Iowa dentist claims privatized Medicaid program improperly denies payments: 5 notes

Dentists

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The Iowa Supreme Court ruled it will hear the appeals case of a dentist who claims a state Medicaid company is improperly denying payments for his services, the Des Moines Register reports.

Five notes:

1. The state for-profit Medicaid program is run by Delta Dental of Iowa and MCNA Insurance Co. Together, the state provides services for more than 155,000 residents.

2. Robert Colwell, DDS, claims Delta Dental has been denying him payments for thousands of dollars in medically necessary services provided under the program. The dentist claims the denials have extended for years.

3. The dentist is also contesting the state's policy that prohibits dentists from appealing a denial. Dr. Colwell alleges the Iowa Department of Human Services failed its responsibility to oversee Delta Dental by denying dentists the chance to appeal claims.

4. Iowa privatized its Medicaid program in 2017. The program now covers almost all adult members. However, since the new management over the program, hundreds of Iowa residents have been denied services.

5. The DHS argues Dr. Colwell did not receive an administrative review because the cases involved individual patients. The department also alleges the issue is a contractual dispute between Dr. Colwell and Delta Dental.

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