Disabled Iowans could be exempted from private Medicaid management


Iowa might resume direct oversight of care for people with serious disabilities instead of having private Medicaid-management companies continue doing it, the state’s human-services director said Wednesday.

Many of the most serious complaints about Iowa’s privatized Medicaid system have come from disabled Iowans and their families. Numerous families have reported having their services cut and their hassles multiplied by the management companies. Their plight has sparked a federal lawsuit against the state.

“We are examining patients that may not be the right mix” for managed care-companies to oversee, Department of Human Services Director Jerry Foxhoven told an advisory council for his agency Wednesday.

Foxhoven, who recently became the department’s director, said the Medicaid management companies could succeed at saving money by helping many other Iowans improve their health, such as by encouraging them to quit smoking. “But somebody who’s a quadriplegic and is on a ventilator, there’s probably not much you’re going to do to improve their health or bring costs down,” Foxhoven told the Council on Human Services.

Iowa shifted last year to having three private companies manage its Medicaid program, which covers health care for nearly 600,000 poor or disabled Iowans. The change has been intensely controversial, especially in regards to how it has affected care for Iowans with serious disabilities.

Foxhoven raised the possibility of exempting some recipients from managed care during a discussion Wednesday of extended negotiations over new payment rates for the for-profit management companies. Those new rates were supposed to take effect July 1. The management companies have been demanding more money, saying they’ve lost hundreds of millions of dollars on the project.