Iowa’s move to Medicaid managed care was delayed for a second time on Tuesday afternoon when the federal Centers for Medicare and Medicaid Services told the state that it would approve an April 1 start date instead, the Cedar Rapids Gazette reported. “Although we understand the state’s preference to move forward on March 1, the April 1 effective date provides additional time for Iowa to complete activities,” stated a letter from Vikki Wachino, director for the Center for Medicaid and CHIP Services at CMS, to Iowa Medicaid Director Mikki Stier. In a separate statement also released on Tuesday, CMS said Iowa has made significant progress since December to improve its call center and provide information to beneficiaries.