The Iowa House has unanimously approved new “accountability measures” for the private companies hired to manage care for Iowa Medicaid patients. Representative Dave Heaton, a Republican from Mount Pleasant, says doctors, hospitals and other health care providers are complaining to legislators about unpaid claims — and patients are complaining about denied care.
The bill that cleared the House directs the private companies to adhere to “national industry guidelines” and meet contract deadlines for paying claims. Any error in processing claims would have to be corrected in 90 days. The bill also seeks to ease the process for patients seeking “prior authorization” for things like seeing a doctor or having surgery. Representative Lisa Heddens, a Democrat from Ames, was on the committee that developed these new guidelines.
She says there’s confusion among patients, pharmacies and managed care companies because the current system has varying co-pays, depending on the type of medication. These changes had been a priority for House Republicans and Democrats. The proposals now go to the Iowa Senate for review.
