Town Hall with State Auditor Rob Sand – MCO Report

#UpgradeMedicaid held a public, virtual town hall with State Auditor Rob Sand on November 22 to discuss the details of his report on MCOs in Iowa. This report, which was released by his office on October 20, detailed an 891% increase in illegal denials of care since the privatization of Medicaid in Iowa. We had 92 people attend this event, including members of the press.

Two main takeaways from our discussion with State Auditor Rob Sand:

1) Appeals are decreasing overall, but the number of cases going to an Administrative Law Judge and being overturned in favor of the Medicaid member and against the Managed Care Organizations (MCO’s) is statistically significant. If we take reports offered by the Dept. of Human Services (DHS) and the independent report done by Sand’s office, there is still a 586%-891% increase in care denials which were overturned. These are things that are overturned because the MCO is doing something illegal.

2) Rob Sand’s report was reviewed independently and the reviewer agreed that the auditor’s office’s methodology was sound.

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