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1
HOUSE RESOLUTION

 
2    WHEREAS, The Health Choice Illinois Medicaid Managed Care
3Program is a program proposed by the Illinois Department of
4Healthcare and Family Services (HFS), which seeks to completely
5change the way the State of Illinois administers its Medicaid
6program; and
 
7    WHEREAS, The purpose of the Health Choice Illinois Medicaid
8Managed Care Program is to increase the number of people
9enrolled in the state's Medicaid Managed Care Program from the
10current 60 percent of Medicaid beneficiaries, to 80 percent and
11to launch the program in all 102 counties (currently, it is
12only in 30 counties); and
 
13    WHEREAS, The Health Choice Illinois Medicaid Managed Care
14Program was implemented as of January 1, 2018; and
 
15    WHEREAS, The transformation into the Health Choice
16Illinois Medicaid Managed Care Program stands to drastically
17affect the providers of Medicaid healthcare services for the
18state's most vulnerable populations, especially residents in
19nursing homes; and
 
20    WHEREAS, It is important that the new program safeguards
21the needs of nursing home residents because of their unique

 

 

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1challenges, while also addressing any additional complications
2for nursing homes in complying with and implementing any new
3managed care agreements; and
 
4    WHEREAS, The Health Choice Illinois Medicaid Managed Care
5Program lacked transparency from its inception, since it was
6procured outside of the standard procurement process, had no
7independent review, and was not subject to the transparency and
8ethics requirements of a standard procurement, despite the fact
9that it was the largest procurement in the history of the State
10of Illinois, with a value of $63 billion; and
 
11    WHEREAS, The Illinois General Assembly passed legislation
12to increase oversight for the Health Choice Illinois Medicaid
13Managed Care Program and place the awarding of the Managed Care
14Organization (MCO) contracts within the Illinois Procurement
15Code; however, this legislation was vetoed by Governor Rauner;
16and
 
17    WHEREAS, HFS had sole discretion in awarding the winning
18contracts to the MCOs with no oversight from the legislature,
19the Chief Procurement Officer, the Illinois Office of the
20Comptroller, or other independent oversight agencies to ensure
21a clear and transparent procurement process; and
 
22    WHEREAS, The Health Choice Illinois Medicaid Managed Care

 

 

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1Program required the State of Illinois and the Department of
2Healthcare and Family Services to sign a master contract with
3the MCOs; and
 
4    WHEREAS, The Medicaid MCOs are now pursuing individual
5contracts with providers to maintain an adequate network for
6Medicaid beneficiaries; and
 
7    WHEREAS, There are major issues with the MCO contracts that
8are being offered to providers, with some contracts not
9complying with the provisions of the master contract between
10HFS and the MCOs; and
 
11    WHEREAS, During a review of the provider contract language
12with the MCOs, it has been noted that there are provisions that
13may violate federal or state law; and
 
14    WHEREAS, It is unjust that providers be pressured to sign
15contracts to be a part of the Health Choice Illinois Medicaid
16Managed Care Program until these compliance issues are
17resolved; providers deserve to know the terms and conditions to
18which they are agreeing, with appropriate due diligence and
19review; and
 
20    WHEREAS, Some providers have already signed these provider
21contracts after threats were made by HFS that the provider

 

 

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1either sign the contract now or not have an opportunity to sign
2the contract at a later date; and
 
3    WHEREAS, In the event that addendums to these provider
4contracts are issued by HFS in the future, providers will not
5have the opportunity to review them prior to being
6contractually bound to obey them; therefore, be it
 
7    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE
8HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we
9strongly urge the Department of Healthcare and Family Services
10to delay the implementation of the Health Choice Illinois
11Medicaid Managed Care Program for nursing homes for 60 to 90
12days to give the providers and the MCOs the opportunity to
13correct these contractual deficiencies and help to ensure a
14seamless transition for this new program; and be it further
 
15    RESOLVED, That in the event that any provisions within the
16provider contracts are in conflict with state or federal law,
17that the state or federal law will govern; and be it further
 
18    RESOLVED, That suitable copies of this resolution be
19delivered to the Governor of the State of Illinois and the
20Director of the Department of healthcare and Family Services.