March 5, 2019
CHICAGO — Comptroller Susana A. Mendoza is releasing a digital video today encouraging passage of her bill to hold Illinois' MCOs accountable. Doctors, dentists and other medical personnel who treat Illinois Medicaid patients wait to be paid by Illinois' Managed Care Organizations (MCOs). The front-line providers often complain to our office that they wait a long time to be paid.
Starting last year, Illinois implemented a massive expansion of Medicaid Managed Care. This $63 billion procurement was the largest in Illinois’ history. With Illinois’ increased reliance on MCOs, there is a higher call for transparency and accountability in how these entities are serving patients, the medical providers they work with and, ultimately, taxpayers.
Despite the state’s reliance on the MCOs to administer the Medicaid program, the state has relatively little information about when providers can expect payment from MCOs. The Comptroller’s office routinely hears horror stories from providers frustrated by not receiving payments from the MCO in a timely manner after providing service. Providers like nursing homes and safety net hospitals in rural and low-income communities rely on reimbursements from MCOs to keep their doors open and serve this vulnerable population.
Comptroller Mendoza's bill, HB 2117/SB 1238, would require MCOs to disclose provider payment information every quarter.
* Total number of claims received by the MCO for that quarter;
* The number and amount of claims paid to providers;
* When the payments were made;
* When the claims for those payments were received; and
* For what service dates the payments were made.
The bill is sponsored in the House of Representatives by State Rep. Natalie Manley, D-Joliet, and in the State Senate by Sen. Laure Fine, D -Glenview.
View full video here.
You can download a PDF of this release here.