712 Digital Group - top

Medicaid patient says she was forced to wait six weeks for catheters

News

August 29th, 2016 by Ric Hanson

Some of Iowa’s Medicaid patients and the professionals who serve them testified this (Monday) morning during a two-hour “listening post” at the statehouse, organized by Democratic legislators. Health care providers complained about late payments and confusion in dealing with the three out-of-state companies that now review and either approve or deny all claims. Medicaid patient Michelle Meadors, of Des Moines, was the final person to testify. She was in a serious car accident five years ago and now is wheelchair-bound.

“I’m here because I was optimistic about this managed care organization because I thought, ‘This is my chance to manage my health care,’ which is what I wanted to do in the first place,” Meadors told lawmakers. “Well, it’s far from being managed. It’s far from being manageable.” Meadors says she was forced to wait six weeks for the catheter tubes she needs. “Now tell me, with everybody that’s in here complaining and whining…because they’re not being paid, that directly affects someone like me,” Meadors says. “So I don’t care what it takes to get it fixed, but we need to stop and get it fixed.”

In addition to Democrats, one Republican legislator and the legislature’s lone independent attended today’s (Monday’s) statehouse hearing. Senator Amanda Ragan, a Democrat from Mason City, says 70 percent of Medicaid spending for disabled Iowans like Meadors and for very poor elderly citizens, many of whom are in Iowa nursing homes. “Unfortunately, problems persist. The problems are serious and the problems are systematic,” Ragan says. “Iowa families, health care providers and communities are suffering from late payments, burdensome paperwork, red tape and unforeseen changes in the three managed care organizations. Iowa’s Medicaid mess is everyone’s problem.”

Derek Laney is the C-E-O of Iowa Focus, an agency with offices in Council Bluffs and Creston that provides services to Iowans with mental illness or who’ve suffered brain injuries. Laney says he “appreciates” the effort by the managed care organizations to control costs. “But I also have direct experience with what isn’t working,” Laney says. “…Authorizations must be processed timely…and all the (managed care organizations) must acknowledge the billing and payment problems that exist.”

One business owner with 70 employees said he had to hire another full-time worker just to file claims for Medicaid patients who are being fitted with prosthetics. His company may soon decide to stop serving Medicaid patients because of the hassle with unpaid claims.

A representative for one of the insurance companies overseeing Iowa’s newly privatized Medicaid program says it has lost money during the system’s implementation. Kim Foltz, CEO for UnitedHealthcare’s Iowa operations, cited information in a new quarterly report in telling a legislative oversight committee on Monday at the Iowa Capitol that the company has lost money. She later declined to provide specific information on a dollar figure.

The confirmation means all three insurance companies that run Iowa’s health care program for more than 500,000 poor and disabled residents have lost money in the initial months of implementation. AmeriHealth Caritas and Amerigroup, the other companies, filed reports recently showing losses in the tens of millions of dollars in the first six months. UnitedHealthcare did not break down those costs in its filing.

(Radio Iowa/A-P)