- Associated Press - Friday, March 25, 2016

DES MOINES, Iowa (AP) - Iowa residents with Medicaid health coverage won’t be able to routinely use the Mayo Clinic when the state shifts the $4 billion program to private management next week.

The Des Moines Register (https://dmreg.co/1RpYX4u ) reports that the three managed-care companies that will run the state’s Medicaid program told lawmakers this week that they haven’t been able to negotiate contracts with Mayo’s well-known hospital system, located just across the border in Rochester, Minnesota.

Amerihealth’s top executive in Iowa, Cheryl Harding, told legislators that her firm has signed contracts with three Mayo-affiliated primary care clinics in Iowa, but not with the main medical center in Rochester. UnitedHealth and Amerigroup also said they haven’t obtained such contracts.

“The hospitals have notified all of us that they do not wish to be a provider for Iowa Medicaid any longer, which is unfortunate,” Harding said.

The three managed-care companies say they’ll continue trying to persuade Mayo to sign contracts to give routine care for the 560,000 Iowa residents on Medicaid.

However, Mayo has agreed to consider single-case contracts for Iowa Medicaid recipients who need particular care that isn’t provided elsewhere.

“Mayo Clinic will work with Medicaid-eligible patients in Iowa and their managed care organizations to make this insurance coverage transition as smooth as possible,” Mayo spokeswoman Kelley Luckstein wrote in an email. “If specialized care is not available elsewhere in Iowa, Mayo Clinic will work with patients’ MCOs (managed care organizations) to try to get prior authorization to continue care at Mayo Clinic.”

Iowa Department of Human Services spokeswoman Amy McCoy said 5,800 Medicaid members in the state used the Rochester medical center in 2015. She said that with the current situation, these northern Iowa patients would have to travel to Iowa City.

Sen. Amanda Ragan, D-Mason City, asked the managed-care executives why the leaders at Mayo declined the contracts to serve Iowa Medicaid participants.

“We didn’t get a lot of reasoning, except that they just made a business decision,” Harding said.


Information from: The Des Moines Register, https://www.desmoinesregister.com

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