Health care expansion must include prompt payment for providers      

[OCT. 13, 2005]  FORSYTH -- State Rep. Bill Mitchell said the governor's plan to expand state health care coverage to more children without health insurance deserves debate, but he stressed that any expansion must include provisions to ensure prompt payment of providers. Mitchell, R-Forsyth, introduced legislation Oct. 7 to make any expansion of state health care coverage a "pay as you go" endeavor.

"The governor's plan certainly deserves our careful consideration, but government has a propensity to overpromise and underperform," said Mitchell. "We're more than $1 billion behind in Medicaid payments now. Some doctors and pharmacies are considering turning away Medicaid patients. Any expansion of state health care coverage without also ensuring prompt payment of providers will only make matters worse."

According to a recent survey conducted by the Illinois Pharmacists Association, the average wait for Medicaid reimbursement is 111 days, with one pharmacy reporting an amazing 237-day wait. More than half of the pharmacists surveyed have had to borrow money to stay afloat. Some have been forced to take second mortgages on their homes to keep their business doors open.

Mitchell's legislation mandates that the state will pay Medicaid reimbursements within 30 days of when the Department of Healthcare and Family Services, formerly known as Public Aid, receives bills from local providers. Currently, Illinois' Prompt Payment Act allows 60 days. Mitchell's measure also beefs up penalties the state will incur for late payments, doubling the interest rate on overdue payments.

"This is very important legislation," said Gary Himstedt, owner of The Prescription Shoppe in Clinton. "The state is currently between three and a half to four months behind in my Medicaid reimbursements. It had been up to five months. We have had to borrow to keep our operation going and to pay our suppliers every two weeks. If we could get Medicaid payments on a more prompt, reliable cycle like that for the state's SeniorCare prescription plan, that would really help take care of the problem."

"My wholesalers require payment from me in 15 days -- my last payment from the state was for prescriptions filled 16 weeks ago," said Tom Curry, owner of Curry's Family Pharmacy in Riverton. "We're the only pharmacy in town. If we were forced to stop accepting public aid, that would be a real hardship for local patients. It would certainly be very helpful if [the] state would pay in a timely manner like they're supposed to."

"I have to pay my bills on time," added John Sherman, who owns Sherman's Pharmacy in Atlanta. "I don't understand why if I'm one day late paying my taxes I'm assessed penalties and interest, but the state can pay its bills 120 days late and there are no real repercussions. It's easy to expand programs and services, but until you can pay for it, you haven't solved the problem. Representative Mitchell's legislation will help immensely."

"We want to help middle-class families provide coverage for their kids, but it won't do any good if no one will treat them because the state is so far behind on Medicaid reimbursements," Mitchell said. "This legislation will ensure the state lives up to its obligations, or pays the financial consequences just as you or I would."

Mitchell said he will push for consideration of his "pay as you go" measure in the upcoming fall veto session, alongside the governor's health care expansion plan.

[News release from Rep. Bill Mitchell] 

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