Iowa's plan to privatize Medicaid has received the go-ahead from the federal government. The state announced Tuesday afternoon that the Centers for Medicare and Medicaid Services (CMS) signed off on an implementation date of April 1, 2016.
In a letter dated Feb. 23, 2016, CMS Director Vikki Wachino thanked Iowa’s Medicaid Director, Mikki Steir, for the hard work of her and her staff to reach this point.
“Over the past 60 days, CMS has seen significant improvement to the extent in which MCO networks would cover expected utilization for their expected enrollment based on historical claims data, and in CMS’ assessment, the MCO’s provider networks cover a meaningful percentage of historical utilization.”
The state had previously hoped to transition to a privatized system managed by three providers by January 1, 2016, but CMS did not approve the waiver because some key requirements were not met.
In response to Tuesday's announcement, Iowa Governor Terry Branstad said the agreement between the state and CMS gives certainty to patients and providers.
“It is time to move forward with a modern and managed Medicaid system. Nationwide, over 40 million Medicaid patients have managed care. Here in Iowa, for more than 20 years, portions of our Medicaid population have received managed care. Now we can work together towards successfully bringing the benefits to all our Medicaid patients,” said Branstad.
Lt. Governor Kim Reynolds said this is an example of the needs of people being placed above politics.
“We’re glad to see that CMS saw past the partisan politics and put patients and providers first. The agreement with CMS gives Iowa full federal approval to move forward. We have already begun working on implementing modern managed care for Iowa Medicaid patients beginning April 1. We know that this modernized Medicaid system is the right way to provide a better health system focused on outcomes for Medicaid patients.
Congressman Dave Loebsack (D-IA) had called for CMS to continue delaying the implementation to ensure more people are signed up and there is proper oversight. He said that even though he's disappointed with Tuesday's announcement, “The number one priority must now be to guarantee that the 560,000 Iowans who rely on Medicaid do not see an interruption in their services.
“The transition to a privatized program has been rushed, to say the least. Now it is time for Iowa Medicaid Enterprise to be held accountable and ensure patients, including our state’s most vulnerable populations, such as low-income families, children, seniors and individuals with disabilities, have the answers they need and access to the providers they trust.”
Iowa will be the 40th state with a managed care system for Medicaid services.