2017 ISSUE #11
Issue 11, 11/13/2017
Go To Newsletter Archives
Articles in This Issue:
- AMERIHEALTH LEAVES IOWA
- COMMITTEES MEET, DISCUSS HEALTH CARE
- LOCAL ELECTION RESULTS 2017
- ANOTHER MONTH, ANOTHER SPECIAL ELECTION
- MORE CHANGES IN LEGISLATURE
- HEALTHCARE.GOV INSURANCE ENROLLING NOW
- ABLE CONTRIBUTIONS INCREASED
- CANNABIDIOL BOARD MEETS
- GET THIS ISSUE IN PDF
AMERIHEALTH LEAVES IOWA
Lots to talk about this month. First came the news that AmeriHealth Caritas is leaving the state, and will no longer manage Medicaid services to more than 200,000 Iowans. A few days later, DHS told the Medical Assistance Advisory Council that all AmeriHealth members would be transferred to United Health Services (rather than divided between the two remaining MCOs). This is being done to reduce confusion, and make the change seamless. Members still have a choice - they have 90 days to switch to Amerigroup.
DHS also announced that it will delay bringing on another MCO to replace AmeriHealth. DHS has requested proposals from other MCOs wiling to work in Iowa, but new contracts will not begin until July 1, 2019. They want to give a new company time to get ready and ramp up services, and want to give Medicaid members more stability while working on providing them with more choices.
We know this change is causing a lot of concern among Iowans with disabilities. As you can see from the charts below, AmeriHealth served a much larger share of the long term supports & services (LTSS) population, including thousands of Iowans with disabilities.
AmeriHealth Caritas was also the only MCO left to contract with providers for their case management services, which was one of the reasons many Iowans with disabilities decided to go with them (allowing them to keep their case managers). Both United and Amerigroup do case management in-house.
DHS continues to put together resources for members impacted by this change, so watch your mail, your email, and talk to your case managers and providers to make sure you are ready for this change. Some resources are available now:
- Member Letter
- Press Release (annoucement)
- Frequently Asked Questions
- More information will be posted on Iowa HealthLink.
infoNET live tweeted the AmeriHealth announcement and the decision to assign all members to United. If you are not following us on social media, you're missing out on breaking news! Make sure you are signed up to get the latest news, as it happens. Make sure you friend us on Facebook and follow us on Twitter!
COMMITTEES MEET, DISCUSS HEALTH CARE
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.
- 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.
Tickets are free, but limited. You can request tickets at DesMoinesRegister.com/MentalHealth.
LOCAL ELECTION RESULTS 2017
Were you one of the thousands of Iowans that voted in the November 7 local election? If so, you might have been part of some Iowa history! While official results will not be available for another week, here are a few highlights from last Tuesday:
- Polk County was on track to have a record year for voting. After counting up absentee ballots sent in before Election Day, Polk County Auditor Jamie Fitzgerald predicted one of the biggest city election turnouts in nearly three decades.
- One Des Moines City Council race made history - as the most expensive race in city history. Two candidates spent over $300,0000 for their campaigns.
- Iowans elected the first Sudanese-American. Mazahir Salih was elected to the City Council in Iowa City, receiving a whopping 77% of the vote. But this isn't just an Iowa first. She is the first Sudanese born American to be elected to any office in the United States!
- Typical local elections see about 8-10% of those registered voting - Mason City had 36% this year.
Several city councils saw new faces elected, and more familiar faces retired. City elections do not usually get much attention, but they are the place where people often get started in public service, and are the level of government that is the closest, and most accessible, to voters.
Whether you voted or not, get to know your city council members and mayors. Who knows, maybe someday you'll want to run!
ANOTHER MONTH, ANOTHER SPECIAL ELECTION
Last month, Senator Bill Anderson (R-Sioux City) announced he would be leaving the Senate. Voters in Plymouth and parts of Woodbury County will go to the polls on Tuesday, December 12 to pick his replacement. The winner of this Special Election will serve only one year, and will need to run again in November 2018.
Republicans and Democrats will pick their nominees in a special nominating convention, where each party's "central committee" meets and picks their candidate. So far, two people have announced:
- Todd Wendt, a retired LeMars School Superintendent, will seek the Democratic nomination. His father, the late Roger Wendt, served in the Iowa House 2003-2011.
- Rep. Jim Carlin, currently representing Sioux City in the Iowa House, will seek the Republican nomination. He has just finished his first year in the Iowa House of Representatives.
Not sure if you are in this district? You can see a map of Senate District 3 here.
This is the 5th special election held in the last year. Should Rep. Carlin win, it would trigger another (6th) special election, which would probably be scheduled in January. On top of that, there could be more special elections ahead.
Iowa's Secretary of Agriculture is awaiting confirmation for a top post at the US Department of Agriculture. If confirmed, the Governor will appoint a new Secretary of Agriculture. At least three state legislators are rumored to be possible replacements - Rep. Pat Grassley, Sen. Dan Zumbach and Sen. Tim Kapucian. If one of them is appointed, that would mean one (maybe two) more special elections! Will it ever end?
