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You are here: Home / News / State Auditor questions medicaid handling of 2 patient claims

State Auditor questions medicaid handling of 2 patient claims

June 27, 2019 By Radio Iowa Contributor

State Auditor Rob Sand says the private insurance companies that manage Iowa’s Medicaid system violated their contracts with the state in their treatment of two paralyzed individuals.

Both patients were notified their care would end in 30 days, and Sand says the companies tried to pressure them into nursing homes rather than find new providers. Sand says he’s forming a plan for a broader review of these issues.  “The goal of it is to figure out how big of a problem this is,” Sand says. “Once we know how big of a problem non-compliance is in the state of Iowa, at that point the state of Iowa has a lot of decisions to make.”

Sand says the two patients mentioned in his letter to the state agency overseeing Medicaid deserve to have their in-home care restored, but he says this is also about the state holding the companies, known as MCOs, accountable. Sand says, “What I want people to take away from this, if they’re on Medicaid, is that fundamentally, someone is looking at this and trying to figure out — at the very least — if the MCOs are doing the bare minimum they’re supposed to for Iowans.”

The state can withhold some payment or sever contracts if the companies violate contracts. Sand is a Democrat. Other Democrats have called for a reversal of Medicaid privatization, but Republican officials support continuing the policy.

(Thanks to Katarina Sostaric, Iowa Public Radio)

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