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The state's move to Medicaid managed care has been rocky from the beginning.  Every week there is another twist that threatens the stability of the system.  It's no surprise that many Iowans with disabilities are confused, scared, and angry.  

In the past month, AmeriHealth Caritas has left the state and all of its members were moved to United. About 10,000 former AmeriHealth members had asked to change to Amerigroup, which didn't have capacity.  Instead, the state is temporarily managing their care until Amerigroup has capacity, or another MCO is added.  But no one knows what "temporary" means.  

Last week, United began telling providers that they would be ending the successful Integrated Health Home (IHH) program for AmeriHealth transfers that are not receiving habilitation or children's mental health waiver services.  This impacts approximately 5,000 Iowans with disabilities, and could be effective at the beginning of the year.    

If you are unfamilar with the IHH program, it was created in 2013 to help Iowans with serious emotional disorders and serious mental illnesses receive the support they need in the community through intensive care coordination.  Ironically, the IHH program was created by a managed care organization (Magellan) to improve outcomes, allow individuals to experience recovery while living safely in their communities, and ultimately save Medicaid dollars.

At this point, we do not know if this change will be allowed, and if the state has any say in the change.  Because these changes are happening so quickly, we do not want to add to the confusion by printing something in a newsletter that will be reversed or revised the next week.  It's easy to feel like you cannot make a difference, but there are things you can do to take control of your care:

  • Let people know what's going on with your Medicaid services.  Tell your story. You can do this through traditional means - emails, letters, calls, visits. Or you can use social media to get your story out.  Tweet, post on legislator facebook pages, or send them a videotaped advocacy message.  In 2018, we will be collecting video advocacy messages throughout the session, and sending them to legislators.  Use your smart phone or YouTube to tape a 3-5 minute message. What's working? What's not? What can your legislators do to help? You can send us your video messages at infonet@idaction.org.
  • File a complaint with the Long Term Care Ombudsman Office. Each month the Managed Care Ombudsman Program submits a monthly report to the Federal government. The Managed Care Ombudsman Program has a complaint form that members (or their representatives) can use. The complaint form can be a valuable resource to inform stakeholders and decision makers about member experiences. Members may select if they would or would not like to be contacted by a Managed Care Ombudsman to discuss their complaint, but please note that this is an internal Managed Care Ombudsman process and is separate from the MCO grievance and appeal process. You can submit the complaint form by mail, fax, or email:
Office of the State Long-Term Care Ombudsman
                Attn: Managed Care Ombudsman
Jessie M. Parker Building
510 E 12th Street, Suite 2
Des Moines, IA 50313-9025 
515-725-3313 (fax)
ManagedCareOmbudsman@iowa.gov (email)
  •  Check the DHS website frequently for updates.  DHS has been posting information and frequently asked questions regularly (http://dhs.iowa.gov/ime/members), so make sure you look there first to get your questions answered and call the Medicaid member hotline for answers to questions that are not listed:
1-800-338-8366 (Toll Free); 515-256-4606 (Des Moines Area); 1-800-735-2942 for interpreter services (hearing disabilities, difficulty speaking, Spanish)
  • Talk to your lawmakers.  Legislators have been hearing stories like yours for the last year, so do not hesitate to share yours.  If you do not want to make a video, email or call your legislators (or invite them to sit down over a cup of coffee to talk).  You can find out how to contact your legislators here.

In the words of former First Lady Eleanor Roosevelt, "Do one thing every day that scares you" and "It's not fair to ask of others what you are not willing to do yourself."  So take action - even if it scares you!