DES MOINES, Iowa (AP) – One of the companies involved in Iowa’s privately managed Medicaid system intends to reduce payments to agencies that serve thousands of people with disabilities, which is raising concerns that some of the organizations could go out of business.

The Des Moines Register reports that letters sent this week show AmeriHealth Caritas plans to cut the rates to the minimum. AmeriHealth is one of three national insurance companies that took over management of Iowa’s Medicaid program last April. The program covers about 600,000 Iowa residents, including tens of thousands with serious disabilities.

The company negotiated higher rates than Iowa required it to pay community agencies for services given to residents with disabilities. But contracts with the agencies allow the management company to cut those rates at any time.