We WILL be re-printing our 2018 Guide to the Iowa Legislature later this year, but in the meantime, you can get updated versions online at: http://www.infonetiowa.org/documents/cms/docs/2017_Legislative_Guide_version_11-29-17.pdf.
MORE CHANGES IN LEGISLATURE
Special elections are not the only things that bring change in the Iowa Legislature. This summer two prominent Senate Republicans from Sioux City were removed from their committee leadership posts, and last month Senate Democrats elected a new Minority Leader.
Senator Janet Petersen of Des Moines became the new Senate Minority Leader in October. Sen. Rob Hogg of Cedar Rapids had led that caucus since their former leader (Mike Gronstal) lost his Senate seat.
Senator Petersen is the Senate Democratic Leader and ranking member on the Commerce Committee. She also serves on the Government Oversight, Judiciary, State Government and Ways & Means committees.
Sen. Petersen graduated from UNI with a degree in Communications and earned a master’s degree in Integrated Communications from Drake University. Before joining the Iowa Legislature, she worked on the 1992 Clinton/Gore Campaign, for the American Heart Association and for Strategic America, a marketing communications firm.
In 2004, Janet proclaimed a goal of making Iowa “the safest place in the nation to have a baby” after losing her own daughter, Grace, to an umbilical cord complication when she was nine months pregnant. That year, she helped Iowa launch its stillbirth registry project which has brought more than $2 million in research funding to our state to help find the causes and cures for stillbirths, which cause more than 26,000 deaths in the United States each year.
In 2008, Sen. Petersen founded a nonprofit organization with four other central Iowa women called Healthy Birth Day. The organization is devoted to reducing the number of stillbirths in Iowa and nationwide through research, education and advocacy. Sen. Petersen lists the 2008 Smoke-free Air Act, which she sponsored, as one of her top accomplishments. Janet is married to Brian Pattinson, who works for Principal Global Investors, and together they have three children.
As you might expect, it has been tough keeping our Guide to the Iowa Legislature updated with all these changes. You can always find our most current version (right now, that's dated 11/10/17) online here.
HEALTHCARE.GOV INSURANCE ENROLLING NOW
Iowans who plan to buy their own health insurance for 2018 can enroll through December 15. HealthCare.gov is the only official government website selling health insurance. Iowans may call 1-800-318-2596 or visit HealthCare.gov to learn about enrolling and to see if you qualify for subsidies to help pay for your coverage.
Local insurance agents, navigators and application counselors can help you review the available plans to find what best fits your needs. To find help close to home, go to localhelp.HealthCare.gov.
Medica is the only insurer offering plans to Iowans who purchase their own health insurance for 2018. Medica will offer three different insurance plans depending on your county of residence. You can choose a Health Savings Account or a co-pay plan, whichever best meets your needs for cost-sharing, deductibles and other out-of-pocket costs. You can look up what these terms mean at www.healthcare.gov/glossary.
- To renew your Medica coverage: Call 1-888-592-8211 or go online to www.medica.com/IndividualRenewal.
- To get started with Medica: Call 1-844-752-6742 or go online to www.medica.com/StayingCovered2018 to learn about your options.
This information was provided by Medica.
ABLE CONTRIBUTIONS INCREASED
Iowans with ABLE savings accounts will be able to save more next year. The total annual contribution limit to an ABLE account will be increased from $14,000 per tax year to $15,000 per tax year beginning in 2018. That means Iowans with ABLE accounts can save an extra $1,000 a year without losing other benefits.
The Stephen Beck Jr. Achieving a Better Life Experience (“ABLE”) Act tied annual contribution limits to the federal tax code, which is changed periodically for inflation. For more information about ABLE accounts, please visit the ABLE National Resource Center at www.ablenrc.org or Iowa's ABLE website at www.iable.gov.
CANNABIDIOL BOARD MEETS
This year the Iowa Legislature expanded the state's limited medical cannabidiol law to allow Iowans with several chronic conditions to legally use the oil of the cannabis (marijuana) plant. Cannabis is legal in one form or another in many states.
The board appointed to oversee the state's expanded medical cannabidiol program met on October 27. The Medical Cannabidiol Advisory Board discussed other state laws around the use of medical cannabis and medical cannabidiol. Their minutes and information presented can be found here.
The Department of Public Health (DPH) reported that nine companies are interested in manufacturing medical cannabidiol in the state, but only one turned in a response to the Request for Proposals. The Medical Cannabidiol Act required DPH to license up to two in-state cannabidiol manufacturers by December 1, 2017. DPH says they are on track to meet that deadline.
You can learn more about who can use medical cannabidiol, and how they can access it from the Office of Medical Cannabidiol (idph.iowa.gov/mcarcp or 515-281-7689). The Board will meet again on December 1, 2017 to discuss recommendations to be included in their annual report.