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Democratic lawmakers: Change Medicaid payments, or maybe get rid of managed care

Illinois Watchdog.Org

Monday, March 11, 2019  |  Article  |  By Benjamin Yount

Hospitals, Health Facilities Planning Board (48) , Medicaid, Managed Care Lightford, Kimberly--State Senate, 4
A group of Democratic lawmakers wants changes to the way some hospitals in Illinois are paid.

State Sen. Kimberly Lightford and some of the people who run Illinois' safety net hospitals say if they can't get paid under Illinois' new Medicaid structure, they may have to make some changes.

Lightford said safety net hospitals, those hospitals that serve primarily low-income areas of the state, are suffering under managed care.

"I know that over the years, since the managed care organizations have been enacted, we've tried a number of times to approach them and offer up an opportunity to come to a happy medium," Lightford said. "And they have not been able to give us any type of support."

Lightford is pushing a plan to have managed care organizations pay more, for more things, and pay more quickly.

The MCOs say they are doing what they're supposed to do, manage care for the nearly 3 million people on Medicaid in Illinois.

Lightford said if the MCOs can't meet her demands, she's not ruling out ending the state's managed care program.

"We'd like to try it with the reforms, and see if we can work with the MCOs," Lightford told. "But I wouldn't discard that coming in the future if that's what's needed. This is a critical issue."

But that may be easier said than done. Gov. J.B. Pritzker is proposing a tax on MCOs in his state budget that would the single largest source of new revenue for the state.