IOWA CITY, Iowa (KCRG) - 37-year-old Ryan Mulhausen has Fragile-X Syndrome. It causes intellectual disabilities. He also is diagnosed with autism. He’s lived on his own with a caregiver for 15 years. He’s also had the same case manager, but that will change Thursday.
“Just thinking that we would lose his case manager, that hit hard,” Ryan’s mother Teresa Mulhausen said.
She said state care has treated Ryan well, now she’s worried that quality of care will change. Ryan was previously covered under AmeriHealth Caritas. When that managed care organization dropped out, many were notified to choose between two other organizations, Amerigroup and United Healthcare. Mulhausen said she did not get to make that choice.
“We got it, the letter, the day after the deadline was,” she said. “We did not choose United Healthcare community plan. We didn’t because there is no choice.”
By default, Ryan is covered under United Healthcare, but Mulhausen said there’s a lack of communication.
“I have had no communication with this company, yet tomorrow they’re responsible for my son’s healthcare, for the decisions about his services,” she said. “My biggest concern is there going to be anyone in that insurance company that’s going to advocate for him like DHS does.”
Monday Iowa's Department of Human Services announced it would take control of thousands of Medicaid patients temporarily.
“Amerigroup of Iowa notified us they current don’t have the capacity to take on any new members. So, any member who did submit a choice prior to November 16, that choice cutoff date, which is a small group of people, around 10,000, are going to be handled under the Iowa Medicaid service system until Amerigroup has the capacity to take on additional members,” Iowa DHS Interim Public Information Officer Matt Highland said.
He said in order to create a smooth transition, providers who are currently not enrolled will be covered through the month of December. That way they can get enrolled and there is no cut to services. Highland also said United Healthcare is working to hire more case managers and other positions.
“The hope is that a lot of members might be able to keep the case managers they’ve had,” Highland said.
Mulhausen said Ryan will not be included because they did not select before the deadline. She said she’s still fighting for change.
“Hope springs eternal that they’re going to have as good a life as opportunities that I’ve had,” Mulhausen said. “The bottom line is he needs total care.”
TV-9 reached out to Governor Kim Reynolds' office for comment on the changes. It provided this statement:
“Medicaid modernization is a proactive, patient-centered approach to modernizing Iowa’s Medicaid program. Recently, JD Power ranked Iowa's Medicaid program as second highest in the nation in patient satisfaction. More than 55 million Medicaid patients are enrolled in managed care health plans in 39 states and Washington, D.C. Governor Reynolds is committed to improving quality and access to care, promoting accountability for patient outcomes and creating a more predictable and sustainable Medicaid budget.
Iowa Medicaid has developed a transition plan to ensure members will continue to receive quality care as health plan options change. Iowa Medicaid will be working closely with, and monitoring, patients as they transition.”