Iowa administrators are still negotiating how much they’ll pay national insurance companies to run the state’s $5 billion Medicaid program in fiscal year 2020, which starts Monday.
Hundreds of millions of state and federal dollars are on the table in the extended contract negotiations between state officials and the insurance companies. The companies, also known as managed care organizations, cover nearly 600,000 poor or disabled Iowans on Medicaid.
The same thing happened last summer. Payment negotiations stretched into August, nearly two months after the insurance companies’ contracts took effect for the year. The Iowa Department of Human Services wound up agreeing to give the companies a $344 million raise — an 8.4% increase in state and federal money — for fiscal year 2019.
Medicaid Director Mike Randol said in an interview Wednesday the negotiations for next fiscal year are going well. “We’re very close to finalizing those,” he said.
He declined to estimate how much more money the state will have to spend on the program, but he said any increase would include money for initiatives legislators approved, such as higher reimbursement rates for nursing homes that care for Iowa Medicaid members.
The closed-door contract negotiations grind on as Iowa’s privatized Medicaid program continues to draw debate. Supporters, including Randol and Republican Gov. Kim Reynolds, say private management saves money over what Iowa would have spent on a state-run Medicaid system, as it did until 2016, and provides more effective care. Critics, including many health-care agencies, patient advocates and Democratic legislators, say Medicaid privatization has led to cuts in services without producing promised savings.
UnitedHealthcare has withdrawn from Iowa’s program, effective July 1. Despite receiving the 8.4% pay raise last summer, the once-largest managed care company in Iowa said it continued to lose millions of dollars covering about 425,000 Iowans on Medicaid. Iowa Total Care, a company owned by the national insurer Centene, is taking its place.
Iowa Total Care is expected to cover about 230,000 Iowa Medicaid members starting July 1, state officials said. Amerigroup, which has participated in Iowa Medicaid since the program was privatized in 2016, is slated to increase its membership from about 200,000 to about 345,000.
Randol said the two companies are prepared to cover health care for their members. Both firms have hired enough staff members, set up bill-paying systems and signed contracts with a sufficient number of hospitals, clinics and social service agencies, he said. “I’m very confident they are ready to provide service starting July 1,” he said.
Some Iowans who depend on Medicaid are skeptical
Date: July 10, 2019
Source: Des Moines Register