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' Medicaid program.
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."
"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.
(By Illinois Information Service & Brad Palmer • Mar 5, 2019)