Iowa’s independent ombudsman says the number of complaints related to the state’s privatized Medicaid program more than doubled last year.
In an annual report released Monday, the Iowa Office of Ombudsman said it had received more than 225 complaints in 2017 regarding the private insurance companies that run Medicaid health programs for more than 750,000 poor and disabled residents.
That’s more than double the nearly 85 complaints lodged in 2016, when the privatization program began. The findings come as more states consider increasing managed care or privatized care options around the country.
The Iowa ombudsman’s report included 15 examples of Medicaid investigations, many of them looking into contractors who reduced care or funding by arguing that beneficiaries were receiving too many services or duplicated services.
Earlier this year, the program drew harsh criticism when a managed care doctor was caught on tape saying a man with cerebral palsy whose home care was reduced could be a “little dirty” for a few days between visits.
In her report, ombudsman Kristie Hirschman said official notices of similar reductions were often not provided as required by law, and that the managed care organizations pressured members to sign new care plans along with their service providers and case managers.
“In our view, this tactic by the MCOs amounted to strong-arming members into accepting reduced services against their better judgment,” Hirschman wrote. “It also deprived members of their due-process rights to appeal the reductions in hours since they never received an official rejection. Family members of these patients, some of whom quit work to care for their loved ones, often continued to provide services at a much-reduced rate.”
The state originally contracted with Amerigroup, AmeriHealth Caritas Iowa and UnitedHealthcare Plan of Iowa to offer managed care plans, but Caritas later withdraw leaving beneficiaries with fewer choices.
The office said complaints were up for the fourth year, citing both Medicaid privatization and the state’s corrections system as reasons, according to U.S. News & World Report.
Hirschman added that she’s not convinced the Iowa Department of Human Services is providing adequate oversight of the private insurance companies, but a bill moving through the Legislature could address some concerns.