Providers, pa­tients op­pose Iowa Med­i­caid waiver re­quest

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

Providers, pa­tients and law­mak­ers in Iowa are urg­ing the CMS to re­ject a waiver re­quest that would per­mit the state’s Med­i­caid pro­gram to be­come ex­clu­sively a man­aged-care pro­gram. Cur­rently, the state ad­min­is­ters the pro­gram through sev­eral de­liv­ery sys­tems, in­clud­ing in­de­pen­dent pri­ma­rycare physi­cians, ac­count­able care or­ga­ni­za­tions and man­aged-care plans.

In Au­gust, Iowa’s Depart­ment of Hu­man Ser­vices awarded Med­i­caid man­aged-care con­tracts to Amer­iHealth Car­i­tas, An­them, Unit­edHealth­care and Wel­lCare Health Plans. The Iowa Hos­pi­tal As­so­ci­a­tion and other crit­ics, in­clud­ing ben­e­fi­cia­ries, say the waiver re­quest will block ac­cess to care for Med­i­caid ben­e­fi­cia­ries and lead to lower provider pay­ments as the man­aged-care com­pa­nies seek to max­i­mize their prof­its.

The state aims to be­gin en­rolling ben­e­fi­cia­ries in man­aged-care plans on Jan. 1, but stake­hold­ers say that’s too soon.

State Sen. Janet Petersen, a Demo­crat, asked act­ing CMS ad­min­is­tra­tor Andy Slavitt to use his author­ity to halt Repub­li­can Gov. Terry Branstad’s “uni­lat­eral” de­ci­sion to “pri­va­tize” Iowa’s Med­i­caid pro­gram.

Some ben­e­fi­cia­ries said they worry their care will suf­fer if the tran­si­tion hap­pens. One uniden­ti­fied per­son de­scribed fears that cer­tain providers and med­i­ca­tions won’t be cov­ered af­ter the tran­si­tion, say­ing, “Be­ing dis­abled, I see many providers, and there are only cer­tain med­i­ca­tions that work for me.”

CMS’ Slavitt has been

asked to in­ter­vene.

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