Uncertainty Continues Among Medicaid Recipients

Date posted - December 10, 2015

Des Moines, Iowa — Thousands of Iowans who are on Medicaid are supposed to decide by Thursday, December 17th, which of four Managed Care plans they want to sign up with. But several providers have not yet decided which plan or plans with which to affiliate.
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Governor Terry Branstad’s administration has essentially extended the deadline for Iowa health care providers who’ve not yet signed contracts with any of the private companies hired to manage care for the 560-thousand Iowans who are on Medicaid. Branstad has aimed to have managed care for the Medicaid program start January 1st, but hospitals, doctors and other health care providers have complained the process has been rushed and they’ve lacked enough details to make business decisions.

The “Safe Harbor” for providers is extended until April 1st, according to Branstad. That means all Medicaid providers in Iowa will be able to receive full reimbursement at existing rates for any care they provide in the first four months of the year, even if they’re not yet signed up with one of the chosen private companies that will be managing patient cases, says Branstad.

A written statement from the governor’s office described the move as a way to provide “peace of mind” to Medicaid patients who’re worried they’ll have to change doctors on January 1st.

Iowa Medicaid spokesperson Amy McCoy says that medicaid recipients still need to make a choice by the 17th, or accept the tentative managed care plan selected for them.

McCoy says Medicaid recipients can contact the plan by phone or on their web sites to see which providers are on their list. She says providers, however do not have a deadline for when they have to sign up.

The federal government must provide a waiver to the State of Iowa for the switch to managed care for Medicaid patients. She says federal officials are in the state this week to analyze the proposed switch.

McCoy says that means that even if federal officials deny the waiver, the old system remains in place. She says Medicaid signup criteria also remain unchanged in the new system.

An administrative law judge in the Iowa Department of Inspections and Appeals has said the state should cancel its contract with WellCare, one of four private companies hired to provide managed care. McCoy says that situation has not yet been resolved, and as of now, WellCare remains on the list.

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