A major topic of discussion this session has been the Governor’s proposal to privatize Medicaid. This proposal was unveiled in August on 2015 with an implementation date originally set in the fall of last year. This week, the federal oversight committee for Medicaid gave Iowa permission to implement the transition beginning April 1st, 2016.
Originally, there were four companies selected to provide services and manage the state’s program. After a quick court ruling, one of the providers was deemed ineligible; therefore the contract field was reduced to three private providers: Amerigroup Iowa, AmeriHealth Caritas Iowa, and the United HealthCare of the River Valley.
Thirty-nine other states manage their Medicaid program through private carriers. In these states, the time taken to shift to a privately managed system varied from three to five years. No state attempted to shift in less than a year, like the Governor’s plan.
Further, many of the states that have a managed care plan have robust oversight. The State Ombudsman office proposed 170 positions to oversee Iowa’s managed care system. Governor Branstad countered that with saying, “Anything more than two would be overkill.”
The contracting of private managed Medicaid is a $4 billion contract. That is Billion with a capital B. Further, the contractors are for profit companies. They increase profits by cutting costs. What a contractor calls a cost cutting measure, a Medicaid patient may see as a necessary service or treatment. The bottom line is this: oversight is needed to insure the proper use of public monies and protection of some of Iowa’s most vulnerable people.
The Senate currently has a bill to kill the Governor’s plan by terminating the contracts with the three providers. House of Representative leaders have already stated that they do not intend to take up the Senate’s bill. Accordingly, it appears that the road to privatization will continue.
I have opposed the Governor’s plan since its announcement last summer, however I can read the writing on the wall, Iowa is going to move quickly to a privatized program. While I think that decision is a rushed mistake, we in the legislature must take strides to protect Iowans enrolled in the programs. I am told the rush to change to a new system is to save money. One’s cost saving measure in the health system, is another’s denial of service or care.
We in the legislature need to provide legislation that effectively oversees these public contracts and protects the beneficiaries of the program, namely the disabled, the elderly and children. I invite the Governor to join in the effort to not only control costs of the program, but also the quality of the services these private contractors provide and insure we protect Iowans with their health coverage. We owe it Iowa’s most vulnerable to ensure their health care will be provided.
Medicaid Privatization Delayed Again
The Governor’s plan to privatize Medicaid is still not ready, so federal officials delayed implementation to April 1. The federal agency has given final approval on the privatization plan.
The Centers for Medicare and Medicaid Services (CMS) stated that Iowa needs another delay to complete activities needed to ensure a smooth transition, such as completing contracting with providers and training case managers on each managed care organization’s (MCO) case management system. This delay comes after a previous delay that was announced by CMS in December of 2015.
As a result of the delay, the privatization will begin on April 1, 2016, and Medicaid members will have until June 16, 2016 to change their MCO for any reason. For providers, each MCO must contract with any willing provider for physical and behavioral health services until September 30, 2016; and for long-term care services until March 31, 2018.
In addition, the Iowa Senate has already approved legislation to terminate the Medicaid privatization contracts and is also working on a bill to provide more oversight on the transition and implementation of the privatization of Medicaid. However, the House majority party has taken no action on these bills.
CMS will continue to monitor Iowa’s transition to managed care. For questions, Medicaid members should contact at IME Member Services, 1-800-338-8366, IMEMemberServices@dhs.state.ia.us. Medicaid providers should contact IME Provider Services: 1-800-338-7909, IMEProviderCommunications@dhs.state.ia.us.
Medicaid Cannabidiol Passes Committee
Iowa’s current medical cannabidiol law is very limited. This year, the Legislature is again looking at expanding the law that was enacted in 2014 to make the medicine more accessible.
Under the new proposal that passed out of Commerce Committee, the list of eligible conditions a person must have to obtain medical cannabidiol is expanded to include intractable epilepsy, multiple sclerosis, and cancer, if the patient has less than one year to live. Current law only allows for intractable epilepsy.
The bill also allows any licensed physician in Iowa to recommend medical cannabidiol for a patient if they qualify. Under current law, only a licensed neurologist may make recommendation on medical cannabidiol.
In addition, the bill allows for two companies to obtain a license to manufacture and dispense medical cannabidiol in Iowa. The company must pay for all laboratory testing done by the State Hygienic Laboratory at the University of Iowa, and the dispensary must be open for business by July 1, 2017. The bill prohibits smoking and vaping cannabidiol.
The bill will continue to be reviewed by legislators as session moves along.
