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MCO Pulling Bait And Switch, Making Plans To Take Patients Away From Assigned Case Managers

Three insurance companies were named Managed Care Organizations (MCOs) last April, tasked with oversight of Iowa’s estimated $4 million Medicaid program. And in a new move, one of those carriers, AmeriHealth Caritas, has now sent out notifications to county case managers that they will be taking some or all of their patients in the near future. Carroll County Case Management Supervisor, Justin Schieffer, explained what was received to the board of supervisors on Monday morning. It all started with a leaked letter that appeared in the Cedar Rapids Gazette.

According to Schieffer, he and his three full-time case managers currently serve about 135 to 140 patients who are customers of AmeriHealth Caritas, which represents the vast majority of their clients. Supervisor Marty Danzer said this is particularly disturbing because of the way the county was treated when it was time to enter into a contractual agreement with the MCO last year.

The very vague nature of the letter and the refusal to answer direct inquiries has left the county agency up in the air, right in the midst of budgeting.

The letter has generated a lot of talk in state and county agencies across Iowa. Schieffer said what was included in the letter are the only known facts, but speculation has the transitions starting in April with a completion deadline of June. He said he has also heard that there will be some case management agencies excluded, but that will not likely include Carroll County. He iterated that this information is not coming directly from AmeriHealth Caritas. Schieffer said the fear is that they could lose all, if not most, of their current clients. One administrator Schieffer talked to said it seems like they are trying to starve these agencies to death by slowly taking away their client base. Schieffer said this has come as a surprise to them as they were promised that the MCO would use their services for the long haul, as they have done in other regions in the past.

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