Health and Fitness : Help protect Iowa\'s most vulnerable; only you can do it now.

Mike Riege, Virginia Gay Hospital and Clinics Administrator

If you were disabled, paralyzed or brain injured from an accident and your care wasn’t covered by insurance, you would receive assistance from Medicaid. If your child was born with a debilitating birth defect and you were unable to afford care on your own, you would receive Medicaid assistance. If your life runs on longer than your money, Medicaid will keep you safe and clean in a well-regulated nursing facility, which is why we no longer have filthy and dangerous “old folks homes” that do nothing but warehouse the elderly.

Those are the most common circumstances of those served by Iowa’s Medicaid system and we believe they deserve the special care and protection Iowans have always shown for our most vulnerable.

Iowa’s long history of caring for those most in need may be destroyed by poor planning and implementation of Gov. Branstad’s plan to turn management of Iowa’s entire program over to four private firms on January 1, 2016.

With less than a month to go, Medicaid recipients are being asked to choose which of the new firms to receive coverage from, even though the extent of each plan hasn’t been fully determined. Hospitals and other care providers are being pressured to sign contracts that haven’t been completely finalized. Pharmacists, a critical part of modern medicine, have been almost completely ignored.

If you are concerned about the most vulnerable Iowans, we ask you to contact the Center for Medicare and Medicaid Services (CMS) by emailing Victoria Wachino, CMS director for Medicaid (Victoria.Wachino@cms.hhs.gov) to ask that changes to Iowa’s program be delayed until the details have been ironed out.

If you haven’t been following along, Iowa received a grant from the federal government to implement improvements designed to reduce costs and improve effectiveness of Iowa’s Medicaid system. Called the Iowa Health and Wellness Program, it was operational just over a year when Gov. Branstad directed the Department of Human Services to abandon it and directed the agency to award contracts to four private firms instead. Those four firms are to begin managing the entire $4.2 billion dollar program starting this January 1st. The contracts to those firms were issued just three months ago on August 17th.

The governor insists on maintaining his timeline despite overwhelming concerns about the poor planning voiced by doctors, hospitals, pharmacists and other providers of services to Medicaid recipients. The timeline hasn’t been changed even though a judge recently ruled that one of the four firms awarded a contract should be disqualified for improper efforts to influence the award.

In a November 26th article, the Cedar Rapids Gazette reported, “Among the (disqualified) company’s representatives during the bidding process were a former Iowa House speaker and a former state representative from Cedar Rapids, who both had contact with the now-chief-of-staff for the Gov.’s office during what was supposed to be a blackout period in the bidding process. WellCare (the firm disqualified) also did not initially disclose all its past legal troubles. The company has faced millions of dollars in fines in other states. Last year, three former WellCare executives went to prison for fraud.”

This was one of the companies Iowa was about to trust with billions of dollars.

Here is an example of a practical issue arising from the poorly planned changes as noted in a Des Moines Register editorial from November 29, 2015, “For example, a Polk County Medicaid recipient using one of the newly hired managed care providers would have to travel more than 40 miles to Pella for covered hospitalization. If that same person was on a different managed-care plan, the nearest hospital would be Fort Madison, a three-hour drive.”

Virginia Gay Hospital and Clinics have been at the forefront of changes to our health care system. We have wholeheartedly embraced changes to improve outcomes, increase patient satisfaction and provide services at lower cost. We are not suggesting that we should ignore potential savings and improvements, but with the welfare of our most vulnerable citizens at stake, we believe the state of Iowa should embrace our first principal: do no harm.

Unfortunately, Iowa’s political leadership has ignored Iowans’ calls for caution. Now the only option is for citizens to ask the Center for Medicare and Medicaid Services to delay implementation until the details can be made public and the process can be made fair.

Please, review all the information you can and email Victoria.Wachino@cms.hhs.gov with your thoughts. A decision by CMS could be made as early as December 18th.