Monday, November 29, 2010

Senators weigh Medicaid and workers' comp reforms

By Jamey Dunn

Senate committees took their first rounds of testimony today on two reform issues that seem to be perpetually up for debate in the Illinois Statehouse. They face a tight deadline to propose solutions to lawmakers.

Workers' compensation and Medicaid reforms are high on the list of things Republican leaders say they want to see addressed before they would consider putting votes on a plan to borrow $4 billion to make the state’s required employee pension payment for this fiscal year or support an income tax increase.

Julie Hamos, director of the Illinois Department of Healthcare and Family Services, laid out some proposed short-term reforms to Medicaid. She said Illinois should raise the bar for verification of eligibility for Medicaid. Hamos said that now, patients only have to prove they have been residents in the state for one month and show one pay stub to show that they qualify for Medicaid assistance. She added that to receive the elevated federal match that came along with the federal stimulus package, the state cannot change the requirements for assistance, but it should do more to confirm that applicants meet them.

She also suggested that the department combat waste and fraud by tracking improper or fraudulent use by patients. In some cases, people may be seeking the wrong kind of treatment, or they may be gaining access to care in an inefficient way.

Hamos wants the state to have the power to recoup revenues sapped by fraud by taking offenders to civil court. She also suggested pushing some of the cost for those eligible for both Medicaid and Medicare to the federal program, shifting to electronic health records and focusing on measurable goals while setting budgets.

“The issue is whether or not [we] are going to be able to forge a consensus. … Whether or not the Democrat leaders, who have been resistant to Medicaid change for the better part of the last decade, are now going to sign on to some of these proposals,” said Dale Righter, a co-chair of the committee.

Righter, a Mattoon Republican, added, “The nice thing about the short timeline we were given: We don’t have to wait very long to find out whether or not they are serious.”

During the committee hearing addressing the workers' compensation system, Senate Minority Leader Christine Radogno said there “are only two things” that she thinks “matter.”

“What we need to do is to lower the cost of workers' comp insurance [in Illinois]. It’s one of the highest in the nation. ... That’s a huge concern. But the other primary concern is we need to make sure workers' comp does what it supposed to do, and that’s protect injured workers.”

Radogno said if lawmakers could find ways to lower the cost to businesses and still protect workers, such reforms would bring more jobs to Illinois.

Mark Flannery, a corporate lawyer for Peoria-based Caterpillar Inc., said permanent disability awards and the “any cause” standard for payment — if the employer is partially responsible for an employee’s need for medical care the employer must pay — drive up costs for Illinois businesses. He also said employers should have a say in where employees receive medical treatment.

Flannery used the case of a worker needing knee surgery as an example of what he says are elevated costs in Illinois. “In Illinois, the disability award [in this case] is four to five times higher than what the medical profession under the [American Medical Association] guides judges the disability to be.”

Michael Carrigan, president of the Illinois American Federation of Labor and Congress of Industrial Organizations (AFL-CIO), said that in the desire to make Illinois more business friendly, lawmakers should not lose sight of what is fair for workers

“Working families deserve to be protected under strong Illinois workers’ compensation law. Those who are injured on the job deserve quality accessible health care from the best physicians and surgeons in the state. They deserve rehabilitation and post-surgery care. And if they cannot return to work, they deserve extended benefits to protect themselves and, most importantly, their families,” Carrigan said.

He added that reform should be achieved through a so-called agreed bill process, which would involve labor and business groups signing off on compromise legislation before the General Assembly votes on it. That is how changes to the workers' compensation system have been made in the past in Illinois.

Both the Special Committee on Medicaid Reform and the Special Committee on Workers' Compensation Reform are scheduled to give their final recommendations to the Senate on January 3.

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