- Associated Press - Tuesday, February 16, 2016

DES MOINES, Iowa (AP) - The state of Iowa is ready to offer its Medicaid program under private management on March 1, a state official insisted on Tuesday despite remaining issues and multiple criticisms from a legislative panel.

Mikki Stier, Medicaid director for the Iowa Department of Human Services, presented documentation to lawmakers on an appropriations subcommittee that showcased some of those lingering issues. They included department efforts on expanding the network of health care providers around the state that will offer Medicaid services under managed care, and ensuring complete case management coverage for patients with certain needs like developmental disabilities.

Stier said the department otherwise had addressed the issues that prevented the state from advancing with managed care on Jan. 1.

“The state’s ready,” she said. “The state was ready in January, we’re more ready now.”

The federal Centers for Medicare and Medicaid Services must give final approval on managed care before Iowa can proceed with its plans for the $4.2 billion program, which provides health care to 560,000 poor and disabled residents, including children. CMS listed concerns over Iowa’s readiness in delaying the switch from Jan. 1 to March 1. It said it would monitor progress on several issues, including network coverage and case management.

Sen. Robert Dvorsky, D-Coralville, criticized the documentation provided by DHS, which implied that the recommendations by CMS had been fully addressed. He noted some points had a “completed” description next to them despite needed work. DHS director Charles Palmer explained that there were some references in the documents to how the agency was still monitoring some transition actions.

“I think we’re misleading people here by saying these things are completed when they’re not,” Dvorsky replied.

Other lawmakers pointed to lingering confusion from Medicaid recipients about how they will receive care under the new system. Some health care providers have also expressed concerns about the potentially negative financial impact of new reimbursement rates for Medicaid coverage that would be paid under the three private insurance companies.

Stier emphasized the department’s new communication outreach and other efforts to address concerns by recipients and health care providers. But Sen. David Johnson, R-Ocheyedan, expressed skepticism about preparedness for March 1.

“I just have too many unanswered questions,” he said.

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