One-third of Iowa’s providers sign managed-care contracts

Gov. Terry Branstad said Thursday that about one-third of the state's 42,000 health providers have signed contracts with at least one of the four out-of-state managed care companies chosen to manage Iowa's 560,000 Medicaid recipients starting Jan. 1.

'I am encouraged that over 12,000 provider contracts have been signed since Nov. 1,” Branstad said in a statement, adding that 576 long-term services and support facility contracts have been signed along with more than 4,500 home and community-based waiver provider contracts.

The governor announced the plan to transition the $5 billion Medicaid program over to four managed-care organizations - Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley and WellCare of Iowa - earlier this year.

And with the New Year's Day deadline quickly approaching, establishing an adequate provider network is key to receiving approval from the Centers for Medicare and Medicaid Services - the federal agency that has final say in whether the state will get a waiver.

Earlier in November, CMS told Iowa Medicaid Director Mikki Stier that it had several concerns regarding readiness, including if adequate provider networks will be established, if the managed-care organizations had adequate staffing, and if adequate information and support had been given to enrollees.

The agency will conduct on-site readiness reviews the first week of December.

CMS wrapped up a series of listening sessions with providers and consumers on Thursday. The four calls had hundreds of participants. Providers told officials they have received old or draft versions of provider manuals from the managed care organizations with some saying the reimbursement rates in contracts were calculated with two-year-old data.

Consumers and advocates said they have yet to receive enrollment packets and worry if they'll still be able to see their doctor.

According to the state:

' 740 of pharmacies in the existing Iowa Medicaid network have signed contracts with an managed-care organization (MCO).

' 576 long-term services and support facility provider contracts have been signed with an MCO.

' 2,805 behavioral health provider contracts have been signed with an MCO.

' 4,659 home and community based waiver provider contracts have been signed with an MCO.

' 2,571 MD and DO provider contracts have been signed with an MCO.

But one key group is missing on that list - hospitals. The Iowa Hospital Association, which has come out against the transition, filed a petition for declaratory judgment and injunctive relief with the Polk County District Court, asking the court to delay the implementation of managed care until a legal conflict is addressed.

'It's unbelievable that Governor Branstad and Lt. Governor Reynolds would claim that it's good news for Iowans that fewer than one-third of Iowa's Medicaid providers have signed up for their proposed Medicaid privatization program,” State Sen. Joe Bolkcom, D-Iowa City, a member of the Health Policy Oversight Committee, said a statement Thursday.

'It is actually bad news because the effect of such low participation by health care providers would be to prevent hundreds of thousands of Iowans from accessing affordable, quality health care.”