Hundreds Denied Medicaid Services Under Privatization; Lawmakers Object

Dec 18, 2017

State legislators of both parties Monday grilled representatives of the for-profit companies who manage Iowa’s health care program for the poor and disabled, after a report was released about how many patients are losing health care services.  

The director of the Managed Care Ombudsman Program presented the report to the legislature’s Health Policy Oversight Committee.

That's an inaccurate characterization. -Kim Foltz, United Health Care

It showed that denial, reduction, or termination of services is the number one complaint of Medicaid recipients under the privatized program.

The report covered complaints from October of 2016 through September of 2017.

“During this time period, Managed Care Ombudsman received a total of 4187 contacts,” said director Cindy Pederson.   “1819 of those contacts were related to services being reduced, denied, or terminated.”

Rep. Rob Taylor (R-West Des Moines) demanded an explanation from one of the representatives of the for-profit companies appearing before the committee.

“This report card says, perception or reality, that we're denying services or te

Rep. Rob Taylor (R-West Des Moines)
Credit Joyce Russell/IPR

rminating services to patients who thought those services were part of the program," Taylor said.  “Would you like to respond to that?” 

“I’d like to say that’s an inaccurate characterization,”    said Kim Foltz, CEO of UnitedHealthcare

Community Plan of Iowa.  

“So the ombudsman report is wrong?” Taylor asked.

“It is an inaccurate representation to have a general statement across the board that says we are not delivering the services,” Foltz replied.   “There are certain circumstances where people are aggrieved by the fact that they believe they need it but there isn’t support for those services.”

The report said the complaints are coming in particular from patients receiving home and community-based services.   

So the ombudsman report is wrong? -Rep. Rob Taylor

Rep. John Forbes (D-Urbandale) asked the company representatives about reports he has heard that case managers are being paid bonuses to reduce services for Medicaid recipients.

“Can you tell me if your organizations pay bonuses for case workers or care coordinators?” Forbes asked.

“Here’s my very strong response,” Foltz said.  “Absolutely not.”

“Unequivocally no,” added AmeriGroup Iowa President Cynthia McDonald.   “Absolutely not.”