Illinois Information Service - March 5, 2019 -- A group of Illinois lawmakers joined safety-net hospitals on Tuesday to
call for landmark reform of managed care companies under Illinois'
Democratic State Representative Camille Lilly from Chicago says they're
fed up with delayed and denied state payments that are compromising quality
health care for the most vulnerable. She says the MCO health plans are
not working for large numbers of Medicaid patients.
"This fact forces health care providers to lay off staff, cut back
on services for communities they serve, drop plans to expand and invest
in their own facilities, delay payments to their vendors, which is causing
a ripple effect in our economy."
Democratic State Senator Andy Manar says he supports the Safety Net Hospital
MCO Reform Act, which would require MCO's to reimburse critical access
hospitals and safety net clinics on an expedited schedule.
"We need to make sure that managed care organizations adopt common
sense business practices to cut down on payment denials and delays for
medically necessary care that hospitals are providing in good faith and
is part of their mission to serve their patients and communities."
The lawmakers say the Safety Net Hospital MCO Reform Act would require,
among other things, MCOs reimburse critical access hospitals and safety
net clinics on an expedited schedule, similar to the schedule the state
uses for non-managed-care patients at those facilities.
The Safety Net Hospital MCO Reform Act is one of three proposals in the
General Assembly related to this issue. One focuses on Medicaid MCO fairness
and accountability while the other concerns the right to a fair review
of improper Medicaid MCO denials.
Illinois Information Service & Brad Palmer
• Mar 5, 2019)