Under the Golden Dome, Too – Time to Question the Status Quo

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One of the biggest concerns during this transition has been that the timeline is too aggressive and it’s moving too quickly.  However, safeguards have been put in place to ensure that Medicaid recipients experience minimal disruption of services.  For physical and mental health services, there will be a 6 month transition period from January 1 to July 1.  Those services have the shortest timeline because mental health is the only sector of Iowa Medicaid that was previously in managed care.  Additionally, nursing homes will have a two year transition period and will be fully phased in by January 1, 2018.

Earlier this week Governor Branstad announced an extension of the provider safe harbor period by an additional three months to April 1, 2016.  This gives patients peace of mind and allows providers to be fully reimbursed while they have additional time to review contracts.

Another concern has been a lack of communication from the Department of Human Services.  Informational toolkits were sent to Medicaid recipients in September and enrollment packets with enrollment assistance details should already be out to members.  The delay in providing information to Iowans was due to the fact that the federal government had to approve what material was being sent out, and they prevented DHS from sending it out sooner.

Currently, Medicaid members have until December 17 to choose which MCO they would like to manage their care that begins on January 1.  While provider networks are not fully complete, I have been assured that new contracts adding more providers are being signed with MCOs on a daily basis.  Members then have until March 18, when provider networks are more complete and robust, to make a final decision on which MCO they would like to manage their healthcare.

With any big change comes some fear of the unknown.  However, I am optimistic that as long as both the State, health care providers, and consumers engage in constructive dialogue, Iowa’s Medicaid program will be better in future years.  As this process moves forward, the Legislature will keep a close eye on the changes and assist our constituents to ensure they receive the care and services they need.

Additionally, the Department of Human Services has established two toll-free hotlines to troubleshoot any problems that providers or consumers experience during the transition.

  • If a consumer has questions, they should contact Iowa Medicaid Member Services at 1-800-338-8366.
  • If a provider has questions, they should contact Iowa Medicaid Provider Services at 1-800-338-7909.

If you have any questions at all about the state’s transition to managed care, please don’t hesitate to contact me.  You can reach me at linda.upmeyer@legis.iowa.gov or (515) 281-3521.

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