March 19, 2024

Democrats challenge officials on Medicaid transition

Sen. Allen demands improved process, services

DES MOINES — The state senator who represents more than half of Jasper County was one of the legislators on a panel addressing Medicaid issues Tuesday, and the director of a major county health care provider was there to witness the dialogue.

Sen. Chaz Allen (D-Newton) mostly listened Tuesday during his Senate’s Human Resources Committee hearing on Medicaid MCO issues, though he did take one turn to make some major points about how the issues affecting his district.

Allen told the Newton Daily News the meeting was helpful to him in understanding not only what patients and providers are going through around the state, but also some of the other challenges of the huge privatization that began April 1. From service providers to emotional patient and family stories to testimony and questioning of both Iowa Medicaid and MCO officials, Allen and the other members of the Senate Human Resources Committee learned a great deal about the state of the transition.

“This helped me a lot,” Allen said. “It really gave me multiple sides. There are a lot of pieces to this transition.”

Allen said there are even legal issues associated with Medicaid delays.

“I had a constituent arrested,” Allen said. “He had been off his meds, but we got it resolved. There was an also an eye care clinic that got pre-authorized, then later claims were denied. These kinds of things are all happening every day.”

Allen told the MCOs, Iowa Medicaid officials and the rest of the 200-plus people at the meeting, the claim and eligibility for benefits process needs to speed up, as he’s aware of medical and even legal problems his constituents are encountering. He gave some examples.

“People are very angry about delays related to Medicaid,” Allen said. “I’m texting a mom right now who is trying to get her mother into hospice. I think she wants me to hop up on the table and start throwing things. I got a few more emails this morning.”

Capstone Behavioral Healthcare is one of the Jasper County organizations that has been fighting to keep Medicaid payments flowing, and nearly had to interrupt service earlier this year when payments were moving slowly. Director Julie Smith and Capstone’s integrated health services director Kristi Howerton, both attended Tuesday’s hearing.

Smith shook her head in doubt after several statements were made by Iowa Medicaid officials. One of those statements was that the average time to pay each claim is 8.7 days.

“Clearly payment checks are not always getting to providers that quickly,” Smith said.

Iowa Medicaid said it paid almost $900 million in claims from the April 1 start of the MCO period to June 30.

Smith said some of the statistics presented at the hearing don’t represent some of the bottlenecks in processing claims.

“There is both a clearinghouse where claims can get kicked back and an MCO receipt of it, but if the MCO sends it back right away, it never gets logged,” Smith said. “So their statistics about how many claims are rejected (more than 100,000 so far) might not be accurate or complete.”

Sens. Joe Bolkcom (D-Iowa City), Pam Jochum (D-Dubuque) and ranking Republican Mark Costello (Imogene) all asked tough questions of MCO and Iowa Medicaid officials. Providers testified as well, describing problems ranging from clients injured while at home awaiting benefit approval to major financial issues from slow payments.

Medicaid issues are being addressed at the local level as well. An Aug. 2 forum at the Baxter Community Center, set for 6:30 p.m., will allow county residents to share their personal Medicaid experiences with Allen, Iowa House District 29 Democratic candidate Wes Breckenridge and House Minority Leader Rep. Mark Smith (D-Marshalltown).

Contact Jason W. Brooks at 641-792-3121 ext. 6532 or jbrooks@newtondailynews.com