DHS Director: Iowa Total Care Is Committed To State Medicaid Program

Jan 9, 2020

Department of Human Services Director Kelly Garcia said despite recent payment issues, she is confident that Iowa Total Care is committed to the state's Medicaid program.

“We have every certainty that Iowa Total Care -- and I'm meeting with them later this afternoon -- remains committed to providing services in this state and a committed partner to our work in the Medicaid program," Garcia said in an interview with Iowa Public Radio on Thursday.

DHS announced last week that it is withholding nearly $44 million from Iowa Total Care -- one of the two managed care organizations for the state’s Medicaid program. The department says the company has failed to resolve more than 100,000 provider claims. 

Garcia said she believes Iowa Total Care is working to resolve the issue.

"We need them to because obviously ensuring that providers are paid timely and accurately is incredibly important to the sustainability of the program," she said.

DHS will reevaluate the company later this month and in Feburary to determine if Iowa Total Care has resolved its payment issue, Garcia said.

Since Iowa privatized its Medicaid system in 2016, there's been significant turnover among MCOs.

Iowa Total Care joined the state’s Medicare program last summer. It replaced AmeriHealth Caritas, which left the state in 2017. 

The state's third MCO, United Healthcare, left the state last summer. Iowa Total Care is one of the state's two MCOs, along with Amerigroup.

Garcia said she's interested in looking at adding a third MCO in the future, but didn't say when.

"We'll have to evaluate when the right time to discuss whether a third MCO would be an option. But I absolutely think it's something we'll be discussing in the future, just don't know the timing yet," she said.

Garcia started her role as DHS director on Nov. 1. She replaced Jerry Foxhoven, who resigned last June.

She previously served as the deputy executive commissioner for the Texas Health and Human Services Commission.

Garcia said she's still in the process of speaking with patients, providers and lawmakers to learn about Iowa's Medicaid system.

"Right now I'm in listening mode, to really understand the unique challenges in Iowa. And, you know, every Medicaid program has some similarities," she said. "But I think if you've seen one Medicaid program, you've seen one Medicaid program, and there are differences here that I need to deeply understand."