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Managed Care Delayed 60 Days

posted by Chris Sparks on Wednesday, December 23, 2015

As you may have heard, federal administrators (staff of Centers for Medicare and Medicaid Services (CMS)) have ordered Iowa to wait at least 60 days before implementation of managed care.

This decision came after CMS spent time in Iowa doing a network readiness review. There was an outcry from members and persons served.  A common complaint was the timeline members needed to make decisions for which they had very little information and didn't understand. CMS outlined the requirements Iowa would need to meet and felt "a transition on January 1 would risk serious disruptions in care for Medicaid beneficiaries."

CMS staff did offer their confident assurance that if Iowa addresses the areas of concern, the transition to managed care will ultimately receive approval. The state is now moving ahead with a projected implementation date of March 1, 2016.

What Does This Mean For You?

  • In the interim, you can continue to see your current provider
  • You should be receiving a letter regarding the IA Health Link updates within the next week
  • Continue working through your enrollment packet. Members will be able to choose their health plan until February 17, 2016 for coverage beginning March 1, 2016. Members will have until May 18, 2016, to make a change for any reason, and then for "good cause" after that.

For more information, visit the Iowa Department of Human Services (DHS) sites for the latest information ( Further, Iowa Medicaid Member Services can be reached at 1-800-338-8366 (8:00 a.m. – 5:00 p.m., Monday- Friday)

Once again, if we can be of further assistance, please feel free to reach out to us at (319) 232-6671. Thank you for allowing us to be of service to you.

About The Author

Chris Sparks served as EPI's third ever Executive Director from 1998 until 2022.