Behavioral health group aims to keep focus on Medicaid

Jan. 08--WATERLOO -- The Republican majority has a number of priorities in the 2017 Iowa legislative session that begins Monday. That agenda includes budget cuts, tax reform, reducing regulations and more.

The Iowa Behavioral Health Association wants to ensure lawmakers also keep their sights on Medicaid.

Chris Hoffman, executive director of Pathways Behavioral Services, is a board member of the association and is chairman of its public policy agenda that states the group's focus for 2017.

He said he expects there to be a lot of Medicaid conversations when the session gets underway Monday, and one of the priorities of the association will be to keep the focus on both policies and funding.

"Medicaid is one of the pots of the money that they're wanting to protect this year, which I find helpful, but you never know what comes at the end of the legislative session once they get started," Hoffman said.

Republican Gov. Terry Branstad -- in light of about $100 million in estimated revenue cuts that need to be made this fiscal year to balance the budget -- said he would exempt Medicaid, K-12 education funding and property tax credits from cuts.

Hoffman does not expect the Legislature to reverse its 2016 decision to privatize Medicaid by contracting with three managed care organizations, so the group's main policies are on making the system work more smoothly.

Hoffman said, for instance, Pathways contracts with all three MCOs for services, and when it has to make a request for preauthorization for substance abuse treatment, that process is done three different ways by the three insurance providers as well as the state Medicaid program.

To remedy that, the group proposes uniform policies for filing claims, prior authorizations, criteria to deny claims and appeals.

The group also is advocating the state move up a federally mandated quality review of its managed care program to take place this year. The external review is required to be done by July 1, 2018, but the group doesn't want to wait.

It also has asked a state university guide the review rather than an out-of-state company.

"Let's spend the money inside the state with our universities, who are very competent at doing things like that (review)," Hoffman said.

The group also will push for the state to fully fund Medicaid. But Hoffman said the group has had some successes in focusing on policies so it aims to keep its attention there.

He noted, however, one challenge to the group's priorities is the impact the federal government may have on the state's Medicaid program. Republican lawmakers at the federal level have vowed to repeal the Affordable Care Act, which expanded access to Medicaid, particularly to single men and women.

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That expansion had been paid 100 percent by the federal government, which is beginning to phase down to 90 percent by 2020. The Medicaid program overall is funded through state and federal dollars.

If the matching dollars or the expansion is repealed, that will affect the state's overall health care funding.

"It all depends on what the folks do in Washington to a large degree, and those tea leaves are getting really difficult to read," Hoffman said.

The group also will prioritize opposition to an expansion of the state's medical marijuana laws, other than for a reclassification of the drug to allow for its use in research.

Hoffman said the current law, which allows people who suffer from epileptic seizures to possess cannabidiol, is OK as is, though it is set to expire this year without state action.

The association also supports expansion of the state's drug courts. Its other major policy priority will be to seek regulations for electronic cigarettes so they are treated like other tobacco products.

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