What’s on your mind this weekend, Bleeding Heartland readers? This is an open thread: all topics welcome.
On April 1, three months later than originally planned, Iowa officially switched to a managed-care model for the Medicaid program. Erin Murphy explained here how privatization will affect almost all of our state’s roughly 560,000 Medicaid recipients.
Many Iowans on Medicaid are learning that their current health care providers are now out of network, a particular concern for those who have special medical needs. The Mayo Clinic in Rochester, Minnesota has not signed contracts with any of the three insurance companies selected to be managed-care providers in Iowa. KCRG’s Katie Wiedemannn reported on March 31 about a 9-year-old cancer patient whose scheduled treatment at Mayo has been delayed because of the new policy. I am aware of other families whose children on Medicaid have relied on out-of-state medical specialists to treat their children’s rare genetic or chronic conditions.
Iowa House Republican leaders have refused to act on an extensive Medicaid oversight bill that cleared the Senate with bipartisan support. However, they promise to unveil their own Medicaid oversight proposal soon. Senate Democrats will seek to add many oversight provisions to the human services budget, which is often one of the last bills to be resolved before lawmakers adjourn for the year.
One major red flag: Iowa hired only “two ombudsmen to investigate and work as advocates for the 560,000 poor or disabled people” on Medicaid. As Jason Clayworth reported for the Des Moines Register in January, a working group that studied the issue recommended hiring 134 more ombudsmen at a possible cost of $17 million annually.
Rhonda Shouse has been among the most vocal opponents of Medicaid privatization. She shared with Bleeding Heartland some resources for recipients who run into problems with their new managed-care providers. I enclose those below.
Some good public health news: state lawmakers recently approved a bill that would allow “First responders, emergency medical service providers, police, firefighters and licensed health care professionals” to maintain a supply of the drug Naloxone (also known as Narcan). The medication can prevent death after an overdose of heroin or prescription opioid pain-killers, both of which have become more prevalent in Iowa, as in many other states. Senate File 2218 passed the upper chamber the Senate unanimously and cleared the House by 93 votes to 2 (the dissenters were Republicans Stan Gustafson and Mike Sexton). Several groups representing law enforcement or medical professionals lobbied for this bill. At this writing, Governor Terry Branstad has not yet signed it.
UPDATE: Branstad signed the bill about the overdose drug on April 6.
Action alert shared by Rhonda Shouse:
PLAN WITH A PURPOSE –
This is for BENEFICIARIES, FAMILY MEMBERS, and PROVIDERS!
We MUST take action in an organized, thoughtful manner, with one voice to create change.
The Health Consumer Ombudsman Alliance, part of Governor Branstad’s own administration, created a report suggesting Iowa needs to hire approximately 134 ombudsman to help Medicaid beneficiaries navigating the Managed Care system. TWO were hired. UNACCEPTABLE! Additionally, the program is designed ONLY for beneficiaries on one of the state’s 7 waivers or in a long term care facility. That leaves about 500,000 of us without the assistance we need.
Here’s how WE are going to change that:
1. Create a paper trail!
2. Document your problems. (You’ll find in the file section a ***very*** basic documentation sheet that you can download and save.)
3. Call, or better yet, if possible email the Managed Care Ombudsman Program. phone: 866-236-1430
email: ManagedCareOmbudsman@iowa.gov
With EVERY email you need to also cc the following:
1. Your state senator AND state representative (even if they are a Republican and have not been supportive of OUR needs) Find them here: https://www.legis.iowa.gov/legislators/find
2. ONE of the following people so they can stay on top of the issues: Senator Pam Jochum, pam.jochum@legis.iowa.gov
Senator Liz Mathis, liz.mathis@legis.iowa.gov
Senator Amanda Ragan, amanda.ragan@legis.iowa.gov
Kris Bell, Senior Research Analyst for Iowa Senate Democrats, kris.bell@legis.iowa.gov
CMS will be contacting the Managed Care Ombudsman Program EACH month to determine the number of complaints and the type of complaints they’re receiving.
IMPLEMENT THIS PLAN IMMEDIATELY! If you want adequate assistance for the future, you must act now!
Iowa Medicaid Managed Care Documentation Sheet.doc
MCOP Overview_Brochure.pdf
Documentation sheet, provided by Rhonda Shouse:
Iowa Medicaid Managed Care Documentation Sheet
Date you tried to get help:
Approximate time of phone call (and length if you believe it is important):Where have you tried to get help from with your problem already (Medicaid Member Services, DHS, MCOs, etc.):
Name of person/s you spoke with at each office:
How long you have been trying to get this specific problem resolved:
Summary of your specific problem:
What to do with your information
Create a paper trail for change!
Managed Care Ombudsman Program
Phone: 866-236-1430
Preferred method –email: ManagedCareOmbudsman@iowa.gov
If sending email, you need to “cc”
1. Your state senator AND state representative (even if they are a Republican and have not been supportive of OUR needs) Find them here: https://www.legis.iowa.gov/legislators/find2. One of the following people so they can stay on top of the issues:
Senator Pam Jochum, pam.jochum@legis.iowa.gov
Senator Liz Mathis, liz.mathis@legis.iowa.gov
Senator Amanda Ragan, amanda.ragan@legis.iowa.gov
Kris Bell, Senior Research Analyst for Senate Democrats, kris.bell@legis.iowa.govLastly, record the date you’re contacting the Managed Care Ombudsman Program:
Managed Care Ombudsman Program brochure:
