Rob Sand: Iowa’s new Medicaid fraud task force will be ineffective

A new task force in Iowa meant to eliminate Medicaid fraud misses the mark on how to actually solve problems with the healthcare program, said Rob Sand, Iowa’s state auditor and the Democratic candidate for governor. 

In July, Republican Gov. Kim Reynolds created the Iowa Medicaid Fraud Elimination Task Force, of which Iowa Attorney General Brenna Bird will serve as chair. 

Sand said in a news release that Iowa had one of the most efficient Medicaid systems in the country before former Republican Gov. Terry Branstad chose to privatize the state’s program 10 years ago. Reynolds succeeded Branstad in 2017 and continued to support privatization. 

A 2021 report from Sand’s office found the privatization of Medicaid in Iowa had led to an 891% increase in the number of cases of private insurers unlawfully denying services to beneficiaries. The news release from Sand’s campaign mentions that Reynolds signed a bill into law in 2023 that gutted the Iowa state auditor’s office, making it harder to uncover waste, fraud and abuse. 

“If the insiders who run state government cared about uncovering Medicaid fraud, they would reverse the privatization of Medicaid, which has been nothing but bureaucratic red tape and headaches for Iowa patients, providers, and pocketbooks,” Sand said. 

If elected governor, Sand said, he would reverse the privatization. 

In a news release about the task force, Reynolds said accountability is needed through the entire process of the program. She said she wants the task force to strengthen alignment with the Centers for Medicaid and Medicare Services’ program integrity initiatives, promote fraud reporting resources, and use recovered funds to invest in technology that further helps program integrity. 

“By identifying and eliminating fraud and abuse from Iowa Medicaid, we will protect taxpayer dollars, strengthen public trust, and ensure these critical benefits remain available to the Iowans who not only qualify for them, but rely on them for their health and well-being,” Reynolds said. 

Sand criticized the makeup of the new task force, which includes members of Iowa’s managed care organizations, or MCOs, which manage the Medicaid program, as well as various state officials. 

The news release from Sand’s campaign says in the 10 years Iowa has had a privatized Medicaid system, five different managed care organizations have operated the program, and none has lasted the full decade. The turnover has forced people who rely on Medicaid to deal with repeated disruptions and changes in paperwork, the release states. 

“This ‘task force’ features no perspectives from patients or providers, yet includes representatives from MCOs,” Sand said. “Like everything else that marks the Reynolds administration, this is just another example of her serving powerful insiders and special interest groups over Iowa families.”

Reynolds is not running for reelection. The Republican nominee for governor is businessman Zach Lahn. 

The task force is required to return its final report to the governor’s office within 120 days. 

Iowa is expected to feel the effects of national changes to Medicaid as well. The budget law President Donald Trump signed last year included an estimated $1 trillion in cuts to Medicaid spending over 10 years nationally and about $9 billion in Iowa, according to KFF, a health policy nonprofit. KFF estimates that 68,000 Iowans will be uninsured in 2034 due to new work and reporting requirements for Medicaid eligibility.