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MANAGED CARE OVERSIGHT STALLS (AGAIN)

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The Senate has passed a comprehensive (some would argue too comprehensive) Medicaid oversight bill intended to hold the three managed care organizations (MCOs) accountable for the promises made in their proposals to the state, and make sure the Medicaid system continues to meet the needs of the Iowans it serves.  That bill passed with bipartisan support in the Senate (you can see how your Senator voted here). 

After the bill died in the second legislative funnel deadline, the Senate Government Oversight Committee introduced an identical, "funnel proof" version of the bill to keep the discussion going.  To date, the House has not yet put out its version of oversight, but is said to be working on one that reflects best practices in other states.  One legislator indicated they used information they got from expert testimony during the Health/Human Services Budget subcommittee to develop their plan. 

Rep. Lisa Heddens (D-Ames) tried to force a House debate on the Senate's oversight plan, but her amendment to the Supplemental Appropriations Bill was ruled not germane (that is, it addressed a different subject).  So no vote was allowed at that time.  Rep. Patty Ruff (D-MacGregor) also tried to amend the bill to require MCOs to pay out-of-network providers at full rates if they have an existing relationship with the Medicaid member, including providers that are out of state (like Mayo).  That amendment was also ruled not germane, as was Rep. Bruce Hunter's (D-Des Moines) amendment to end the MCO contracts.

Both House and Senate agree that some type of oversight is needed of the new Medicaid managed care system, and that it include a way for stakeholders to provide feedback, legislators to see and act on relevant data, and DHS to do course corrections as needed.  How that looks is yet to be seen - but watch the website (www.infonetiowa.org) and Facebook (www.facebook.com/infonetiowa).

Dubuque native Bill Stumpf was in Des Moines two weeks ago advocating for oversight of the Medicaid managed care system. He is pictured here with his Senator Pam Jochum. Both are parents of children with disabilities who are affected by the change to managed care.