Some legislators concerned about sign-up numbers

DES MOINES - More health care providers are signing up each day, but many people still have concerns about whether there will be a sufficient number of providers when private management of Iowa's Medicaid program begins Jan. 1.

Dozens of people, many of them in wheelchairs, poured into the Iowa Capitol on Monday to hear the latest on the state's transition to privately managed care of its $5 billion Medicaid program.

A panel of state lawmakers met to hear from the public, state agencies, and the four managed-care organizations that won state contracts to manage Iowa's Medicaid program, which provides health care to roughly 1 in 5 Iowans, including disabled, low-income and elderly residents.

As of Friday, the four managed-care organizations had contracted with between 28 and 43 percent of Medicaid providers in Iowa. The state was working Monday to gather updated figures.

Representatives of Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley and WellCare of Iowa - the four companies that won contracts to manage Iowa's Medicaid program - said they are working to sign up more providers. Once the major hospital organizations are on board, they added, those numbers will increase exponentially.

The companies also assured state lawmakers that they are accumulating the required staffing and conducting training so they are prepared for Jan. 1.

'We are feeling very positive about where we are with those providers,” said Cheryl Harding, Iowa market president for AmeriHealth.

Some state lawmakers, however, remained worried over the provider sign-up figures.

'I'm a little disappointed in the numbers you're giving me,” Rep. John Forbes, D-Urbandale, a member of the Health Policy Oversight Committee and a pharmacist, told the companies. 'We've got 25 days before this goes live. …

I have some concerns about that.”

Federal officials will be in Iowa this week to meet with those companies to determine whether they are prepared for the transition.

The state administration early Monday alleviated one concern by delaying changes to reimbursement rates to providers until April 1. Providers at a previous hearing had expressed concerns they were being asked to sign contracts without knowing what reimbursement rate they would receive.

The discussion between state lawmakers became heated near the meeting's end, when Sen. Joe Bolkcom, D-Iowa City, expressed his dismay that Republicans refused to go along with Democrats' motion called to make a formal request that implementation be delayed until July 1.

'I don't know why this has become a partisan issue. The people who spoke before us are begging us to slow this down, and I do not understand why my colleagues on the other side of the aisle don't seem to hear that,” Bolkcom said. 'I am flabbergasted. We are in two separate universes here.”

When Bolkcom suggested Gov. Terry Branstad 'doesn't care about this,” some Republican lawmakers became upset, and Rep. Dave Heaton, R-Mount Pleasant and a co-chairman of the committee, said angrily to Bolkcom, 'Don't give me that cheap crap, Senator.”

Heaton later apologized and said Republicans on the committee do not support the motion to request a delay of implementation because that decision ultimately lies with the federal government. Other Republicans on the committee said such a request is outside the committee's charge.