Speaker Upmeyer’s Weekly Newsletter

UTGD

Unprecedented Oversight

We started this week off with a demonstration of new lighting for the State Capitol Building.  Musco Sports Lighting, based out of Oskaloosa, has graciously donated this new lighting to replace the decades old equipment that the Capitol currently uses.  The state will only have to pay for installation of the new lighting system which is more energy efficient and will save the state money on energy costs.  The new lights make the Capitol look more beautiful than it did before!

This week, the House released our oversight plan for Medicaid Modernization.  Our approach will require an unprecedented amount of data and reporting, from the Center for Medicare and Medicaid Services (CMS), the Iowa Department of Human Services (DHS), and the three managed care organizations (MCOs), to be submitted to the legislature for review.  This will provide legislators with a wide assortment of figures and information on the Medicaid program that has never been available in the past.

This plan ensures that consumers are protected, patient health and financial outcomes are monitored and transparent, and the integrity of our health care system remains.

Consumer Protections
Medicaid patients must be able to have access to protections and advocates when needed to ensure that they are receiving the high-quality healthcare that they expect.  Our plan requires that the legislature receive reports on consumer protections like:

  • Customer service satisfaction including call center performance, grievances and appeals filed, and how timely issues are resolved with DHS and the MCOs
  • The number of doctors and providers that are available to patients to ensure adequate access
  • The total number of Medicaid patients and how that changes over time

Healthy Outcomes
One of the main goals of Medicaid Modernization is to promote wellness and healthy living.  However, we need a way to track whether or not people are becoming healthier, which was never part of the old Medicaid system.  As part of our plan, the legislature will receive detailed reports on outcomes like:

  • Annual health care effectiveness data to ensure that patients are becoming healthier
  • Specific reporting on vulnerable Medicaid patients like those with special needs, behavioral issues, and the elderly
  • The percentage of claims paid and denied to confirm that patients are receiving the care they need
  • Cost savings to the Medicaid program including the amount spent on medical care versus administrative costs

Program Integrity
Finally, federal, state, and contractual safeguards are in place for Medicaid Modernization to prevent, detect, and eliminate fraud, waste, and abuse.  Even with all of these protections, the legislature will be monitoring to ensure efficient and effective use of tax dollars and will be able to act on any cases of fraud or abuse.

Equally important is that all of this information will be made public online for Iowans to view.  This provides a level of transparency that the Medicaid program has never before seen.  While patient-specific information will not be made public, aggregate data and summaries will be available in an easy to read format so that Iowans can also review the information themselves.

This plan offers Iowans the assurance that the health care of Iowa’s most vulnerable are not being put in jeopardy.  As the new system continues to roll out, House Republicans will keep a watchful eye on the transition to ensure that Iowans continue to receive the care that they count on.

One final note is that this week the House and Senate agreed to joint budget targets for the 2017 fiscal year budget.  The agreed upon amount is lower than both ongoing revenue and the state’s expenditure limitation, totaling $7.349 billion.  This budget agreement continues to stand by House Republicans’ budget principles of spending less than the state collects and not using one-time funding to pay for ongoing needs.  This spending plan will allow us to invest in the priorities of Iowans in a responsible way.

As always, please keep in touch.  As legislation is moving forward, feel free to send me comments, questions, or feedback that you may have regarding issues before us in the House. I can be reached at linda.upmeyer@legis.iowa.gov or (515) 281-3521.

 

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