- Associated Press - Friday, March 10, 2017

DES MOINES, Iowa (AP) - Officials say more than 220,000 poor or disabled Iowa residents could lose access to Mercy Health Network because of a contract dispute with a Medicaid management company.

The patients receive Medicaid through AmeriHealth Caritas, one of three companies the state hired last year to run the program. The Des Moines Register (https://dmreg.co/2maf3Hj ) reported that AmeriHealth has told those patients in a recent letter that it’s been unable to negotiate new contract terms with Mercy. AmeriHealth said the Mercy system no longer would be an AmeriHealth network provider if a deal isn’t struck by July 1.

AmeriHealth officials said Mercy could continue serving those patients if it were to accept lower, out-of-network fees.

The Mercy Health Network includes Mercy Medical Center in Des Moines, hospitals in 12 other cities, plus about 200 clinics.

Mercy Health Network officials said the insurance company is trying to cut rates that the two sides previously agreed to.

“MHN is disappointed that AmeriHealth-Caritas has chosen to terminate the contract so quickly,” Mercy Health Network Vice President Janell Pittman said in an email. “We are working collaboratively with AmeriHealth-Caritas with the hope that participants will continue to receive affordable care from MHN’s award winning providers in metro and rural communities across the state.”

AmeriHealth spokesman Joshua Brett said his company was seeking to “establish a sustainable Medicaid program” by negotiating different payment rates for services.

“AmeriHealth Caritas Iowa is taking this action now so that there is no impact on our members, as they can continue to see their providers while we work to agree on new contract terms,” Brett said in an email.

The state’s shift to private Medicaid management has been heavily criticized, with some predicting the for-profit companies would aggressively try to cut costs and limit services in order to turn a profit. Supporters contend it can save Iowa money by providing more efficient and effective care.


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

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