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Latest News and Updates: State and Medicaid

Great Lakes Continues Work on Illinois Legislation Affecting HME Providers

Friday, May 18, 2018  
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The Great Lakes association has been tracking two bills in the Illinois state legislature that affect HME providers.  As previously reported, SB 2262 (click here to view, see underlined language on p.10) was introduced in response to supplier contract amendments from IlliniCare (Centene) which reduced fees to suppliers by as much as 60% from contracted rates. We are continuing to work with our government relations consultant to follow the progress of the bill and engage legislators and the managed care plan directly.  The affected parties including Great Lakes will meet again in 6-7 months to review any effects of these reductions and see what/if any problems have developed for patients and providers. 

 

The association was also invited to participate in a recent meeting with the Illinois Medicaid Working Group to share problems that providers are experiencing with the state’s managed care program.  The Illinois State Council developed two primary recommendations which were shared with the working group at the meeting.  Those are: 

1)      Create an MCO/DME rate change oversight process

2)      Protect provider network adequacy and patient choice

The association’s Illinois State Council is also monitoring a DME “re-use” bill SB 3048.  We have had several conversations with the proponents of the bill, the Illinois Assistive Technology Program, to understand the purpose of the legislation. The bill states that Illinois Medicaid or managed care plans may “purchase” used or refurbished DME items. We’re working to clarify and raise concerns about the intent of the bill, specifically the word “purchase” which is confusing given that the state agency and contracted plans don’t purchase equipment/supplies in the traditional sense but instead reimburse suppliers for equipment issued to eligible Medicaid beneficiaries with a prescription for the device. We’ve raised other questions regarding equipment warranties and liability issues, beneficiary choice, state licensing and accreditation and other issues.  We are continuing to work with IATP and legislators and will continue to share information as these discussions progress.