Update: Investigation Shows Iowa’s Medicaid Modernization Bid Process Was Rocky


In mid-August, CivSource reported on a Medicaid modernization effort underway in Iowa. That project was notable because the state picked four contractors to do the work but did not pick Magellan Health, which had been managing the state’s Medicaid system for decades. At the time, some bidders on the project that didn’t get picked said they planned to challenge the award. Today, the Des Moines Register released the results of its own investigation, which tells as much about the open records process as it does on this project.

The investigation was the result of a growing controversy around the contract award. The move by Governor Branstad will effectively privatize Medicaid management in Iowa, and the companies chosen each have records of mismanagement of similar programs in other states. This has prompted some officials to question the legality of moving toward privatization with these contractors.

The Des Moines Register requested the original bid documents to do its own comparison. According to the findings revealed in the paper, several of the contractors responded to the public records request with heavily redacted documents prompting the state to re-release the information. In the first round, even the names of company executives were redacted. In the second version, the state released clearer documents, but the differences between the two releases show just how far private companies will go to shroud their business relationships.

According to the piece:

The company with greatest number of redactions was Amerigroup, another successful bidder. The Register found that 892 pages of its 2,186-page bid were initially missing from its “public folder” and another 125 pages were either completely or partially redacted.

Much of the previously redacted information was generic in nature. Included were statements such as “We will work closely with DHS as we implement to ensure compliance with all regulatory requirements.

According to Iowa law, private companies can hold back information they think impacts trade secrets or is otherwise sensitive. The public has a right to challenge those redactions, but that requires a cumbersome court-based process that may be out of reach for many individuals and organizations. The state is reviewing fixes to this process, but nothing has been recommended yet. Watch this space, and read the full Des Moines Register article here.