Iowa lawmakers skeptical of Medicaid transition

DES MOINES - State officials insist they are taking necessary steps to improve the transition to private management of Iowa's $5 billion Medicaid program.

But many state lawmakers remain unconvinced.

Top state officials updated a panel of state legislators Monday afternoon on the state's managed Medicaid transition. The new system originally was scheduled to take effect on Jan. 1, but the federal government, which jointly funds Medicaid with the states, called for a 90-day delay when it concluded the state was not adequately prepared for the transition.

Iowa Medicaid director Mikki Stier and Department of Human Services director Chuck Palmer testified Monday that the state remains on track for implementation on March 1, when three private companies will assume management of the Medicaid program.

Stier said the state is working to improve call center response times, encourage more providers to sign up with the new managed care organizations and conduct continued outreach to Medicaid beneficiaries.

Stier said 75 percent of the state's providers have signed with at least one managed care organization and 45 percent have signed with all three.

'I'm fairly confident that on March 1 we will be able to display adequate networks,” Stier said.

That response underwhelmed Iowa Sen. David Johnson, R-Ocheyedan.

'That's not as strong a description as what I heard before Jan. 1,” Johnson said.

Multiple legislators asked the state officials what they should tell Medicaid recipients whose physicians have not yet signed with a managed care organization.

Stier said she hopes in time more providers sign up with more managed care organizations and noted Medicaid recipients may remain with their physician as an out-of-network provider.

On March 1, however, those out-of-network providers will receive a 10 percent reduction in their Medicaid payments.

'With a 10 percent ding, a lot of providers are already running on a shoestring budget,” said Senate President Pam Jochum, D-Dubuque, whose adult daughter with intellectual disabilities receives Medicaid services. 'It's pretty darn difficult for (out-of-network providers) to keep their doors open if this goes on for any length of time.”

Stier said the average wait time on calls to the state about Medicaid have been roughly three minutes, with the average call lasting seven minutes. She said the state fielded 15,000 such calls this past week.

Sen. Amanda Ragan, D-Mason City, who co-chairs the Legislature's bipartisan Health and Human Services budget committee, said she remains skeptical the state is prepared for the March 1 launch.

'The magnitude of the problem … I think it's really unrealistic to think this is ready to go on March 1. It does not make any sense,” Ragan said. 'All those things (the federal government noted in its review), there are still big questions we had in there that we're hearing at home and that we just don't think have been addressed.”