Iowa auditor slams state Medicaid program for 'flawed' data

DES MOINES, Iowa (AP) — The Iowa Department of Human Services provided data for an audit of its Medicaid Home Health Program that was so flawed that it was unusable, the state auditor said Thursday.

Auditor Rob Sand's report said his staff tried for months to get usable data on the number of patients served, the services received and fees paid. It took eight months to get information from DHS that could be analyzed and even then, the data was useless, Sand said. He said data was missing, incomplete or incorrect.

The Home Health Program provides services including skilled nursing care, physical therapy and health aides for Medicaid recipients in their homes. The audit began in April 2018, before Sand took office in January 2019, and finished 14 months later.

Contracts Iowa signs with the private managed care organizations that are paid to oversee the program say “performance monitoring and data analysis are critical components in assessing how well the contractor is maintaining and improving the quality of care delivered to members.”

“Obviously, you can’t analyze data if the data is not reliable, so if you don’t have good data to analyze you’re going to have a very hard time measuring quality of care as well as stopping fraud,” Sand said.

The state, under Republican Gov. Terry Branstad's direction, took the Medicaid program from state oversight and placed it under the management of private for-profit insurance companies in 2016. He promised the move would save millions of dollars and improve efficiency but since he departed in July 2017 to become U.S. ambassador to China, Gov. Kim Reynolds has put millions more into Medicaid each year amid calls to reverse privatization and restore stability.

Reynolds' spokesman, Pat Garrett, said in a statement that she has made significant improvements to the...