Rauner also complained about a bill that says people entering medical facilities like nursing homes are presumed to be eligible for Medicaid benefits until the state determines otherwise.
“That has the likelihood of costing tens of millions and potentially hundreds of millions of dollars that cannot be recouped,” Rauner said. “It is a huge mistake on the part of the General Assembly.”
Rauner had proposed changes to the bill that he said would help control costs. However, the House and Senate voted to reject those changes without any dissenting votes.
Lawmakers passed the bill in the first place because the state is far behind in determining if someone is eligible for Medicaid assistance. They were concerned that nursing homes were assuming costs for patients who should have been covered by Medicaid but weren’t because the state was behind in its work.
* From a June 28th press release from Comptroller Susana Mendoza…
Since taking office, Comptroller Mendoza, as the state’s chief fiscal officer, has prioritized payments to programs serving the state’s most vulnerable populations, including the roughly 55,000 Medicaid long-term care (LTC) program participants, many of whom reside in nursing homes and supportive living and hospice care facilities.
But now the failure to process millions of dollars in bills for critical services and a spike in enrollment delays is threatening care providers’ ability to cover basic costs like medicine, food, and payroll, Comptroller Mendoza said. […]
The Comptroller’s report, which uses Department of Healthcare and Family Services (HFS) data, found that the number of pending Medicaid eligibility determinations for LTC over 90-days-old rose 143 percent between December 2017 and May 2018. HFS has reported it can only process 60 percent of new, incoming applications in a timely manner and, as of the end of last month, there were 16,378 pending admissions. According to the Associated Press, the estimated cost of these pending admissions is up to $300 million.
These problems are occurring at the same time the Rauner Administration continues to dump tax dollars into a failed technology solution meant to streamline Medicaid eligibility processes. The state has committed $288 million to Deloitte, the global consulting firm, for an Integrated Eligibility System (IES) to modernize enrollment in benefit programs like LTC or the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps.
* Also from the comptroller’s office…
HB 4771 enshrines into law the decision made in Koss v. Norwood, which requires the State to grant “provisional eligibility status to any applicant whose application is more than 46 days old.” Additionally, the bill requires the Department of Healthcare and Family Services to submit a voucher to the Office of the Comptroller within 10 business days of being granted provisional eligibility.
As noted above, the bill unanimously passed both chambers and then the governor’s veto was overridden without dissent. It had bipartisan sponsors, including Republicans with experience dealing with Medicaid issues.
The GA stepped in to fix something because Rauner couldn’t or wouldn’t. Legislative fixes opposed by the executive are never optimal. But they become necessary in these sorts of situations. And the time to influence legislation is during the spring session, not with a long amendatory veto in August.