A Polk County couple is suing the Iowa Department of Health and Human Services, alleging reduced payments for Medicaid-funded services are now so low they’ve made it almost impossible for them to secure care for their adult son.
The lawsuit, filed by Monty and Linda Kaufman on behalf of their 32-year-old son, Cameron Kaufman, seeks judicial review of a DHHS decision on a rate reduction affecting the payments for the home- and community-based services used by Cameron Kaufman.
Although the lawsuit discloses nothing about the nature of the services or the size of the rate reduction, it asserts that the family appealed the reduction, but the managed care organization upheld its decision on the matter. The dispute then went before an administrative law judge, who allegedly reversed the managed care organization’s decision and ruled in favor of the Kaufmans subject to a final decision by DHHS.
Despite the judge’s findings in the case, the lawsuit claims, DHHS then issued a final agency decision on March 6, 2026, upholding the MCO’s rate reduction.
The family claims they rely on Medicaid’s home- and community-based waiver program to pay for the services that enable Cameron to remain safe at home. According to the lawsuit, the family has “experienced ongoing and significant difficulty locating and maintaining qualified service providers,” and that “the reduced reimbursement rate further limits provider availability.”
As a result, the lawsuit alleges, Cameron’s “access to medically necessary services is impaired,” placing him at risk of harm and institutionalization.
The lawsuit alleges DHHS’ decision is unsupported by substantial evidence and that the evidence in the case demonstrates that “the reduced rate prevents adequate access to care.”
The lawsuit seeks judicial review of the matter, claiming DHHS’ decision on the rate reduction “contradicts the purpose of home- and community-based service waiver programs” that pay for healthcare services rendered in the home rather than in institutions.
The state has yet to respond to the lawsuit, although it has filed a motion to have the court seal from public view the entire administrative record in the case, presumably including the administrative law judge’s decision. Assistant Attorney General Stephanie Graham has told the court that merely redacting the confidential material in the various documents “would be burdensome due to the number of documents involved.”
The court has yet to rule on that motion.
