State Senators Frustrated With Lack Of Medicaid Info From DHS

Mar 16, 2016

Medicaid officials from the Iowa Department of Human Services shared with state senators on Wednesday how the department plans to make sure Medicaid recipients are safe and receive necessary services, once the Iowa's Medicaid system is privatized on April 1.

A major criticism of privatization is that profits are prioritized over quality of care, but Medicaid Director Mikki Stier says if the healthcare management companies don't meet compliance standards, her department can impose penalties. These include withholding payments, reassigning people to another managed care organization, or even ending the contract.

"This is a comprehensive contract monitoring plan designed to ensure the program goals are achieved, to improve quality, promote accountability for outcomes, and create a more predictable and sustainable Medicaid," says Stier. 

Several state senators seemed unimpressed by these penalties, telling Stier they doubt Iowa Medicaid is ready for privatized management since are being inundated with concerns from constituents. Common complaints are a lack of communication from the healthcare companies taking over Medicaid, and a fear that providers won’t be in network.

State Senate President Pam Jochum, a Democrat from Dubuque, told Stier that after doing her own research she found the managed care network in her community was sparse. 

"Tell me what I should tell people. What’s the advice I should give people on what they should do when in two weeks this goes live?" Jochum asked Stier. 

Stier replied that the private healthcare companies are adding more providers daily, and that these companies can create single-case agreements to pay out-of-network providers to see a patient.  The response did not seem to pacify Jochum or many of the other senators, who plan to have Stier testify again in the next couple weeks. 

However, with the privatization deadline a mere two weeks away, it's questionable whether any oversight legislation can be passed by that time.