Two insurance companies that manage Medicaid in Iowa have breached their government contracts, according to the state’s auditor.
Rob Sand has referred two cases he is investigating to the state Department of Human Services, charging that two beneficiaries who are quadriplegic had their home care services reduced and were told to move into nursing homes.
At a press conference, Sand said the practices of Amerigroup Iowa and UnitedHealthcare could indicate “serious concerns” for the state’s broader Medicaid program.
“There’s a 267-page contract these (managed care organizations) signed with the state of Iowa,” Sand said, according to an article in The (Cedar Rapids ) Gazette. “I don’t care if a Democrat or Independent or a Republican, that contract is their obligation to the state, it’s their obligation to the people of Iowa. If they can’t do the bare minimum described in that contract, then they’re going to have problems.”
Amerigroup said it continues to “work closely with our state partners to improve the Medicaid program for those who rely on it, and continue to ensure compliance with our contractual obligations.” UnitedHealthcare, which is exiting the state’s three-year-old privatized program, said the company is “committed to ensuring a smooth and seamless transition for the people we serve in Iowa.”
The query from Sand comes as a new company, Iowa Total Care, gets set to join the provider network on Monday. The state’s private approach has come under scrutiny before. Last year, the Iowa Office of Ombudsman reported the program saw its number of complaints nearly triple after privatization started.
In the cases referred to Human Services this month, both beneficiaries were receiving home healthcare through Iowa-based ComfortCare, but received 30 days’ notice that their services would be winnowed. Each patient’s managed care organizations encouraged them to move into nursing homes, Sand said.
“I wanted to bring this up because these people deserve resolution,” he said. “Any day now, they could throw their hands up and say, ‘Fine, I’ll move into a nursing home.’ If they do that, that’s going to be not just bad for them, but for taxpayers across Iowa because that’s a more expensive alternative than keeping them in their home.”
