IHA Update: Governor Signs Medicaid Managed Care Reform Bill

August 5, 2019

Update: Governor Signs Medicaid Managed Care Reform Bill – SB1321

On Monday (Aug. 5) Governor Pritzker signed Senate Bill 1321 / PA101-0209, comprehensive Medicaid managed care reform legislation strongly backed by IHA. (See the Governor’s press release.)

IHA thanks the Governor, the members of the Medicaid Legislative Work Group, including Rep. Greg Harris, Sen. Heather Steans, Rep. Tom Demmer, and Sen. Dave Syverson, and members of the General Assembly for hearing the concerns of the hospital community and taking action.  We also thank Department of Healthcare and Family Services (HFS) Director Theresa Eagleson and Medicaid Administrator Doug Elwell for committing to work with IHA and the hospital community to resolve our issues and concerns with the Medicaid Managed Care Program.

Please click here for a technical summary of SB1321 that outlines the core components for which IHA strongly advocated on behalf of members, as well as other important provisions.  This new law lays the foundation needed to reduce inappropriate payment denials, significantly ease administrative burden, and enhance patient care.

Our focus now will be on the implementation of the law.  IHA will be working closely with HFS to:

  • Assure timely and effective implementation of the law’s provisions and hold the Managed Care Organizations (MCOs) accountable for complying with the new requirements;
  • Assist in the development of relevant administrative rules;
  • Implement additional performance improvement measures;
  • Monitor claim denial trends;
  • Resolve member-identified concerns through ongoing collaboration; and
  • Resolve issues causing inappropriate denials and to examine MCO policies that can be improved through greater transparency, clarity, and standardization.

In the near future, we will be sending you detailed information about the key implementation steps and activities.

Finally, we want to express our deep appreciation to you for sharing your stories and concerns, demonstrating the urgent need for relief from the MCOs’ most abusive practices, and engaging in strong and unified advocacy with the General Assembly on our top legislative priority for the Spring session.