State announces intent to award Medicaid contract

The Iowa Department of Health and Human Services said it plans to award a new statewide Medicaid contract to Iowa Total Care, a subsidiary of St. Louis-based health insurance provider Centene.

The department announced this week it selected Iowa Total Care to continue providing Medicaid managed care services under the Iowa Health Link program. The program administers Iowa Medicaid, the Iowa Health and Wellness Plan and Healthy and Well Kids in Iowa (Hawki) to eligible adults, children and pregnant women. The four-year contract is expected to begin July 1, 2025, with a possible two-year extension.

Iowa Total Care has been serving Iowa Medicaid members since 2019. Health and Human Services, in a news release, said there will be no change in operations under the new Iowa Medicaid contract period.

According to a Centene news release, Iowa Total Care plans to continue to provide coordinated physical, behavioral and long-term care to more than 218,600 Iowa Medicaid, Iowa Health and Wellness Plan and Hawki members across the state's 99 counties, with a focus on expanding home and community-based services.

Centene, the largest Medicaid administrator in the nation serving about 13 million members, agreed to pay Iowa $44.4 million in 2022 to settle claims that it defrauded the state's Medicaid system by Iowa Total Care overbilling taxpayers for prescription drugs through transactions handled by Envolve, which is also owned by Centene.

Iowa Total Care is one of three for-profit companies that help manage the joint federal and state program that finances roughly $5 to $6 billion in health care coverage annually for more than 700,000 low-income and disabled Iowans.

State officials said Iowa Medicaid members will not see changes to their benefits under their current plan. Members will be able to make an enrollment selection change during the annual open enrollment period in spring 2025.

Health and Human Services Director Kelly Garcia said the state remains committed to "providing access to quality health care" through Iowa Medicaid, and that Iowa Total Care has "demonstrated a commitment to continuous quality improvement."

"We are pleased to award Iowa Total Care with this contract as they continue to meet the needs of Iowans and deliver essential medical services," Garcia said in a statement.