DHS Withholding $43 Million from January Payment to Medicaid Provider

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DES MOINES, Iowa  —  The Iowa Department of Human Services is withholding a $43 million payment from one of the groups that manages the state’s Medicaid program due to unpaid claims.

Iowa’s Medicaid Director, Mike Randol, informed Iowa Total Care, Inc. on Friday that the company will not receive its fully scheduled capitation payment for the month of January.  Randol says in a letter to the company that it has 106,000 unpaid claims currently.  Randol says Iowa Total Care has also had issues with incorrect pricing and payments to providers for months.

The DHS says the money will be released once Iowa Total Care corrects issues with claim payments and other reporting issues.

Iowa Total Care is one of two organizations that manage Iowa’s Medicaid payments.

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