
State Auditor Rob Sand said Wednesday Iowa’s two Managed Care Organizations are breaking their contracts with the state by not providing proper care for two quadriplegic people who live in rural Iowa.
Sand did not name the two people whose cases he’s looking into, but he said their provider, ComfortCare, recently gave them each a 30-day notice to terminate services.
“During that 30-day period, they each personally made scores of phone calls attempted daily to ensure continuity of their care,” according to a news release from Sand. “I, too, made dozens of phone calls and sent dozens of emails to better understand their situations and to review the MCO’s compliance with their obligations … Both were pushed by their MCOs towards moving into a nursing home.”
Sand said the only way the two were able to avoid moving into a nursing home is because of their families, who stepped in to care for them. One person’s care workers also agreed to help them even if they weren’t being paid.
Sand cited several clauses the MCOs seemed to be breaking by failing to provide services and said the MCOs should have required the provider to continue to serve the two Iowans until they found a new provider. Sand will host a news conference in the coming weeks to address how the auditor’s office will respond to the situation.
There are “more than a few” complaints on Sand’s desk now, he said, but that doesn’t necessarily mean all of those complaints include a lack of compliance with the state’s contract.
[inline-ad id=”0″]
“Even if the issues they’re experiencing don’t comply within the contract, it doesn’t minimize the fact they are experiencing a lot of stress and experiencing a lot of frustration in their dealings with Medicaid,” Sand said.
The goal, Sand said of his current investigation into the issue, is to figure out how big of a compliance problem there is in Iowa.
One consequence Sand said the state could deliver should it be found the MCOs aren’t complying is to withhold payment to the MCOs in part or in whole.
Sand also said he’s not sure who has the obligation to provide care — the MCOs or the State of Iowa.
“I do not know if that obligation fundamentally, at the absolute bottom level, is contracted out to the MCOs or still belongs to the state,” Sand said. “That would be a much deeper dive. However, I also point out if the federal regulations are in fact an issue, that that is a determination is probably going to be made at a federal level and not at the state auditor’s office.”
by Paige Godden
Photo by Julie Fleming
Posted 6/26/19

Iowa Republicans make outlawing gay marriage key 2024 campaign priority
Iowa Republicans have made outlawing gay marriage a key goal in their 2024 party platform. During the Iowa GOP’s 2024 state convention on Saturday,...

Department of Justice says Iowa immigration law violates US Constitution
If Iowa doesn’t suspend the enforcement of its new immigration law by May 7, the state could face a federal lawsuit, according to the Des Moines...

Rushing: Iowa State president said the quiet part out loud
I want to thank Iowa State University President Wendy Wintersteen for doing us all a favor by finally saying the quiet part out loud: all the...

Iowa sets aside almost $180 million for year two of voucher program
Iowa has committed nearly $180 million in taxpayer funds to support private school tuition in the 2024-25 school year, which is almost $50 million...

Kalbach: Immediate action needed on corporate ag pollution
Iowa agriculture has undergone substantial changes over the past 40 years. We see it all around us. Rather than crops and livestock being raised on...

VIDEO: Jochum calls Gov. Reynolds’ summer meal program a ‘hunger game’
Iowa Gov. Reynolds announced a competitive $900,000 grant program to feed Iowa children over the summer, months after she declined $29 million in...