Amerigroup Unable To Accept More Members
In the latest unexpected development in the Iowa Medicaid transition, Amerigroup Iowa announced that they do not currently have capacity to take any new members. This includes those members who have already chosen Amerigroup as their MCO since the announcement last month by AmeriHealth Caritas that they would not be renewing their contract with the State and will be withdrawing on November 30, 2017.
This announcement comes nearly a month after AmeriHealth Caritas’ announcement to withdraw due to stalled contract negotations with the State of Iowa, following a year of significant losses for AmeriHealth Caritas in the Iowa Medicaid program. This comes only days before the transition to UnitedhealthCare and Amerigroup was to take place on December 1.
AmeriHealth Caritas currently insures a significant portion of Iowa’s Medicaid members, with their withdrawal impacting over 200,000 Iowans.
Amerigroup’s announcement comes as a shock to many throughout Iowa, including legislators and Amerigroup members. Amerigroup indicated in their announcement that they will continue to provide services for the current Iowa Medicaid members enrolled, which is over 180,000 members.
Iowans Left Without Any Options
This development means that Iowans eligible for new Medicaid coverage will generally only have one option for their Medicaid insurance — UnitedHealthcare.
This would normally be a violation of CMS’ rules that require states that contract out their Medicaid management to offer recipients more than one option, but the State of Iowa has already received a temporary exception to this protocol. When the State sought this exception is unclear, which is cause for further frustration regarding transparency and a lack of communication from the State of Iowa. Critics of the Iowa Medicaid program and the transition point to this exception, indicating that the State must have known of Amerigroup’s limitation long before this week’s announcement.
UnitedhealthCare has indicated they are ready and able to welcome the 200,000 members who will be switching from AmeriHealth Caritas.
Critics question the State’s transparency in this entire process, and are concerned that the State has already delayed the implementation of a new MCO until July 2019, and now leaving new members without the ability to choose their coverage.
What This Means For You
The lack of options for those eligible for Medicaid leaves members without options for coverage, as well as the possibility of needing to change doctors due to the forced transition.
Providers will now be forced to be contracted and enrolled with UnitedhealthCare in order to accept Medicaid in Iowa. If you are not yet credentialed and contracted with UHC, now is the time to take action, if you are wanting to continue to accept Medicaid members. Credentialing and contracting is a service KASA offers, and you can reach us to get started today.