Senate Democrats blocked legislation during a March 19 Senate Human Services Committee sponsored by State Sen. Dale Righter (R-Mattoon) that would have reversed the Quinn Administration’s actions undermining the key aspect of the state’s bipartisan Medicaid reform law aimed to reduce fraud. Both Righter and State Rep. Patti Bellock (R-Hinsdale) filed companion legislation in their respective chambers to address the legal issues that have halted implementation of the 2012 Medicaid reforms and allow for the third party review of state Medicaid rolls to continue.
“A vast majority of lawmakers agreed two years ago that a redetermination process conducted by an outside vendor was the cornerstone of effective Medicaid reform. This legislation rectifies the issues raised in the arbitrator’s ruling, so there is no reason why we shouldn’t move forward with this legislation,” said Righter. “If Governor Quinn and his Democrat colleagues are sincere about their desire to reform the Medicaid system, they would have embraced this opportunity to target fraud and abuse in the program.”
Specifically, the Righter legislation addresses legal concerns identified in a recent arbitrator’s ruling that stymied the state’s Medicaid redetermination efforts. Both SB 3415 and HB 4489, still pending in the House, outline the procedural steps that the Governor must take to comply with the terms of the state’s labor agreement with AFSCME, and requires the state to reopen the bidding process to hire an independent vendor to audit the state’s Medicaid rolls for a two-year contract, with up to a maximum of two one-year renewal options.
Bellock said this is critical in order to re-focus state resources on providing health care for the most vulnerable children and families in Illinois.
“The health care of over a million Illinois families should not be held hostage by politics,” Rep. Bellock said. “We hired Maximus in order to preserve Medicaid as a safety net for low-income families, children, and people with disabilities to have access to health care. Recent actions by the Quinn Administration have threatened that safety net. We’re taking action to ensure we finish the job on Medicaid reform.”
The Quinn Administration has been backpedaling on Medicaid reforms since June 2013, when an arbitrator ruled in favor of a grievance filed by the state’s largest public sector union that an independent contractor could not be hired to perform the audits. Following months of pressure by House and Senate Republicans to appeal the ruling, the Administration instead announced an agreement had been secretly negotiated to hire 520 new state employees to take over review of the Medicaid eligibility audits and let the Maximus contract expire.
As a result, scrubbing of the Medicaid rolls has slowed down considerably since the state assumed responsibility for conducting the audits last year. Bellock and Righter stress this slowdown jeopardizes access to health care for the truly needy, as an increasing number of doctors and hospitals across Illinois choose not to accept Medicaid patients due to the lengthy backlog of state reimbursement payments to health care providers. Additionally, fraud and waste in Medicaid spending continue as ineligible recipients – tens of thousands of whom no longer live in Illinois or meet basic income verification standards – continue to receive taxpayer-funded benefits.