Breeze-Courier | Taylorville, IL
weather sponsored by
Landmark of Taylorville

The Weather Network
Advanced Search
search sponsored by


LOGIN | SUBSCRIBE




KMRM

home : news : state news free September 15, 2019

8/6/2019 10:59:00 AM
Medicaid managed care reforms signed into law
Bill aims to reduce application backlog, speed payments to providers
Peter Hancock
Capitol News Illinois

SPRINGFIELD – Gov. J.B. Pritzker said Monday that people applying for Medicaid benefits in Illinois will see those applications processed more quickly, and health care providers will be paid more promptly, under a comprehensive reform bill now signed into law.

“This legislation launches one of the most aggressive, cross-agency efforts in Illinois history to expand health care access and to eliminate the multi-year Medicaid backlog once and for all,” Pritzker said during a bill-signing ceremony in Chicago.

Medicaid is a publicly-funded health insurance program for low-income families, seniors and the disabled. Established in 1966, it is jointly funded by the state and federal governments and it is the largest health insurance program in Illinois, covering nearly 3 million individuals, or nearly one quarter of the state’s population.

Illinois operates its Medicaid program under what’s known as a “managed care” model. That means people who are covered by the system enroll in a plan administered by private insurance companies, known as managed care organizations, or MCOs. Those companies, in turn, are paid a flat, monthly per-person rate, which they use to pay for each person’s medical care.

In recent years, though, the Illinois program, called HealthChoice Illinois, has been plagued with a backlog of applications from individuals trying to get into the program as well as people trying to renew their coverage.

The backlog, defined as applications that have not been processed within 45 days of their submission, peaked around 121,000 cases during former Republican Gov. Bruce Rauner’s administration and now is about 95,000.

Health care providers have also complained about slow payments from the MCOs as well as high rates of claim denials.

Senate Bill 1321, which was drafted by the bipartisan Medicaid Legislative Working Group, seeks to address both of those issues.

Among other things, it requires the Illinois Department of Healthcare and Family Services to set up a new claims clearinghouse to collect and analyze data about medical bills and to adjudicate claims. That agency will also establish a dispute resolution process and will act as the arbiter in disagreements between providers and MCOs.

The new law also requires MCOs to pay claims within 30 days and to make expedited payments to providers that serve large numbers of Medicaid patients, including long-term care facilities where more than 80 percent of the patients are on Medicaid, safety net hospitals and government-owned providers.

And the bill calls for streamlining the process of determining people’s eligibility and calls for changes that will allow more Medicaid recipients to be renewed automatically.

“This legislation expands access to care,” said House Majority Leader Greg Harris, D-Chicago. “It cuts bureaucracy; it adds transparency (and) accountability to the eligibility system.”

Sen. Dave Syverson, R-Rockford, echoed that sentiment, saying, “As a result of these reforms Illinois will be able to deliver health care more seamlessly, leading to better health outcomes.”





Article Comment Submission Form
Please feel free to submit your comments.

If you are looking for the SPEAK OUT submission form, you can find it by clicking here: Speak Out Form


Article comments are not posted immediately to the Web site. Each submission must be approved by the Web site editor, who may edit content for appropriateness. There may be a delay of 24-48 hours for any submission while the web site editor reviews and approves it.

NOTE: All information on this form is required. Your telephone number and email address will not be displayed or shared.
Submit an Article Comment
First Name:
Required
Last Name:
Required
Telephone:
Required
Email:
Required
Comment:
Required
Passcode:
Required
Anti-SPAM Passcode Click here to see a new mix of characters.
This is an anti-SPAM device. It is not case sensitive.
   












Trinity Dodge Fixed
Dr Paul The Dentist
NewsWebPagesOpinionPeopleObituariesAg & BusinessSportsContact UsLife
Subscriptions | Username & Password Reminder | Change Password | Life

Breeze-Courier & Printing | 212 S Main St. Taylorville, IL 62568 | (217) 824-2233 |
website@breezecourier.com

© Copyright 2014 Breeze-Courier & Printing. All Rights Reserved.
Original content may not be reprinted or distributed without the written permission of Breeze-Courier & Printing.

Software © 1998-2019 1up! Software, All Rights Reserved