Iowa Medicaid leaders update lawmakers on problems, successes

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DES MOINES, Iowa (KCRG-TV9) - Officials with Iowa Medicaid and the three private insurance companies managing the system said the program's first week and half under privatization came with expected glitches but no system-wide failures.

A Senate committee continues to meet with Medicaid leaders to request information about the transition and talk about problems they hear from Iowans.

Wednesday, one senator who is not a part of that committee asked for a seat at the table after receiving two letter from constituents who said the system switch has delayed their cancer treatment.

"She didn’t receive her card, she didn’t receive her number, she had an appointment with her dermatologist who she had gone to for the past ten years," said Senator Janet Petersen, a democrat from Des Moines. "She went ahead with the appointment, and when she got there they said she’d have to pay cash.”

A second constituent wrote to Petersen detailing problems receiving treatment for a rare form of cancer at Mayo Clinic, a hospital that is not contracted with any of Iowa's three managed care organizations.

"I still, after sitting in that meeting don’t know how many doctors will this woman have to see before they know what she’s known for years, that there’s one doctor in the Midwest who can treat this cancer and that’s at Mayo," Petersen said.

Representatives from the managed care organizations said they have and will continue to work with out-of-network hospitals like Mayo Clinic to negotiate singe-case agreements.

"We are already working with Mayo to serve one Iowan," said Kim Foltz, a representative with UnitedHealthcare.

Delays in cancer treatments are just one problem lawmakers said they're hearing from constituents. Others issues discussed at Wednesday's meeting include prior-authorization requirements, confusion from providers working to navigate three separate systems, and transportation for Medicaid members.

According to Amy McCoy, an Iowa Department of Human Services spokewoman, the state will work to resolve issues on a case-by-case basis.

"It’s really the only way to do it, is to address our members issues on a case-by-case basis because they are so unique," McCoy said. "So when we have an issue that comes in, we have rapid response teams available to take that member’s needs and make sure they’re getting matched up with what they need.”

McCoy noted the anecdotal and individual stories lawmakers shared also illustrate that no system-wide failures occurred.