CHICAGO – A controversial proposal to overhaul the state’s healthcare network that serves more than three million Illinoisans took another step forward on Monday: A total of nine entities submitted proposals by the noon deadline today to participate in Governor Rauner’s consolidation of the State’s Medicaid and Managed Care Organization (MCO) system.
The Rauner proposal includes moving an estimated 500,000 Medicaid recipients into the MCO system while reducing the number of MCOs statewide from 12 to as few as four. He exempts this procurement -- the largest in the state’s history -- from the state’s procurement code, taking it outside the oversight that comes with that.
“Calling this a ‘Purchase of Care,’ instead of a procurement means no independent procurement officer reviews it,” Comptroller Mendoza said. “This is not afforded the same independent oversight as, say, a contract to purchase paper clips.”
Comptroller Mendoza told the House Human Services Committees Wednesday that, in light of the current instability of the national healthcare system and the state of Illinois’ finances, this procurement which will cost between $35 billion and $40 billion over four years should be put on hold until after the state passes a budget.
“As Illinois’ chief fiscal and accountability officer, my concerns over MCO restructuring start with three issues: timing, transparency and accountability,” Mendoza told committee members. “With State finances in disarray, and the future of our national healthcare system uncertain, why is this the time to restructure managed care?”
Mendoza’s full statement is available here:
On May 2, Mendoza’s Office released a comprehensive report on the Rauner MCO RFP. The report can be found here:
http://illinoiscomptroller.gov/comptroller/assets/File/news_releases/MCORFP_FINAL_050217%20(1).pdf
Per the RFP, three to five of the final contracts will be offered to MCOs seeking to provide coverage to all 102 counties in the State. One or two contracts will be offered to bidders seeking to provide coverage in Cook County only, and shall be either a government- or minority-owned organization. Entities were not allowed to bid on both contract types.
The following companies responded to the HFS RFP on Monday: Aetna; Blue Cross Blue Shield; Cook County Care; Harmony; Illini Care Health; Meridian Health; Molina; Next Level; and Trusted Health Plan
Four current MCOs – Cigna; Community Care Alliance; Family Health Network; and Humana – did not respond to the RFP. Those entities collectively serve about 250,000 individuals in Illinois.
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You can view the PDF version of this release here.