Medicaid modernization to take effect January

DUBUQUE – By January, Medicaid in Iowa is going to look very different. The state is in the process of contracting out its Medicaid program to four for-profit corporations; a move that Governor Terry Branstad says will save the state money while still providing quality health care.

But not everyone agrees. The 560,000 Iowans that receive Medicaid will be impacted, and it’s still unclear what services will be provided under these four corporations.

Local woman Carole Porter who cares for her 35 year old son Bryan who has Down Syndrome is worried that some of his services that are covered under Medicaid now, will not be covered under their now Managed Care Organizer, or MCO.

Specifically, Porter is concerned that Bryan’s community trainer who helps him at his volunteer jobs, takes him to social outings and helps him practice everyday life skills will not be covered as it is not considered “medically needy.” The Porters, however, consider this service a basic need in Bryan’s life.

“For us it is a lifelong service that we need for the rest of his life,” she asserts.

Staffers at Unified Therapy Services are also concerned that they will have to cut services from their patients.

Director of Business Operations and Development Sarah Sievers explains, “Right now, you know, for example there’s another child that has speech therapy for a developmental delay.Well, potentially that diagnosis might not be covered anymore because they’re only going to cover it for if it happens to be a stroke, or injury, or something like that.”

All Iowans that are on Medicaid are being asked to choose one of the four corporations as their MCO by December 17. That choice is impossible to make for some because many doctors have yet to sign up with an MCO.

“In our situation we can’t because my son’s doctors are making no decision until after the end of the year,” Porter says.

With deadlines quickly approaching, many patients and caregivers are complaining about little information with no time to make these decisions. Gov. Branstad says that the transition will take effect on the first of the new year regardless.

Sievers explains, “So January 1 everyone will be switched over. Another important thing for members to know as well is that they’ll have, they’ll still have their Iowa Medicaid card, and then they’ll have a new MCO card, so they’ll have two insurance cards now.”

The new Medicaid program will be called Iowa Health Link. If you want more information about the transition, click here.

 

Add a Comment