Bill Text: IL SR0480 | 2017-2018 | 100th General Assembly | Introduced


Bill Title: Urges the Department of Health and Family Services to immediately suspend the Medicaid managed care RFP for a Purchase of Care Contract for review by the General Assembly to allow for transparency and assurance of non-discriminatory actions and fair competition for all sizes and business models of managed care organizations. Urges the General Assembly to convene the Special Committee on Oversight of Medicaid Managed Care to meet as soon as possible to review the RFP for a Purchase of Care Contract and seek answers from the Director of Healthcare and Family Services, the Procurement Policy Board, the Office of Inspector General, the Illinois Attorney General, and the individual in charge of the Medicaid managed care RFP for a Purchase of Care Contract.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Introduced) 2017-08-04 - Rule 3-9(a) / Re-referred to Assignments [SR0480 Detail]

Download: Illinois-2017-SR0480-Introduced.html


SR0480LRB100 12608 MST 25833 r
1
SENATE RESOLUTION
2 WHEREAS, Founded in 1995, the Family Health Network (FHN)
3is the only not-for-profit managed care organization in
4Illinois; FHN ensures quality healthcare for the underserved
5minority communities of Cook County through a care network in
6coordination with FHN's five director hospitals; and
7 WHEREAS, FHN is directed by five Illinois Disproportionate
8Share Safety Net Hospitals: Saint Anthony's Hospital, the
9Norwegian American Hospital, St. Bernard Hospital, the Sinai
10Health System, and Presence Saint Mary and Saint Elizabeth
11Hospital; and
12 WHEREAS, FHN's status as a not-for-profit affords it the
13ability to direct its profits to supplement the operational
14budget of its five Hospital Directors instead of that money
15going into profits of private insurance companies such as other
16Illinois Medicaid HMOs; in some cases resulting in 10%-15% of
17the operating budget for the five FHN supported Safety Net
18Hospitals; and
19 WHEREAS, FHN's revenue distribution accounts for 10% to 15%
20of the operating budget for these five FHN supported Safety Net
21Hospitals; this revenue is critically needed to meet the
22financial obligations of the hospitals in meeting the

SR0480- 2 -LRB100 12608 MST 25833 r
1healthcare needs of more than 250,000 poor Latino and African
2American Illinois citizens; and
3 WHEREAS, Since Medicaid Managed Care replaced traditional
4fee-for-service for most of the Illinois Medicaid population,
5these hospitals have seen a nearly 10% reduction in revenue for
6the same services performed because of claim denials and added
7costs, both for the benefit of the for-profit insurance
8companies instead of the poor people the program is designed to
9help; and
10 WHEREAS, On February 27, 2017, the Department of Health and
11Family Services (DHFS) released a Medicaid managed care RFP for
12a Purchase of Care Contract to arbitrarily narrow the number of
13managed care organizations contracted in the State; the RFP for
14a Purchase of Care Contract was released without input from
15healthcare providers, the General Assembly, or advocates for
16the underserved communities; and
17 WHEREAS, This RFP for a Purchase of Care Contract comes at
18a time of fiscal and regulatory uncertainty on healthcare and
19the Affordable Care Act in Washington as President Donald Trump
20calls to radically overturn Medicaid, putting healthcare at
21risk for hundreds of thousands of Illinoisans, both documented
22and undocumented children and adults; and

SR0480- 3 -LRB100 12608 MST 25833 r
1 WHEREAS, The State currently owes FHN more than $260
2million, severely stressing the financial viability of FHN and
3the financial health of their safety net directors; and
4 WHEREAS, The RFP for a Purchase of Care Contract
5arbitrarily requires all non-exempted respondents to provide
6statewide care network even though under its current contract
7with the State, FHN is only required to provide a Cook County
8network; FHN's current Cook County network provides care for
9more than 250,000 Medicaid recipients; this radical and highly
10questionable new statewide requirement was put forward with no
11explanation from DHFS; and
12 WHEREAS, If FHN is no longer contracted to provide care for
13the 250,000 Latino and African-American Illinoisans, these
14communities will have severely reduced access to critical
15healthcare, forcing the closure of Illinois-only
16not-for-profit managed care organizations; the only benefactor
17of this change will be the profit margin of the for-profit
18insurance companies bidding to replace FHN, displacing
19thousands of minority and poor healthcare recipients; and
20 WHEREAS, Excluding FHN from the Medicaid program in Cook
21County will severely jeopardize the five safety-net hospitals
22and the 4,000 employees who operate these essential community
23anchors; there failures would cause a dramatic negative

SR0480- 4 -LRB100 12608 MST 25833 r
1economic and social impact on their southside and westside
2communities; and
3 WHEREAS, The General Assembly has the duty to appropriate
4expenditures from public funds, including the estimated $9
5billion per year RFP for a Purchase of Care Contract resulting
6in $54 Billion in expenditures over the six-year potential
7contract term; the General Assembly also has the duty to review
8actions that have the potential to cause negative impact on the
9lives of the residents of Illinois through questionable
10executive branch decisions whether the questions arise from
11policy or ethical concerns; therefore, be it
12 RESOLVED, BY THE SENATE OF THE ONE HUNDREDTH GENERAL
13ASSEMBLY OF THE STATE OF ILLINOIS, that we urge the Department
14of Health and Family Services to immediately suspend the
15Medicaid managed care RFP for a Purchase of Care Contract for
16review by the General Assembly to allow for transparency and
17assurance of non-discriminatory actions and fair competition
18for all sizes and business models of managed care
19organizations; and be it further
20 RESOLVED, That the General Assembly should convene the
21Special Committee on Oversight of Medicaid Managed Care to meet
22as soon as possible to review the RFP for a Purchase of Care
23Contract and seek answers from the Director of Healthcare and

SR0480- 5 -LRB100 12608 MST 25833 r
1Family Services, the Procurement Policy Board, the Office of
2Inspector General, the Illinois Attorney General, and the
3individual in charge of the Medicaid managed care RFP for a
4Purchase of Care Contract; and be it further
5 RESOLVED, That we urge the DHFS to cooperate and
6participate in this review to avoid the appearance of
7impropriety and unethical actions related to the RFP for a
8Purchase of Care Contract process as well as to provide a
9positive outcome for the residents of Illinois; and be it
10further
11 RESOLVED, That suitable copies of this resolution be
12delivered to the Governor, the Director of Healthcare and
13Family Services, and all members of the Illinois General
14Assembly.
feedback