medical assistance” separately in section 249A.2, and observing section 249A.”
Exceptional Persons, Inc. New Choices, Inc. Handicapped Dev. Ctr. Life Works Cmty. Servs. Candeo, Vocational Dev. Ctr., Inc., Healthy Connections, Inc. & Krysilis, Inc. v. Iowa Dep't of Human Servs., 878 N.W.2d 247 (Iowa 2016). “Iowa Code § 249A.2(7) (2015). IDHS is responsible for managing the Medicaid program in Iowa.”
EerieAnna Good & Carol Beal v. Iowa Dep't of Human Servs. (Iowa Ct. App. 2019). “See Iowa Code § 249A.2(7) (“‘Medical assistance’ or ‘Medicaid’ means payment of all or part of the costs of the care and services made in accordance with Tit.”
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