Pat Giorgio anticipated some problems with the transition of state-run Medicaid to three private management companies, but she didn't quite anticipate the breadth and depth of the woes the transition would cause for Evergreen Estates, residential communities she founded to serve the elderly in Cedar Rapids.
"Because I heard that it might be a difficult transition, I got a line of credit with my bankers of $100,000. I'm billing roughly $40-50,000 a month to Home and Community Based Services, and I've used up that $100,000 in my line of credit."
Giorgio says before the transition she was paid in eight days or so. Now, she says, 15 percent of her claims from three months ago have not been paid.
Just last week, Senator Liz Mathis, Democrat from Cedar Rapids, held an out-of-session meeting of the Human Resources Committee. In it, she questioned the three MCOs about billing and other oversight issues, and heard from providers like Giorgio who were having issues with the new system.
"We did hear from Micki Stier, who is the head of the IME [Iowa Medicaid Enterprises], that they were ready to go on January 1st, and then we heard they were ready to go on March 1st, and then on April 1st. And clearly this transition has been pretty bumpy. [...] To try to change a system that is this large between September and December and be ready to go January 1st was an impossibility," says Mathis.