Friday, March 18, 2016

Iowa to switch to Medicaid managed care; 25,000 people receiving Home and Community-Based Services affected

“Problems With Medicaid Privatization Plague Other States Ahead of Iowa's Switch” is a TV news report from Cedar Rapids, Iowa, looking into a similar plan in Kansas that has been in effect for three years. Kansas has had multiple problems with managed care affecting people with developmental and other disabilities. Here is a link to a video of the report and the written story from 2/29/16

According to, the problems that Kansas has encountered include “a lack of meaningful oversight, confusing reimbursement requirements from the three managed care organizations, or MCOs, who are contracted with the state, and cuts to care.” In Iowa and Kansas, two of the managed care organizations (MCOs) are the same - “Both companies are facing accusations in Kansas of systematically denying claims to turn a profit.”

For people who receive Home and  Community-Based Services (HCBS) (13,000 in Kansas and 25,000 in Iowa), the threat of service cuts is a significant problem.  According to Sharon Spratt, CEO of Cottonwood, Inc.,  a provider of long-term community-based care in Lawrence, Kansas, round-the-clock services are not cheap and it has been a constant battle to maintain them:

“We understood there could be some efficiencies on the medical side,” Spratt said. “But the right service at the right time doesn’t cure our folks. Our folks have lifelong disabilities.”
Spratt said Cottonwood often deals with the same problem of denied or unpaid claims, but most levels of care have remained the same. But following our Feb. 19 interview, Cottonwood received its first notice of an MCO denying all residential care for one of its clients. Cottonwood plans to appeal the decision.

Despite the warnings from Kansas, Iowa is poised to take the plunge into privatization and managed care. Whether Iowa has any better chance of success, remains to be seen. 

More dysfunction from Kansas:  A couple with a 21-year-old daughter with intellectual and developmental disabilities, autism, and a seizure disorder has been waiting since 2008 for state-funded services. 3,450 people are on the waiting list. On a lighter note (?), a woman whose daughter needed a new wheelchair and receives state services, says the state covered the wheelchair, but not the wheels.

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