Iowa set to make Medicaid transition in March--without WellCare

Iowa's governor says the state will be ready to shift management of its Medicaid program to three private managed care companies by March 1, following a tumultuous past week in which a fourth company--WellCare--officially lost its contract, the The Gazette reports.

State officials last week upheld a judge's ruling to boot WellCare from the privatization plan, noting that it failed in the bidding process to disclose the $137.5 million in fines it once incurred to resolve false claims litigation, according to the article. But WellCare isn't going down without a fight--a company official told the newspaper that it "intends to use every avenue available within the legal system to correct this erroneous outcome."

The Centers for Medicare & Medicaid Services also said last week that the state wasn't ready to privatize its Medicaid program by Jan. 1 as Republican Gov. Terry Branstad intended, and ordered it to delay the transition by 60 days, according to the newspaper. The delay will mean the state will lose out on $14.3 million in savings in this fiscal year, the Des Moines Register said, though that's expected to have only a minor impact on the budget, as the state does have reserve funds at its disposal.

The two-month delay also gives the remaining managed care organizations picked by the state--AmeriHealth Caritas, Anthem member AmeriGroup Iowa and UnitedHealthcare Plan of the River Valley--time to contract with more providers, the Quad-City Times reports, and the 560,000 Iowans on Medicaid will get more time to chose between the three companies. Those who enrolled in WellCare health plans will be reassigned to one of the other three organizations, The Gazette article adds.

Iowa's transition to privatized Medicaid managed care follows a decision to scrap its Medicaid expansion plan known as Marketplace Choice, FierceHealthPayer has reported. Insurers have also taken issue with the state's choice of companies to contract with, as Aetna Better Health of Iowa petitioned for an injunction that would stop the state from signing contracts with the four it chose, a bid denied by an Iowa judge.

Elsewhere, Blue Cross and Blue Shield of Montana won the contract to be the third-party administrator of Montana's Medicaid expansion program.

To learn more:
- read The Gazette report
- here's the Des Moines Register article
- read the Quad-City Times article

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