* From a press release…
The Illinois Department of Healthcare and Family Services (HFS) and the Illinois Department of Human Services (IDHS) [yesterday] announced that an Arbitrator has issued a supplemental order impacting the State’s largest public employee union that will allow for a contract with an outside vendor that handles Medicaid eligibility screening to be amended instead of abruptly cancelled.
The arbitrator’s supplemental order allows the state to maintain the improved screening process put in place this year to verify that Medicaid clients remain eligible for benefits when they re-apply annually to remain in the program. The state was faced with the abrupt termination of the eligibility screening contract with Maximus, Inc., at the end of this year, under an arbitrator’s initial ruling - issued this summer- in response to a grievance by the American Federation of State, County and Municipal Employees (AFSCME) Council 31.
Under the supplemental order, the Maximus contract will be amended and the state will retain the ability to use Maximus to make preliminary electronic determinations through the end of June. In addition, the agencies will be able to retain the use of Maximus’s call center and mail room operations through June 30, 2015. The screening program, known as the Illinois Medicaid Redetermination Project, was authorized by the General Assembly as part of the “Save Medicaid Access and Resources Together Act” (SMART Act) of 2012. The amended contract will comply with State and federal law and the collective bargaining agreement.
* But that’s not entirely true. The arbitrator’s “supplemental order” came after some negotiations…
In order to bring down costs, the administration of Gov. Pat Quinn agreed to hire Maximus, a company with experience verifying eligibility for Medicaid in other states. But the AFSCME union objected, saying the job should be done by government employees.
An arbitrator agreed, and the Quinn administration, warned by its lawyers that an appeal might not succeed, cut a deal with the union.
* Two Republican legislators called the new agreement a “backroom deal” and defended Maximus…
But lawmakers say the private company, Maximus, was “a stunning success” and should have never been fired.
“As of the latest update, 216,000 people who were receiving Medicaid benefits were taken off the program because the third-party contractor was involved,” said state Sen. Dale Righter, R-Mattoon, adding that Maximus only looked at about a half million Medicaid files.
State Rep. Patti Bellock, R-Hinsdale, said before Maximus took over the review, state workers did a terrible job of checking incomes and addresses.
“These people were not even living in Illinois,” Bellock said. “They were (in) Wisconsin, Indiana, Michigan.”
* AFSCME disagrees that Maximus was so great…
The union, however, points to the same report to contend that Maximus has a roughly 30 percent error rate among those 127,000 cases. Union leaders also say Maximus was duplicating work being done by state employees and argue that the company “found favor with a small vocal minority of legislators and conservative lobbyists.”
“It’s time to end this failed experiment with outsourcing a critical public watchdog role to a private, for-profit corporation,” said Henry Bayer, executive director of AFSCME Council 31. “This order will bring oversight back to state government where it is directly accountable, and save money in the process.”
Actually, Maximus has some Democratic and regular Republican lobsters.
* Quinn defended the new arrangement…
Quinn denied any “backroom deal.”
“That isn’t the case,” Quinn told reporters in Chicago. “The fact of the matter is that I respect everyone. But I don’t want to spend the rest of my life in court.”
Mike Claffey, a spokesman for HFS, said there was “nothing secret” about the deal, noting that legislators were told about the “two-track strategy” in September and it was in the department’s quarterly report.
* Look, the problem before wasn’t with the state employees, it was with management. If competent management is determined to cleanse the Medicaid rolls, then the job will get done. The question is whether state management is competent enough to do that and has the will to go forward.