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Illinois will appeal a ruling that that says state workers - rather than an outside firm - must scrub Medicaid rolls. A top state official made the announcement Tuesday at a hearing in Chicago. Amanda Vinicky reports.
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Illinois' attempts to remove ineligible people from the state's Medicaid rolls are on hold, as Illinois and its largest public employees' union fight over who should actually do the scrubbing.
Now the state says it will appeal a ruling that says it has to cancel its $77 million contract with an outside firm.
Big changes are ahead for Medicaid, the state's health insurance program for the poor. Hundreds of thousands of residents are expected to be added to the rolls under the federal health care law.
But first, Illinois wants to remove people who are ineligible.
The state hired a company - Maximus - to do that, and since January, about 125,000 people have been dropped. Henry Bayer, with the AFSCME union, says state employees should have had that duty.
"The state of Illinois could have accomplished the same task for $18 million less."
An arbitrator agreed; meaning Illinois would have to end its contract with Maximus months early. But State Sen. Dale Righter, a Republican from Mattoon, says a private vendor was needed because state workers weren't getting the job done.
"The reason the third party contractor was insisted upon, and approved with an overwhelming, bipartisan majority in both chambers and signed by the governor, was because looking back since 2011 the history kind of demonstrated to us that we needed something more. Cause just kinda the same old statements about 'we're going to get this thing cleaned up' and the same press releases and the same 'come on now team let's go' wasn't getting it done."
The state says its workforce has dwindled to the point where there aren't enough case workers to carry out the job. It'll appeal the arbitrator's decision.
Department of Healthcare and Family Services Director Julie Hamos says it's especially important now that Illinois get its Medicaid numbers down because the state's moving to a managed care system. Instead of reimbursing doctors when they provide services to a Medicaid patient, Illinois will pay a per-client fee, regardless of whether the Medicaid participant actually goes to the doctor or not.
