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Iowa let major Medicaid provider keep $2.4M in overpayments

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December 6th, 2018 by Ric Hanson

IOWA CITY, Iowa (AP) — After a major provider agreed to stay in Iowa’s troubled Medicaid program, state officials quietly let its hospitals and clinics keep $2.4 million in mistaken overpayments. UnityPoint Health threatened to quit Iowa’s Medicaid program a year ago, saying that it had reached an impasse in contract negotiations with the managed care organization AmeriGroup. Its departure would have disrupted health care for 54,000 Medicaid recipients beginning April 1. But UnityPoint and AmeriGroup reached a last-minute agreement to keep its provider network in the program, a victory for Gov. Kim Reynolds.

In April, Iowa Department of Human Services Director Jerry Foxhoven signed a settlement that allowed UnityPoint to keep $2.4 million in overpayments for electronic health records incentives that had been identified by auditors. The Associated Press obtained a copy under the open records law. Democratic Sen. Joe Bolkcom of Iowa City says the deal “looks fishy” and that lawmakers were never informed about it.
UnityPoint says the agreement was unrelated to its continued participation in Medicaid.