DHS announces temporary Managed Care Organization choice plan

DES MOINES – Recently the Iowa Department of Human Services (DHS) announced that AmeriHealth Caritas Iowa, Inc., will be withdrawing from the IA Health Link program. DHS is focused on ensuring members will continue to receive quality care and to make this transition as smooth as possible, the agency says.

AmeriHealth Caritas members were tentatively assigned to UnitedHealthcare as Amerigroup Iowa does not currently have the capacity to take additional members. Members were notified they were able to make choice to change their Managed Care Organization (MCO), as member choice is a key component of managed care.

Amerigroup Iowa has informed the Department they do not currently have capacity to take any new members. The Department has been in communication with the Centers for Medicare and Medicaid Services (CMS) to keep them informed of what is happening, and will continue to do so.

All new IA Health Link members will be assigned to UnitedHealthcare. In the future members again will have a choice in MCOs and will be notified when that choice is available.

The Department, along with our managed care partners, are working diligently to get member information transferred to UnitedHealthcare, to make sure members and providers are informed, and identify and address areas of concern.

To learn more about AmeriHealth Caritas withdrawing from the IA Health Link program and about the suspension of MCO choice, visit www.IAHealthLink.org.

Prior to this announcement, The Iowa Department of Human Services (DHS) announced that Michael Randol has been appointed director of the Iowa Medicaid Enterprise (IME).

In his new role, Mr. Randol will oversee the $5 billion program which serves more than 600,000 Iowans each year. He transitions to DHS leadership from his post with the Kansas Department of Health and Environment, where he served as the State Medicaid Director. Prior to this he was the Veterans Services Manager with the Department of Commerce.

“Michael Randol is experienced as a leader and has a comprehensive understanding of Medicaid and specifically, managed care,” said DHS Director Jerry R. Foxhoven. “His expertise will be an asset to the Department as we continue improving the IA Health Link managed care program. I look forward to working with Michael as we focus on improved health outcomes and on oversight and accountability of our managed care partners.”

The primary goals of the IA Health Link managed care program are improved quality and access to care, accountability for patient outcomes and creating a more predictable and sustainable budget. Randol’s extensive financial and accounting background will be an invaluable asset as we work to create a sustainable Medicaid program for Iowans most in need.

As the State Medicaid Director for Kansas, Randol was responsible for leading all activities for the state Medicaid program including KanCare, State Employee Health Plan and the State Self-Insurance Fund. He has served his country as a proud member of the United States Air Force, which included assignments in New Mexico, Colorado, Illinois, California, Okinawa Japan and North Dakota.

Randol holds a Master of Business Administration degree from William Woods University with an emphasis on finance, as well as a Bachelor of Science degree in accounting from the University of the State of New York. He begins his new duties with the IME on December 4.