Gazette: Iowa agencies providing elderly care run into Medicaid billing issues

Enrollment information for managed-care organizations in Iowa’s Medicaid privatization plan, photographed in Cedar Rapids on Friday, Dec. 18, 2015. (Liz Martin/The Gazette

Many of the state’s agencies caring for the elderly are running into huge billing issues, resulting in millions of dollars of unpaid Medicaid claims and forcing some to take out loans to stay in operation.

The state handed over its $5 billion Medicaid program, with 560,000 beneficiaries, to three private insurers April 1. Since the move, providers — from Meals on Wheels to rehabilitation therapists — have reported billing problems ranging from incorrect fees to denied claims.

During a Thursday news conference highlighting the importance of Medicaid managed-care oversight — which starts July 1 — Sen. Liz Mathis, D-Cedar Rapids, said she spoke with an executive at the Iowa Health Care Association, which represents home care agencies, nursing homes and assisted living facilities. The executive told her that 150 members have called in the past two days because MCOs are rejecting claims and not paying for millions of dollars of care.

“Health care providers are businesses,” Mathis said. “They pay taxes, employ people, contribute to our communities and care for people.”

Four agencies spoke Thursday at the news conference, and all reported having problems obtaining consistent answers from MCOs — with many phones calls and emails going unanswered, they said.

Read the full article at The Gazette>>

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