Tuesday, January 25, 2011

Quinn signs Medicaid reforms

By Lauren N. Johnson

Gov. Pat Quinn signed a bill today enacting comprehensive reforms to the Medicaid system in Illinois.

“It’s a very important day for health care in Illinois,” said Quinn, highlighting the measure’s passage during a challenging economic time for the state and the bipartisan effort put forth to approve the package in the last few weeks of session.

The governor said the measure is an “efficient” and “proper” response by lawmakers to remove waste and fraud from the state’s Medicaid system while saving taxpayers' money. He said the reforms also will help stabilize Illinois’ budget.

The legislation was sponsored in the Senate by Sen. Heather Steans, a Chicago Democrat, and Sen. Dale Righter a Mattoon Republican, and in the House by Rep. Barbara Flynn Currie, a Chicago Democrat, and Rep. Patricia Bellock, a Hinsdale Republican.

The state’s Medicaid system, which is administered by the Department of Healthcare and Family Services, provides health coverage to 2.8 million low-income individuals and families, people with disabilities and older adults. Of those, 160,000 are in the state’s voluntary managed-care program.

Under the new law, the department will expand so-called coordinated care – focused on wellness and prevention – to cover at least 50 percent of recipients eligible for Medicaid by 2015. That and other reforms are expected to achieve savings of more than $624 million during the next five years.

“We are reforming the [health care provider] service delivery system at the same time that we are reforming the payment system,” said Julie Hamos, director of the Department of Healthcare and Family Services, “and the combination of those two will produce the kind of incentives we need to keep people healthier and ultimately cheaper to provide health care for.”

As part of the coordinated care, said Michelle Saddler, secretary of the Department of Human Services, the department aims to put all Medicaid enrollees into “medical homes,” where they will consistently see primary care physicians.

The new law also will allow the state to save on prescription drug costs by increasing co-payments, promoting 90-day maintenance prescriptions and controlling utilization, and reducing prompt payment interest rates for pharmacy bills from 2 percent to 1 percent.

Beginning in July, the department will enhance the eligibility process – subject to federal approval – by requiring participants to prove Illinois residency annually and verify their incomes. The stepped-up process will require a month’s worth of income information instead of a single pay stub. Annual redetermination of eligibility will begin October 1.

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