State Audit Finds Iowa’s Two MCO’s Non- Compliant

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DES MOINES, Iowa– The Iowa State Auditor is investigating Iowa’s Medicaid Program.

Rob Sand’s audit found Iowa’s two Managed Care Organizations are non-complaint.

“It’s the state of Iowa’s responsibility to see to it that the MCO’s act according to their contracts,” Ankeny resident Rick Durham said.

Auditor Sand sent a letter to the Department of Human Services saying Amerigroup and United Healthcare violated their contracts with the state in their treatment of two quadriplegics.

The patients were informed more than 30 days ago that their providers were ending services.

“It’s up to the MCO’s to make sure that those individuals are taken care of and that there are no gaps in their service,” Sand said.

Instead the audit says the MCO’s pushed the individuals to move into a nursing home.

“These two individuals had the courage to say no and had the courage to work on their behalf and if these folks go into nursing homes that’s often time more expensive for taxpayers,” Auditor Sand said.

Durham’s son has severe autism. Similarly he is left advocating for his son’s continued medical services.

“Our biggest concern is, and it always has been, what’s going to happen to my son when I am no longer here to advocate for him,” Durham said.

Auditor Sand says the goal of the audit is figure how widespread the issues are.

The Department of Human Services says it has received the letter and is looking into the issues.

United Healthcare says: “We remain committed to ensuring a smooth and seamless transition for the people we serve in Iowa”.

Amerigroup Says: “Amerigroup takes privacy laws regarding our members’ privacy seriously, so we are unable to comment on any member-specific situation. Amerigroup is proud to have served Iowans enrolled in Medicaid since managed care was introduced here in 2016. We remain as focused as ever on providing access to the medical care and support services our members need. We continue to work closely with our state partners to improve the Medicaid program for those who rely on it, and continue to ensure compliance with our contractual obligations”. 


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