Iowa Gets Federal Approval To Reduce Retroactive Medicaid Coverage

The state has provided payments for services that enrollees received in the three months before they were formally declared eligible for Medicaid. Officials said the change would save the Medicaid program nearly $37 million, but health care providers said they would have to absorb those costs. In other news, a private insurance company pulls out of Iowa’s managed care program, Ohio officials approve spending and Oregon’s governor reportedly was not told of the state’s overpayments.

Des Moines Register:
Medicaid Cuts To Roughly 40,000 Iowans Approved By The Feds

Over the protests of hospitals and medical providers, Iowa has received federal approval to reduce coverage for new Medicaid beneficiaries. An estimated 40,000 Iowans are expected to be affected by the change, which will reduce their coverage for medical care delivered in the days and weeks before they are officially declared eligible for Medicaid. … Historically, Iowa Medicaid has included a retroactive-eligibility provision that provides payment for health care services delivered in the three months leading to a person being formally declared eligible for Medicaid. (Kauffman, 10/31)

Iowa Public Radio:
Change Of Course For Privatized Medicaid In Iowa: For-Profit Company Quits

Nearly a quarter of a million patients covered by Medicaid, Iowa’s health care program for the poor, disabled, and elderly, are advised to watch the mail for a new insurance card. One of the three for-profit companies who have been managing the program since last year is pulling out. The Department of Human Services has been negotiating for months with the companies trying to agree on rates and terms for this year. Talks broke down with AmeriHealth Caritas. They will no longer be participating in the program. (Russell, 10/31)

The Associated Press:
Medicaid Money, Including Gov. Kasich’s Expansion, Approved Despite GOP Complaints

A state funding allotment crucial to doctors, hospitals and other Ohio Medicaid providers cleared a powerful legislative panel Monday given extraordinary authority over the government health program. Medicaid Director Barbara Sears told the state Controlling Board ahead of its unanimous vote that failing to authorize Ohio’s $264 million share of program spending risked “devastating” consequences for program providers and the 3 million Ohioans that Medicaid serves. Another $638 million in federal matching dollars hinged on Monday’s approval by the panel, whose say-so was required under a change placed into the state budget bill passed earlier this year. (Carr Smyth, 10/31)

Columbus Dispatch:
State Panel Unanimously Approves Medicaid Funding

At Gov. John Kasich’s urging, the Republican-led state Controlling Board voted unanimously Monday to continue funding for tax-funded health insurance for more than 3 million poor Ohioans. The legislative panel agreed to release $264 million in state funding that will draw $638 million in federal matching money for the Medicaid program, which covers more than 1 in 4 Ohioans. … The Kasich administration said without the funds, payments to doctors, hospitals and other Medicaid providers would need to be cut 16 percent effective Jan. 1 or the program would run out of money in May. (Candisky, 10/30)

The Oregonian:
Oregon Overpays More Than $74 Million For Medicaid, Governor Kept In The Dark

The financial quagmire at the Oregon Health Authority continues to deepen. On Tuesday, the agency’s new chief financial officer, Laura Robison, acknowledged that Oregon wrongly paid Oregon health care organizations roughly $74 million in federal Medicaid money from 2014 to 2016. … Top officials at the health authority, including then-director Lynne Saxton, knew about the overpayments for months, including some who learned of it more than a year ago. But they withheld that information from the public and, according to Gov. Kate Brown’s spokesman, from the governor as well. (Borrud and Manning, 10/31)

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