HR0755 100TH GENERAL ASSEMBLY

HR0755 LRB100 17071 ALS 32492 r

HOUSE RESOLUTION

WHEREAS, The Health Choice Illinois Medicaid Managed Care Program is a program proposed by the Illinois Department of Healthcare and Family Services (HFS), which seeks to completely change the way the State of Illinois administers its Medicaid program; and

WHEREAS, The purpose of the Health Choice Illinois Medicaid Managed Care Program is to increase the number of people enrolled in the state's Medicaid Managed Care Program from the current 60 percent of Medicaid beneficiaries, to 80 percent and to launch the program in all 102 counties (currently, it is only in 30 counties); and

WHEREAS, The Health Choice Illinois Medicaid Managed Care Program was implemented as of January 1, 2018; and

WHEREAS, The transformation into the Health Choice Illinois Medicaid Managed Care Program stands to drastically affect the providers of Medicaid healthcare services for the state's most vulnerable populations, especially residents in nursing homes; and

WHEREAS, It is important that the new program safeguards the needs of nursing home residents because of their unique challenges, while also addressing any additional complications for nursing homes in complying with and implementing any new managed care agreements; and

WHEREAS, The Health Choice Illinois Medicaid Managed Care Program lacked transparency from its inception, since it was procured outside of the standard procurement process, had no independent review, and was not subject to the transparency and ethics requirements of a standard procurement, despite the fact that it was the largest procurement in the history of the State of Illinois, with a value of $63 billion; and

WHEREAS, The Illinois General Assembly passed legislation to increase oversight for the Health Choice Illinois Medicaid Managed Care Program and place the awarding of the Managed Care Organization (MCO) contracts within the Illinois Procurement Code; however, this legislation was vetoed by Governor Rauner; and

WHEREAS, HFS had sole discretion in awarding the winning contracts to the MCOs with no oversight from the legislature, the Chief Procurement Officer, the Illinois Office of the Comptroller, or other independent oversight agencies to ensure a clear and transparent procurement process; and

WHEREAS, The Health Choice Illinois Medicaid Managed Care Program required the State of Illinois and the Department of Healthcare and Family Services to sign a master contract with the MCOs; and

WHEREAS, The Medicaid MCOs are now pursuing individual contracts with providers to maintain an adequate network for Medicaid beneficiaries; and

WHEREAS, There are major issues with the MCO contracts that are being offered to providers, with some contracts not complying with the provisions of the master contract between HFS and the MCOs; and

WHEREAS, During a review of the provider contract language with the MCOs, it has been noted that there are provisions that may violate federal or state law; and

WHEREAS, It is unjust that providers be pressured to sign contracts to be a part of the Health Choice Illinois Medicaid Managed Care Program until these compliance issues are resolved; providers deserve to know the terms and conditions to which they are agreeing, with appropriate due diligence and review; and

WHEREAS, Some providers have already signed these provider contracts after threats were made by HFS that the provider either sign the contract now or not have an opportunity to sign the contract at a later date; and

WHEREAS, In the event that addendums to these provider contracts are issued by HFS in the future, providers will not have the opportunity to review them prior to being contractually bound to obey them; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we strongly urge the Department of Healthcare and Family Services to delay the implementation of the Health Choice Illinois Medicaid Managed Care Program for nursing homes for 60 to 90 days to give the providers and the MCOs the opportunity to correct these contractual deficiencies and help to ensure a seamless transition for this new program; and be it further

RESOLVED, That in the event that any provisions within the provider contracts are in conflict with state or federal law, that the state or federal law will govern; and be it further

RESOLVED, That suitable copies of this resolution be delivered to the Governor of the State of Illinois and the Director of the Department of healthcare and Family Services.