Members of Iowa’s newly created Medicaid Fraud Elimination Task Force met Wednesday for their inaugural meeting to begin crafting recommendations to stop incidents of fraud in the taxpayer supported healthcare program.
The 11-person task force, led by Attorney General Brenna Bird, established five working groups that Bird said will be the “engine” that drives the research, analyses and problem-solving recommendations the task force will include in a final report due to the governor by Oct. 29.
“We’re here to focus our collective resources and expertise on a single vital goal, and that’s to eliminate Medicaid fraud, waste, and abuse in Iowa,” Bird said to members of the task force.
Gov. Kim Reynolds signed an executive order July 1 creating the task force with a mission of “eradicating” Medicaid fraud.
Iowa’s task force aligns with federal efforts to curb Medicaid fraud, including the fraud task force led by Vice President J.D. Vance and a provision in the Republican-backed reconciliation bill, known as the “One Big Beautiful Bill” act, that will require states to pay for Medicaid payments made in error if their average error rate is above a certain threshold.
In the most recent report for Iowa, the U.S. Centers for Medicare & Medicaid Services reported the state had a projected improper payment rate of 1.9%.
Bird, when asked if Medicaid fraud was an issue in Iowa, said “there is no acceptable amount of Medicaid fraud” and that providers committing fraud need to be held accountable in criminal and civil courts.
“When providers are committing that Medicaid fraud, it is taking money away from the taxpayers that was supposed to be used to help people that really need the Medicaid program and depend on it,” Bird said. “So it’s important that our Medicaid program has integrity.”
Bird said the task force pulls key partners together in the state to stop fraud from happening in the first place and to develop a system for investigations, prosecution and the civil recovery of erroneous payments.
In addition to Bird, the 11-person task force includes:
- Larry Johnson, principal deputy director at Iowa Health and Human Services
- Jennifer Vermeer, plan president for Molina Healthcare of Iowa, one of the state’s three Medicaid managed-care providers
- Kraig Paulsen, director of the Iowa Department of Management and director of Iowa HHS
- Aaron Baack, director of the Iowa Department of Inspections, Appeals and Licensing
- Dax Oberreuter, from the Office of the Governor
- Stephan Bayens, commissioner at the Iowa Department of Public Safety
- Colleen Askvig, a representative from Iowa Total Care, another contracted Medicaid managed-care provider
- Jeremy Ingrim, director Iowa’s Medicaid Fraud Control Unit
- Lee Grossman, the director of Iowa Medicaid
- Teresa Hursey, president of Wellpoint Iowa, formerly Amerigroup Iowa, the third Medicaid managed-care provider in the state
Dean Lerner, a former director of DIAL and a former Iowa assistant attorney general, said the task force is “a bunch of political self-aggrandizement” considering the Medicaid Fraud Control Unit already exists with a set mission of investigating and prosecuting providers making fraudulent Medicaid claims.
He said if the state wants to crack down on Medicaid fraud, it should instead offer additional support to the control unit, especially as there is evidence that Iowa consistently funds its Medicaid Fraud Control Unit at significantly lower rates than states with comparable Medicaid spending.
“It is nonsensical to create a task force to do what the Medicaid Fraud Control Unit is already by law required to do,” Lerner said.
As its first order of business, the task force approved five work groups whose reports will help inform the task force’s final report to the governor.
Each working group was assigned a different focus, like optimizing federal alignment, investing in technology and data analytics, establishing integrity quality initiatives for high-risk services, supporting Managed Care Organizations and enhancing fraud awareness in the state and public reporting of suspected fraud.
The task force meetings will be streamed to the public and Iowans can submit recommendations to the task force at MedicaidTaskForceComments@ag.iowa.gov
“There’s a lot of work ahead of us,” Bird said to task members. “It’s a pretty complex issue, as you know, but there’s a great deal of good that can come from bringing a group of talented people like you together to work on such an important issue for Iowans.”
