Saturday, December 12, 2015

Iowa's private Medicaid Plan: Chaos, Corruption, Cronyism.

Want to get a taste of what privatized, insurance based, so called “patient centered” health care looks like when Republican roll out their plan for the country?

Iowa is going to experiment on 560,000 of its citizens right away. Nothing like a modest roll out. Keep in mind, the federal government may not approve of Iowa's changes, but we'll see. Not to sound cruel, but I hope they get it, just to prove a point. 

After a lot of chaos and contracting with insurers who've already committed Medicare and Medicaid fraud, you might get a sense this could go terribly wrong:
Preparation Time?:The most sweeping and radical privatization of Medicaid ever attempted ... no state has tried to make such a wholesale change so quickly — in Iowa’s case, launching the program fewer than 90 days after signing contracts with private health-care companies ... some beneficiaries of the program are only now getting their enrollment packets (Dec.12), though the deadline for signing up is Dec. 17.

Chaotic Roll Out: The transition of Iowa’s $4.2 billion Medicaid program has made the rollout of HealthCare.gov look orderly.

Hiring Corrupt Insurers: An Iowa administrative law judge late last month recommended that Iowa throw out the contract it awarded to WellCare, one of the four companies hired to manage the new program, noting that the company failed to disclose details of its “integrity agreement” with the federal government after the 2014 convictions of three former executives involving the misuse of Medicaid money. In addition, WellCare had paid $138 million to resolve claims that it overbilled Medicare and Medicaid ... the four companies selected to operate the Iowa program have had more than 1,500 regulatory sanctions combined and have paid $10.2 million in fines over the past five years. These involved canceled appointments, privacy breaches, untimely processing and failure to obtain informed consent.

GOP Cronyism: Wellcare had also hired two former Iowa legislators, who improperly communicated with the Branstad administration during the bidding process.

Doctors and Hospitals Sign Incomplete Stripped Down Contracts: Health-care providers complain that they are being forced to sign incomplete contracts or face a penalty, and they complain that some contracts don’t cover services that had been covered under the existing Medicaid program.

Can't Prove Grandiose Savings Claim: Gov. Branstad’s administration has answered critics by saying the new program will save $51 million in its first six months. But he has been unable to come up with documentation to justify the cost savings for Iowa.

Faster, More Disastrous Roll Out than The Affordable Care Act: Branstad has implicitly acknowledged some difficulty. This week he extended until April the “safe harbor” in which Medicaid providers will receive 100 percent reimbursement regardless of managed-care network ... a Medicaid expert with the Kaiser Family Foundation said, “The provider networks for the plans have not yet been established. There’s a lot of confusion among beneficiaries.” Branstad could recognize this, and slow things down. In failing to do so, he’s relying more on dogma — faith that the private sector always does things better — than reality.

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