Bill Text: IL HR0386 | 2017-2018 | 100th General Assembly | Introduced
Bill Title: Recommends and urges Governor Rauner to instruct the Director of the Department of Healthcare and Family Services, Felicia Norwood, to issue an amendment to the current request for proposal separating out dental care for Medicaid eligible recipients into separate stand-alone dental administrators.
Spectrum: Bipartisan Bill
Status: (Passed) 2017-06-26 - Resolution Adopted [HR0386 Detail]
Download: Illinois-2017-HR0386-Introduced.html
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1 | HOUSE RESOLUTION
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2 | WHEREAS, The Illinois State Dental Society (ISDS) has a | ||||||
3 | growing concern with how dental care is
being provided and | ||||||
4 | monitored by managed care organizations (MCOs) to their two | ||||||
5 | million Medicaid
enrollees; and
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6 | WHEREAS, The ISDS has recently submitted several FOIA | ||||||
7 | requests to
the Department of Healthcare and Family Services | ||||||
8 | (DHFS) which have uncovered large gaps in basic dental care | ||||||
9 | data that MCOs are supposed to be providing; and
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10 | WHEREAS, Care coordination under current MCOs may work with | ||||||
11 | ancillary medical
programs such as specialty care and | ||||||
12 | behavioral health, where physicians oversee global medical | ||||||
13 | issues,
but dental care is quite different; and
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14 | WHEREAS, A true care coordination program established by | ||||||
15 | the MCO with their dental
administrator would ensure that | ||||||
16 | pregnant women have access to the additional cleanings and
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17 | periodontal services; a true care coordination program would | ||||||
18 | have the MCO sharing information with
the dental administrator | ||||||
19 | on patients that are diabetic, none of which are occurring; and
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20 | WHEREAS, Current MCO contracts with DHFS require | ||||||
21 | systematic monitoring and evaluation
for ancillary services, |
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1 | including dental services, and for the MCO to provide a written | ||||||
2 | Quality Assurance
Plan to DHFS, along with guidelines for their | ||||||
3 | dental services; additionally, the MCO contract with DHFS
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4 | requires utilization reporting for dental benefits and ongoing | ||||||
5 | evaluation of continuity of care, access, and
utilization, | ||||||
6 | including appropriate linkage between medical and dental | ||||||
7 | coordination none of which is
taking place; and
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8 | WHEREAS, DHFS has adopted 20 HEDIS (Healthcare | ||||||
9 | Effectiveness Data and Information Set)
quality measurements | ||||||
10 | to monitor care provided by the MCOs; none of these metrics | ||||||
11 | look at the quality
of dental care provided to Medicaid | ||||||
12 | enrollees; and
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13 | WHEREAS, ISDS believes that dental care should not be | ||||||
14 | included under the MCOs, but that dental
administrators should | ||||||
15 | be able to directly contract with DHFS; this would allow DHFS | ||||||
16 | to have direct
oversight of the programs that provide dental | ||||||
17 | care to the two million Medicaid enrollees in Illinois; and
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18 | WHEREAS, There is now a new request for proposal (RFP) that | ||||||
19 | would expand the existing coverage model using
medical MCOs for | ||||||
20 | up to 80% of the State's Medicaid population with none of the | ||||||
21 | concerns for dental
care being addressed; therefore, be it
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22 | RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE |
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1 | HUNDREDTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we | ||||||
2 | strongly recommend and urge Governor Rauner to instruct the | ||||||
3 | Director of the Department of Healthcare and Family Services, | ||||||
4 | Felicia Norwood, to issue an amendment to the current request | ||||||
5 | for proposal separating out dental care for Medicaid eligible | ||||||
6 | recipients into separate stand-alone dental administrators; | ||||||
7 | and be it further
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8 | RESOLVED, That this will provide better dental care, | ||||||
9 | increase utilization, control costs, and decrease tooth and gum | ||||||
10 | decay and the suffering prevalent with this population; and be | ||||||
11 | it further
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12 | RESOLVED, That adult preventive services should be | ||||||
13 | included and reimbursed at a reasonable
level as a key part of | ||||||
14 | this new dental RFP; and be it further
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15 | RESOLVED, That suitable copies of this resolution be | ||||||
16 | delivered to the Governor and the Director
of Healthcare and | ||||||
17 | Family Services.
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