Gazette: Managed Care Year One: Some beneficiaries, providers still face real challenges


State Sen. Liz Mathis listens to home health care providers discussing billing challengers during a news conference on the difficulties facing care providers and their clients after the first three months of managed care of Medicaid in the state of Iowa at the Kirkwood Training and Outreach Service Center in Marion on Thursday, June 30, 2016. (Cliff Jette/The Gazette)

It’s been three months since Iowa handed over its $5 billion Medicaid program to three private insurance companies.

In the months leading up to that transition, opponents — including Iowa Senate Democrats and many beneficiaries and providers — loudly asked if the timeline was too crunched, if the provider network was ready and if services would be cut to achieve any potential savings.

The switch was twice delayed by the federal government, the state tossed out a contract with one managed-care organization (MCO) and a group of Iowa hospitals even filed an injunction in district court to stop the move.

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State Sen. Liz Mathis, D-Cedar Rapids, said she’s receiving the same number of calls and emails from constituents at the end of June as she did in early April. They range from a father trying to get a hearing aid for his disabled daughter to home health care providers seeing a drop in approved hours for clients.

State senator Liz Mathis thanks home health care providers for sharing their problems getting paid by managed care companies during a news conference on the difficulties facing care providers and their clients after the first three months of managed care of Medicaid in the state of Iowa at the Kirkwood Training and Outreach Service Center in Marion on Thursday, June 30, 2016. (Cliff Jette/The Gazette)

“I can’t get to them all,” she said, adding she sends many requests for help along to DHS. “It feels like one big circle. DHS calls and does their customer service, but there’s still no resolution.

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Mathis — a staunch opponent to the privatization plan from the start — said she’s been frustrated by Branstad’s view on the transition, saying his office is not acknowledging real problems.

She and other Senate democrats are holding listening posts throughout the summer to give enrollees and beneficiaries a chance to discuss any unresolved problems.

Mathis held the first meeting of the series in Marion at the end of May. More than 65 people attended and asked questions of representatives of the state and MCOs for more than two hours.

The second meeting, hosted by Sen. Chris Brase, D-Muscatine, took place Tuesday in Muscatine. Brase said the MCOs were invited to attend his listening post but ultimately decided to not come.

He heard from more than a dozen individuals, including a representative from a pediatric clinic in Southeast Iowa that has not received any payments from one MCO since May.

“They’re taking out a loan just to make payroll,” he said. “They may have to turn down clients if they don’t get paid. And they’re feeling like the bad guy.”

Read the full article at The Gazette>>


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