Senate Human Resources Committee Meets After Issues with Medicaid Privatization Raised

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DES MOINES, Iowa – Lawmakers came back to the statehouse for a rare summer hearing Tuesday.

The Senate Human Resources Committee met after concerns were raised from an Iowa health provider survey.

For hours, members of the committee heard from providers and caretakers about the problems they're having with the Medicaid switch after claims providers have seen increased costs, reduced services and are not getting paid on time.

"What happened since the transition to the new Medicaid plan, Orchard Place is awaiting payment from the MCOs in the amount of $978,370,” said Anne Starr, CEO of Orchard Place.

Starr said on top of the payment, the transition has also taken its therapists away from client care.

“I had a therapist in our residential program stop me and really, really, deflated say ‘I have spent more time this week on the phone with managed care companies than I have spent with kids,’ not why he gets up in the morning to come to work,” said Starr.

Lawmakers say the hearing was a chance to publically document all the problems.

“I think the transition has been rugged, it`s been sloppy,” said Liz Mathis, (D) Chair, Human Resources Committee. “I think there`s a disconnect in what we`re seeing in the data and what we`re hearing from providers.”

But the Iowa Department of Human Services says it’s only seen a 10-15 percent denial rate in claims which it says is similar to the previous program.

“As we move to a new system we want an efficient program, we want a program that pays accurately, through medically necessary claims and that`s what these state of the art systems will help us do,” said Amy McCoy, Iowa Department of Services, PIO.

Lawmakers also heard from some caretakers as well as a union representative about similar problems.

The Iowa Department of Human Services says it expected some bumps through the move to privatized Medicaid and will continue to work with providers to answer questions and concerns.


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