Public provides input on Medicaid

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Area residents shared their thoughts on Iowa’s recent Medicaid privatization April 15, during a public meeting in Elkader with State Rep. Patti Ruff, of McGregor, and State Senator Joe Bolkcom, of Iowa City. (Photo by Audrey Posten)

By Audrey Posten, North Iowa Times 

Area residents shared their thoughts on Iowa’s recent Medicaid privatization April 15, during a public meeting in Elkader with State Rep. Patti Ruff, of McGregor, and State Senator Joe Bolkcom, of Iowa City.

“We’re here to hear your stories and give any updates,” Ruff said to start the meeting. “This is probably the biggest issue we’ve had to deal with on the health and human services side.”

“We remain concerned about the decision,” said Bolkcom, who’s served 18 years in the state senate. “It was supposed to start Jan. 1, but we worked with the federal government to delay it, and they agreed Iowa was not ready. It went live April 1.”

Currently, 560,000 elderly and disabled Iowans rely on Medicaid for health care. With privatization, Medicaid management was turned over to three managed care organizations (MCOs).

The main concerns among those gathered at the meeting were a stoppage of coverage and not being able to continue receiving health care from providers they’ve doctored with for years.

Julie Schmidt, of Elkader,  is on Medicare but relies on Medicaid to help curb additional costs. She’s been seeing doctors in Madison for 20 years.

“I was just figuring out what was covered and where to go,” she said. “As far as I know, I’ll still be able to go, but I don’t know if it will continue.”

One man said his wife sees doctors at Mayo Clinic in Prairie du Chien and travels to Mayo in La Crosse to see specialists, with Mayo Clinic in Rochester as a back-up. He’s worried about her care being disrupted since Iowa’s MCOs have yet to sign contracts with the main medical center in Rochester.

Jan Heikes, a community systems consultant with the Iowa Department of Human Services Division of Mental Health and Disability Services, as well as a candidate for the Iowa State Senate District 28 seat, said some local clinics have signed on, but there are coverage issues with specialists.

“Mayo is hard. It took mandated legislation in Minnesota for them to go with their MCOs,” Ruff said. “We’re in a particular area where we’d be so fortunate for all of Mayo to come on board.”

“We in Northeast Iowa are unique because of Mayo and Gundersen,” added attendee and former state representative Roger Thomas.

Bolkcom said the main reason Mayo and other providers have not signed on is because they are unsure how much they will be reimbursed.

“They didn’t want to sign contracts if they weren’t confident in what they’re going to be paid,” he explained.

Cheri Leachman, the administrator at the Strawberry Point Lutheran Home Community, said, since the change, she’s run into transportation issues and also lost workers, since MCOs cut funding. Communication has also been difficult, she added.

“We have signed contracts from all three MCOs, but when we call, they say we’re not in network and need to provide more paperwork,” Leachman said. “It’s hard enough to apply for Medicaid. There’s a lot falling to the wayside. What about the people who don’t know where to call or don’t think they matter?”

Representatives from two of the MCOs, Amerigroup and AmeriHealth, attended the meeting, assuring they’re working to resolve issues.

“We know we need to work with providers. We know you’re working in good faith and we’re working in good faith,” said the Amerigroup representative. “The transition is going to have glitches, but we intend to get everything in place.”

Although just 1.5 weeks remain in this year’s session, Ruff and Bolkcom said they want to see legislation passed providing more sufficient oversight of the system.

“We want to leave with some good language on oversight,” Bolkcom stated. “We feel we need to have hands, eyes and ears on it to make sure people are getting help.”

The two said they would also like to see additional managed care ombudsmen, to advocate for, educate and help Medicaid members.

Thomas suggested giving those who call 211 a direct
hotline to the three MCOs.

“There are a lot of issues out here, and the message is not getting out,” he said. “It would be a really easy number to publicize.”

Ruff said people can also contact their legislators: “That’s why we’re here, to help if people don’t know where to go and there’s some type of roadblock.”

To get help answering your Medicaid questions:

Managed Care Ombudsman Program

(866) 236-1430

Iowa Medicaid Enterprise Member Services

1 (800) 338-8366 (toll free)

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