- Associated Press - Tuesday, July 26, 2016

DES MOINES, Iowa (AP) - Several Democratic lawmakers on Tuesday challenged Iowa health officials on the effectiveness of the state’s newly privatized Medicaid program, continuing to push back on statements by Gov. Terry Branstad that the new system is working without systemic issues.

Members of the Democrat-led Senate Human Resources Committee expressed frustration after hearing testimony from Medicaid patients and health care providers who said they’re having multiple negative experiences under the program since it switched to private management on April 1. The program provides health care for roughly 560,000 poor and disabled Iowa residents.

Some health care providers testified their businesses haven’t been properly paid for months. Others said they’ve received miscommunication on why some claims for payment are being denied.

“We’ve got to take action on this,” said Democratic Sen. Liz Mathis, the committee chair. “The governor declares states of emergency. This is a state of emergency.”

Mathis said she expects updates on some reported concerns when a separate oversight committee meets in August.



Representatives for the three private health insurance companies that now oversee the program - Amerigroup, AmeriHealth Caritas and United Healthcare - said they’re responding to any reported issues. They also noted positive stories out of the new system.

“Our commitment is to work with providers and members to ensure we’re getting their questions answered,” said Kim Foltz, who leads United Healthcare’s operations in Iowa.

Mikki Stier is Medicaid director for the Iowa Department of Human Services, the state agency that previously ran the program and now contracts with the insurance companies. She said officials are working to improve communication with health care providers. A DHS spokeswoman said training events and webinars will be scheduled to help providers fill out claims properly.

Committee members also questioned newly released performance data from DHS for April and May. It showed all three insurance companies had a high percentage rate for responding to completed requests for Medicaid payments within certain periods. At times they asked some health care providers at the Capitol whether that data reflected their experiences. They said no.

Some lawmakers openly criticized Branstad, a strong supporter of the switch. The Republican governor’s office has distributed several press releases highlighting the new Medicaid program and that patients have more access to better health care.

“Gov. Branstad is clueless about what’s going on here,” said Sen. Joe Bolkcom, a Democrat from Iowa City.

Ben Hammes, a spokesman for the governor, circled back to the DHS data in an email.

“Legislative Democrats are entitled to give their own partisan opinions at their own hearing, but they are not entitled to twist the facts,” he said.

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