DES MOINES, Iowa (AP) - One of the companies involved in Iowa’s privately managed Medicaid system intends to reduce payments to agencies that serve thousands of people with disabilities, which is raising concerns that some of the organizations could go out of business.
Letters sent this week show AmeriHealth Caritas plans to cut the rates to the minimum, The Des Moines Register (https://dmreg.co/2kqBzuC ) reported.
AmeriHealth is one of three national insurance companies that took over management of Iowa’s Medicaid program last April. The program covers about 600,000 Iowa residents, including more than 23,000 people with serious disabilities. That amount is about 9,400 more people than the combined total of the other two managed-care companies, UnitedHealthcare and Amerigroup.
The company negotiated higher rates than Iowa required it to pay community agencies for services given to residents with disabilities. But contracts with the agencies allow the management company to cut those rates at any time.
“We are taking action to achieve better alignment with the Medicaid rate structure,” the company said in a statement. “In doing so, we can establish a more sustainable program that better serves our members. The state of Iowa set the Medicaid rate based on what providers were paid prior to the implementation of managed care. This change will not impact the care and services our members receive.”
But the agencies providing these services say the new rates don’t equal what many of them were paid before.
Iowa Association of Community Providers executive director Shelly Chandler says the cuts would mainly affect agencies that serve people with brain injuries or intellectual disabilities. She says some agencies would face losses in the hundreds of thousands of dollars if the AmeriHealth cuts take effect.
Linda Dunshee, executive director of Link Associates, which serves residents with intellectual disabilities in central Iowa, said her agency’s contract with AmeriHealth allows the company to cut its rates to the minimum allowed by the state, but that she can’t appeal the decision.
“It’s not a matter of whether we can be patient - we can’t pay our bills,” she said. “You can’t pay staff with a wish.”
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Information from: The Des Moines Register, https://www.desmoinesregister.com
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