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The Medical Assistance Advisory Council (MAAC) and the Legislative Health Policy Oversight Committee did not have a shortage of issues to discuss when they met the week of November 6.  Medicaid stakeholders and legislators heard presentations from the three managed care organizations (MCOs) and the Iowa Association of Community Providers.

Here are few highlights of the meeting. You can read public testimony and presentation materials from the Health Policy Oversight Committee meeting here, and from the MAAC here.

  • DHS Director Jerry Foxhoven said they would do "everything possible" to help United build capacity to meet the needs of the 200,000 Iowans impacted by the AmeriHealth departure.  He also said:
    • AmeriHealth will remain in Iowa for at least 180 days to make sure payments are processed and the transition to United is smooth.
    • United's contract requires them to remain in Iowa through June 30, 2017.  Amerigroup's contract requires at least 90 days notice if they plan to call it quits.  This was changed from the current 30-day notice that was used by AmeriHealth.

    • New Medicaid cards will be mailed out to Medicaid members affected by the change as soon as possible, so members should watch the mail.
  • Sen. Liz Mathis (Cedar Rapids) asked if United would guarantee that the affected people could keep their current case manager.  DHS said United will need to hire more case managers, and will probably want to hire the case managers currently providing services.  They said their goal is to keep people with their case managers - but they did not promise to continue existing AmeriHealth case management contracts.
  • Rep. Rob Taylor (West Des Moines) asked if DHS could provide examples of what is going well. " You said that you want the best service for your members and will not be satisfied unless people get the service they need," Taylor remarked.  "Providers continue to express displeasure about not being paid timely, or not being paid at all.  Patients say they are not receiving services they once had...Do you feel you’ve done a good job thus far, and give me a couple wins to give me some assurance that this isn’t just a bump in the road."    DHS stated they hear from many individuals that are happy with the way things are going, but added that a system that serves 1 in every 4 Iowans will not please everyone.
  • Sen. Mark Chelgren (Ottumwa) urged United to reach out to individuals with complex needs and work with their providers to make sure needs are met.  He also asked DHS to spend extra time with individuals who were first assigned to United, and then chose to move to AmeriHealth.  He said it would be hard for someone who spent the time to change from United to AmeriHealth, only to find themselves back with United.   He wanted to make sure those individuals got some extra attention.
  • Legislators asked about "clean claims" and requested information about why claims are being rejected (so if there is a common reason, that can be addressed). 
  • Craig Syata of the Iowa Association of Community Providers said that 80% of the people his association's members serve are with AmeriHealth.  He said the change was going to be difficult to manage because it comes at the same time they have a new payment system going into place (tiered rates).  He made several suggestions:
    • Fully fund the ID waiver, which "has been underfunded from day 1."  
    • Recognize AmeriHealth providers as a part of the United network (for at least a few months).
    • Extend prior authorizations for services that expire in late November or early December.
    • Take more time to implement tiered rates (2,600 Iowans with intellectual disabilities served do not have a functional assessment score, which determines how much a supported community living provider will be paid for their services - yet tiered rates are to begin December 1).

If you missed this meeting, there is still an opportunity to offer your two cents worth.  The final Medicaid public comment meeting for 2017 has been changed to December 5 in Des Moines.  Unfortunately this conflicts with a gubernatorial candidate forum on mental health that is being hosted by Des Moines University and the Des Moines Register.   Details on the meetings are below - you can always find these and other meetings on our calendar here.

Tuesday, December 5, 2017 (5 - 7 pm) | Iowa HealthLink (Medicaid) Public Meeting
Des Moines Central Library, Meeting Rooms 1 & 2
1000 Grand Ave, Des Moines, IA 50309
Public may comment on Iowa's Medicaid system; DHS and MCOs will be present.
Tuesday, December 5, 2017 (6:30 - 8 pm) |Mental Health Forum with Candidates for Governor
Des Moines University, Student Education Center
3200 Grand Ave, Des Moines, IA 50312
Des Moines University & Des Moines Register will welcome candidates for Iowa governor for a conversation on how to fill the gaps in the state’s mental health care system.  Register political columnist Kathie Obradovich will moderate. 
Tickets are free, but limited.  You can request tickets at