Iowa Medicaid Shifts to Private Companies April 1st

Beginning April 1, 2016, Iowans will see a new way in which Medicaid services in the state will be administered. After months of delays and political debate on both sides of this controversial issue, private management companies will take over the administration of Medicaid from state agencies and their employees.

The privatization shift was originally supposed to take place on January 1, 2016, but the Federal oversight agency, Center for Medicaid Services (CMS) ordered the state to delay the plan until at least March 1. When approval was finally granted on February 23rd an additional month was ordered to help all parties gain enough time to prepare for this major undertaking. Thus, April 1 became the kickoff day for Managed Care in Iowa.

Now that April 1st has arrived, what does this plan, called Medicaid Modernization by Iowa Governor Terry Branstad, mean for the 560,000 Iowans who receive its benefits?

“Our agreement with CMS gives certainty for our patients and our providers. It is time to move forward with a modern and managed Medicaid system. Nationwide, over 40 million Medicaid patients have managed care. Here in Iowa, for more than 20 years, portions of our Medicaid population have received managed care. Now we can work together towards successfully bringing the benefits to all our Medicaid patients.  We’re pleased that CMS has approved Iowa’s plan to provide a better system for Medicaid patients on April 1,” said Branstad.  “Iowa is ready for a new system that provides access through more doctors and will create a more sustainable Medicaid program for taxpayers.”

For those who first opposed the privatization plan, their efforts are now focused on oversight of the program to make sure beneficiaries with concerns have a place to go to get any potential problems solved.

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The new health plan will be called IA Health Link. Providers like Elderbridge Agency on Aging and the 5 other Agencies on Aging in Iowa are now contracted with the three managed care companies to work with them to continue to provide case management for all Medicaid recipients. Managed Care contracts for Elderbridge will also include Home Delivered Meals to some qualified Medicaid beneficiaries. Those meal services will continue with no noticeable changes for recipients.

The managed care organizations selected to oversee the new health plan are:

 

Amerigroup Iowa 800-600-4441 or www.myamerigroup.com/IA

Email: MOSWeb@amerigroup.com

 

AmeriHealth Caritas Iowa 855-332-2440 or www.amerihealthcaritasia.com

Email: members@amerihealthcaritas.com

 

UnitedHealthCare of the River Valley 800-464-9484 or www.uhcommunityplan.com

 

If you or a family member is currently in Medicaid, you can get information about managed care in the following ways:

  • Call Iowa Medicaid Member Services: 1‐800‐338‐8366
  • Iowa Medicaid website: www.iahealthlink.gov

Iowa’s Area Agencies on Aging Role with Managed Care

The Iowa Area Agencies on Aging are working to support consumers, family members, community‐based providers, the Iowa Department of Human Services, and the managed care organizations with the implementation of managed care in Iowa.

Area Agencies on Aging staff members cannot make decisions for consumers and family members. Our goal is to provide accurate communication and guidance on where to go for additional information or assistance.

Managed Care Organizations will be assigned. Can a change be made?  

Medicaid members are assigned to a managed care organization (MCO). You have the option to stay with the MCO you are assigned or move to another MCO. If you do not indicate you would like to make a change, you will remain with the MCO you have been assigned. After the initial assignment and selection period, members also have the opportunity to change MCOs until June 16, 2016. After that Medicaid members can only change if their provider hasn’t joined the network.

What are some questions to ask when selecting a managed care organization (MCO)?

  • Are my local, community‐based providers part of the MCO network/available in my community?
  • Are my pharmacies part of the MCO network/available in my community?
  • Are my doctors and health care specialists part of the MCO network/available in my community?
  • Does the MCO have value‐added services or health programs that are beneficial for my care?
  • Does the MCO have member support available to fit my needs such as call center hours, languages, etc.?

Will everything change April 1, 2016?

The services you receive today should continue until at least June 30, 2016.

Will case managers stay the same with managed care?

The Iowa Area Agencies on Aging have contracts for case management with the three managed care organizations mentioned earlier. It is possible, however, you may not have the same case manager after September 30, 2016.

The mission of the Iowa Area Agencies on Aging (AAA’s) is to facilitate a coordinated, valuebased and costeffective system that connects clients – aging, individuals living with disabilities, veterans, and caregivers – and community organizations who focus on individuals’ health and independence. The Iowa AAA’s integrated delivery system, with offices in 15 cities, serve ALL Iowans in all 99 counties with information and decision making support through LifeLong™Links – Iowa’s Aging and Disability Resource Center.

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