Iowa may seek Medicaid reimbursement for inmate hospitalizations

Pool of eligible inmates set to increase next year

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Iowa is among states that do not seek Medicaid reimbursement for inmate hospitalizations, but that may change next year as the pool of eligible inmates increases, officials said.

Iowa is unique in that nearly all prison inmates who are hospitalized go to the University of Iowa Hospitals and Clinics in Iowa City. Sick and pregnant inmates are housed at the Iowa Medical and Classification Center in Coralville, where they can be quickly shuttled to the UI Hospitals.

UI Hospitals doesn’t bill the Iowa Department of Corrections for inmate medical care, which costs between $5 million and $7 million a year. The hospital eats most of these costs now because only pregnant, disabled or elderly people qualify for Medicaid. Some inmates also refuse to sign the Medicaid application, Hospital spokesman Tom Moore said.

But starting Jan. 1, single adults – including inmates – can be eligible for Medicaid under the Affordable Care Act. This expansion means states like Iowa have more to gain by submitting Medicaid claims for inmate hospitalizations, said Iowa Medicaid Director Jennifer Vermeer.

“It’s an area we need to pursue further,” she said.

Iowa has about 8,000 inmates in state prisons. Of those, 4,700 inmates received outpatient hospital care last year and 300 were treated as inpatients. This does not include inmates in Iowa’s county jails, which could also seek reimbursement for inmate hospitalizations.

Although seeking Medicaid reimbursement for inmates has been discussed in Iowa, one of the roadblocks is state match money, Vermeer said. While local governments, in the case of county jails, wouldn’t have to pay for inmate hospitalizations, the state would have to come up with a match for federal funds.

“It’s a very complex issue,” she said. But “it’s good for everyone to spend less if they can.”

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