Choice of Managed Care Organizations (MCO’s) Suspended for IA Health Link Participants

AmeriGroup Cites Limited Capacity as Reason for Not Accepting New Members

On October 31, 2017, the Iowa Department of Human Services (DHS) announced it had signed contracts with two Managed Care Organizations (MCOs)—Amerigroup Iowa, Inc., and UnitedHealthcare Plan of the River Valley, Inc.—to continue to administer the IA Health Link managed care program. A third MCO, AmeriHealth Caritas Iowa, Inc. is withdrawing from the IA Health Link program on November 30 as the result of a contract dispute.

DHS initially informed the 215,000 participants served by AmeriHealth Caritas they would have the choice of switching to AmeriGroup or United Health Care.  Subsequently, AmeriGroup informed DHS it did not have the capacity to take on new members. As a result, the 10,121 members who tried to switch to AmeriGroup by November 16 will be served by Iowa Medicaid Fee-for-Service, the state-administered model in place prior to the conversion to managed care.  The remaining members formerly served by AmeriHealth Caritas will automatically be switched to UnitedHealthcare, with exceptions made on an extremely limited basis.

The IA Health Link page has an updated notice on the suspension of MCO choice, with links to related FAQs for Medicaid members and providers here.

Read a Des Moines Register article discussing the impact on Medicaid participants here.

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