 Illinois Department of Healthcare and Family Services boss Julie
Hamos made only a few comments at the budget signing on Thursday,
but she did say that the state is going ahead with significant changes
to the Medicaid system.
Most of the planned changes involve three pieces of legislation
approved unanimously by lawmakers this past session and signed into
law by Quinn last week.
However, Hamos on Thursday indicated a move to managed care for
Medicaid patients may be on the horizon, meaning patients would work
with a primary doctor, much like a private HMO.
But Hamos was quick to say the state is not going to arbitrarily
toss people out of the system.
"We will continue to provide access to health care to 2.4 million low-income individuals and families in our Medicaid program. But this
year we intend to make our Medicaid system more efficient, getting
more for less," she said.
Medicaid is the health care program for the poor and disabled, with
costs shared by both the state and federal governments. Illinois
currently spends a little more than $13.5 billion a year on the
Medicaid system. Lawmakers, particularly Republicans, have cried for
years that the state could save $1 billion by simply verifying
eligibility, tightening restrictions and creating a managed care
system for Medicaid.
State Sen. Dave Syverson, R-Rockford, said the system is broken, but
he thinks many Democrats are scared to try to fix it.
"There have been reforms that we have talked about for a number of
years," he said. "The number of people that don't qualify for (care) still in
the system, the number of people who have aged out but are still
getting KidCare, the number of illegals that are getting health
coverage."
Syverson said the toughest step to reform is finding the political
will.
In announcing on Thursday that some of those verifications will take
place as part of
House Bill 5054, Hamos, the HFS director, sounded as if she'd found the
will.
[to top of second column] |
"We are undertaking a top to bottom review of our eligibility and
enrollment procedures to make sure that only those who qualify for
Medicaid actually receive those services," she said.
She did not say when the state will begin that process. Another
major change under HB 5054 calls for Medicaid cards to be issued
annually rather than the current practice of monthly. The new timing will
begin Jan. 1.
Quinn signed the legislation last week along with a law to post Medicaid
claims online (HB 5241) and another new law that will allow the
state to contract for private audits aimed at recovering fraudulent
Medicaid claims (HB 5242).
State Rep. Dave Winters, R-Rockford, believes the verification and
review of Medicaid would be a major step toward pulling Illinois out
of its financial hole. But he said he said he's not holding his
breath.
"That's a real reform. My God, (but) I wonder how long that will
take to kick in. That's a great step, but why haven't we done this in
the past? It's one of the reasons we're in this hole," he said.
Hamos said the goal of the changes is not just to save the state
money, but to move the Medicaid system from where it is to where she
wants it to be.
"All of these initiatives are intended to transform our agency from
one that pays health care bills after people get sick to an agency
that demands better and more cost-effective outcomes by keeping
people healthy," she said.
[Illinois
Statehouse News; By BENJAMIN YOUNT]
 |
