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Exceptions to Policy (ETP)

Printable PDF of FAQ at this link.
What is an Exception to Policy?

An Exception to Policy (ETP) is special permission from the Iowa Department of Health and Human Services (HHS) to do something that is normally not allowed under the Iowa Administrative Code.


What is a Waiver of Administrative Rules?

This is the legal term for an ETP. Both terms mean the same thing.


Why might I need an ETP?

You might ask for an ETP if you need something that does not fit within standard Medicaid rules. Examples include:

  • Requesting to have certain rules waived for your specific situation
  • Requesting more services than normally allowed
  • Requesting to pay a provider a different rate than Medicaid typically pays
  • Requesting medical equipment that Medicaid does not usually cover

Who can request an ETP?

You can request an ETP on your own using the form liked here, to the HHS website. More information can be found by following this link. If you have a case manager, it can be helpful to work with them. They can ensure your request is complete and provide supporting information.


What type of information should I include in my ETP request?

Your request should clearly explain:

  • Why you need the ETP
  • What may happen if it is not approved
  • What other services or equipment you have tried and why they did not meet your needs
  • The cost of what you are requesting and, if relevant, why it is the most cost‑effective option
  • If a doctor or medical provider is recommending what you are asking for, include letters of support, medical records, or other documentation from them.
What if my ETP is denied?

ETP decisions are granted at the discretion of the Director of the Department of Health and Human Services. A denied ETP cannot be appealed. However, you may ask the Director to reconsider by:

  • Submitting a new ETP request, or
  • Writing a letter to the Director asking for a different decision

More information can be found by following this link.

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Copyright © 2026 · DISABILITY RIGHTS IOWA · All rights reserved.
Information contained on the website is for informational purposes only and does not constitute legal advice. Neither the information contained on the website nor the use thereof by a site visitor creates a contract or an attorney-client relationship. There is no promise or warranty as to the accuracy, completeness, adequacy, timeliness, or relevance of the information contained on the website. Disability Rights Iowa is not responsible for the content of any third party comments posted on Disability Rights Iowa’s site or any site accessible through a hyperlink on the Disability Rights Iowa’s website.

DISABILITY RIGHTS IOWA is committed to providing a website that is accessible to the widest possible audience, regardless of technology or ability.

We are actively working to increase the accessibility and usability of our website and in doing so adhere to many of the available standards and guidelines. If you require any of DRI's resources on this website translated into another language including a foreign language or ASL, please email contact@driowa.org with your request.

ACKNOWLEDGEMENT
The following federal authorities share in the partial cost of funding this website: The U.S. Department of Health and Human Services, Administration for Community Living (ACL) and the Substance Abuse and Mental Health Services Administration (SAMHSA); the U.S. Department of Education, Rehabilitation Services Administration (RSA); and the U.S. Social Security Administration (SSA). Although SSA reviewed certain publication for accuracy, it does not constitute an official SSA document. The contents do not necessarily represent the official views of ACL, SAMHSA, RSA, SSA, or any other funder. We developed this website partially at U.S. taxpayer expense.