Accountability is bipartisan

Acknowledging that people all across Iowa have conflicting feelings of the state’s decision to privatize its Medicaid program, Iowa State Auditor Rob Sand says he is more interested in whether this form of privatization is actually working.

A good way of assessing that, Sand claimed during a town hall meeting Thursday afternoon at Newton City Hall, is finding out whether taxpayers are getting what they are paying for from the managed care organizations (MCOs). Sand visited Newton during a multi-county tour updating voters on what his office has accomplished and is working on during these past nine months since he was elected.

The way Sand sees it, taxpayers are “paying hundreds of millions of dollars every year to MCOs” and he believes it is a very good question “to ask if they’re living up to the contract they signed with the state.” When somebody signs a contract, Sand argued, doesn’t that mean he or she or a company plans to follow through with what has been agreed upon?

“If somebody breaks that contract — whether you’re a conservative or a liberal or a moderate — you’re going to want accountability for breaking the contract,” Sand, a Democrat, said. “So I think a more effective way of looking at this question is: Are we getting what we’re paying for? Is the contract being followed?”

Sand told the Jasper County crowd Iowans were advised they would be paying for improved quality, improved access and reduced cost following the transition to a privately operated system. Since then, two Medicaid management companies have dropped out of the privatized system, according to reports by the Des Moines Register’s Tony Leys in March.

Referring back to a case he first talked about in June, Sand spoke of two people, who were quadriplegic, experiencing reduced services. They were given 30 days notice and they would no longer get the care they needed. Sand alleged the MCOs were legally and contractually obligated to make sure people don’t experience service gaps.

A solution, Sand continued, would have been to force providers to continue to offer care services until another provider was found. The MCOs in this instance “didn’t exercise their contractual power” to make sure those people got the care they needed, which led to them going days without assistance for showers and no physical therapy.

This situation took weeks to resolve and led to Sand announce he would perform an audit on MCO compliance.

“Are the MCOs in Iowa doing the absolute bare minimum? Are circumstances like this that these two people experienced, are they a pattern or a practice?” Sand said. “We are going to work on figuring that out and we are going to have an answer for you at some point in the future.”

Contact Christopher Braunschweig at 641-792-3121 ext. 6560 or cbraunschweig@newtondailynews.com