 But Greg
Pagliuzza, Trinity's chief financial officer, said the
Moline hospital may have to cut back its support groups and classes
because of dwindling state funding due to Gov. Pat Quinn's order to
spend $276 million less on Medicaid."Our total reimbursement ...
will drop about a half-million to a million bucks," Pagliuzza said.
Only 10 percent to 15 percent of Trinity's patients are eligible
for Medicaid, which is only 8 percent, or $20 million, of the
hospital's revenue, said Pagliuzza. The hospital's Medicaid costs
will not change, he said. Trinity will just have to wait longer to
be paid.
Lawmakers balanced the 2012 state budget by dragging out Medicaid
payments to 110 days. Quinn's order June 30 to cut Medicaid spending
will increase the payment cycle again, to 162 days. Illinois
hospitals had been getting paid every 30 days because of the federal
stimulus, but that stimulus expired July 1.
Many of Illinois' hundreds of other hospitals were reluctant to
comment about changes in Medicaid payments. The hospitals contacted
by Illinois Statehouse News did not want to speak on the record.
Illinois' safety-net hospitals -- those that have a
disproportionate number of Medicaid patients -- "will be protected,"
said Kelly Kraft, Quinn's budget spokeswoman, though she did not
specify how quickly those hospitals will be paid. More than a
half-dozen safety-net hospitals existed in Illinois in 2010, though
the state Department of Healthcare and Family Services said a
safety-net hospital does not have a clear definition.
Kraft said the longer Medicaid payment cycle will add to
Illinois' backlog of unpaid bills.
"The budget passed by the General Assembly will push $1.4 billion
in Medicaid bills into next year," said Kraft.
Danny Chun, spokesman for the Illinois Hospital Association,
which lobbies for hospitals in the state, said the hospitals gave
their blessing to a longer payment cycle because the alternative was
"unacceptable."
"Extending the payment cycle was much preferable than to a blunt
rate cut," he said. "Remember that Illinois already has extremely
low reimbursement rates. Cutting those low reimbursement rates even
further would not be beneficial."
Illinois has not had a Medicaid reimbursement rate increase since
1995, said Chun.
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Pagliuzza said Trinity Regional Medical System experiences the
stark differences in reimbursement rates, because it has hospitals
on both the Illinois and Iowa sides of the Mississippi River.
Iowa "is more timely," he said. "I think they pay within a normal
60 days."
"But the payment rates are much closer to our costs. (In
Illinois) we get about 70 cents on the dollar. On the Iowa side,
it's more like 95 cents," he said.
And Chun said it's not just the state that is shortchanging
Illinois hospitals.
"Illinois is already at the lowest federal match rate for
Medicaid," he added.
Illinois had been receiving more federal money for Medicaid, but
the enhanced federal match ended July 1, when the federal stimulus
expired. That match, for example in June, allowed Illinois to use
$365 million in an enhanced match to pay $1.8 billion in Medicaid
bills.
"We were getting over 60 percent reimbursement," said Mike
Claffey, a spokesman for the state Department of Healthcare and
Family Services. "But now we're back down to the standard 50
percent."
Claffey said that Illinois has a history of late Medicaid
payments. For example, in 2008, hospitals and doctors were waiting
180 days or more for payment.
"No one should be surprised by the reality of the Medicaid system
in Illinois," he said.
[Illinois
Statehouse News; By BENJAMIN YOUNT]
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