AP NEWS

Iowa DHS penalizes Medicaid provider for delayed payments

January 3, 2020 GMT

DES MOINES, Iowa (AP) — Iowa Department of Human Services officials said Friday they are temporarily withholding nearly $44 million in payments for this month to one of the management companies overseeing the state’s Medicaid program.

Iowa DHS spokesman Matt Highland said in a statement the agency has informed Iowa Total Care of the penalty because of several compliance issues.

They include unpaid claims, inaccurate claims payments, problems with pricing methods and pharmacy dispensing fee problems.

The agency said more than 106,000 claims were not paid and the company was given ample time to correct the problems.

“The department takes these issues seriously and intends to use our contractual remedies to ensure proper administration of the program,” DHS said in a letter to the company.

Highland says the money will be released to the company once the problems are resolved.

Iowa Total Care is a division of Centene Corp. The company began serving Iowans on July 1, replacing AmeriHealth Caritas, which left the Iowa Medicaid program in October 2017.

Centene did not immediately return messages.

The withheld amount is about 26% of the nearly $170 million payment the company would be due.