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How the impasse endangered children who needed vaccines

Thursday, May 9, 2019

* In normal times under a more normal governor, few would care too much about a $24 million debt. It’s a rounding error on a rounding error and money could likely be found to pay the bill, or at least pay down the bill enough to keep moving forward. It’s for childrens’ vaccines, after all. But those weren’t normal times and that wasn’t a normal governor

The Illinois Department of Public Health owes the federal government an estimated $24 million for debt that piled up from a complicated state program to vaccinate poor kids, WBEZ has learned.

The revelation adds another layer to Illinois’ byzantine effort to get vaccines for roughly 130,000 low-income children. The state had been using free vaccines from the federal government for kids in the Children’s Health Insurance Program, known as CHIP.

But then the feds called for states including Illinois to pay for those doses. So former Republican Gov. Bruce Rauner stopped the financial bleeding with a major policy shift that led some doctors to stop vaccinating low-income children. Dozens of physicians have told Illinois public health officials this “could lead to a public health crisis with disastrous consequences” in light of the nationwide measles outbreak.

Now, the new administration under Democratic Gov. JB Pritzker is hustling to potentially unwind his predecessor’s efforts while negotiating with the feds on how to pay down the state’s big debt. […]

Illinois doctors say they thought they were allowed to use the free vaccine for patients on CHIP. In fact, Illinois was supposed to reimburse the CDC for those shots. To complicate matters, the state didn’t have a good system to track when doctors used the free vaccine for kids on CHIP.

So the debt swelled, reaching an estimated $24 million.

Concerned about this climbing IOU, Rauner’s administration hit the brakes in 2016. The state public health department stopped providing free vaccines to doctors for CHIP patients. The providers would have to pay out of their own pockets to buy vaccines instead from manufacturers, then wait for private insurers that contract with the Illinois Medicaid program to reimburse them.

- Posted by Rich Miller        

11 Comments »
  1. - Oswego Willy - Thursday, May 9, 19 @ 10:33 am:

    ===Concerned about this climbing IOU, Rauner’s administration hit the brakes in 2016. The state public health department stopped providing free vaccines to doctors for CHIP patients. The providers would have to pay out of their own pockets to buy vaccines instead from manufacturers, then wait for private insurers that contract with the Illinois Medicaid program to reimburse them.===

    This was the feature, not the bug, not the bug that causes illness is part and parcel of the Rauner legacy.


  2. - Huh? - Thursday, May 9, 19 @ 10:34 am:

    The truth of the matter was that 1.4% was an anti-vaxxer. /s


  3. - wordslinger - Thursday, May 9, 19 @ 10:45 am:

    –Concerned about this climbing IOU, Rauner’s administration hit the brakes in 2016.–

    Oh please, the guy piled on $12 billion in unpaid bills in 2.5 years, on purpose. $12 billion is $24 million X 500.

    There was no “concern” about this Mickey Mouse debt. It was just more “squeeze the beast,” to stick it to the “collectivists.”

    Rauner and Wingman Munger certainly made sure that the IT patronage army got paid, raiding GRF to pay them when there was other money for them in a dedicated account.

    A new low for Rauner, and that’s saying a lot.


  4. - Perrid - Thursday, May 9, 19 @ 10:58 am:

    How exactly was the policy shift supposed to save a dime? So before, the feds gave the state free vaccines, and then the state distributed them the providers and paid the providers for giving the shot only. So the feds were out the cost of the vaccines, not the state. With the policy shift, docs buy vaccines and then charge the state for the cost of the vaccine, plus the cost of giving the shot. So the state still has to pay back the cost of the vaccine, it’s just the providers who the state pays back, not the federal government. Is that right? So the state still needs to pay more, because the feds don’t give the state free vaccines for these kids.


  5. - Wednesday morning - Thursday, May 9, 19 @ 10:59 am:

    “How the impasse endangered children who needed vaccines” might better be written “How the impasse gave Governor Rauner another opportunity to hurt people”


  6. - efudd - Thursday, May 9, 19 @ 11:08 am:

    No, no, no.
    How many times do you people have to be told.
    It was the greedy unions and retired teachers drawing that fat pension which no one else gets that caused this vaccine crisis.


  7. - Reserved - Thursday, May 9, 19 @ 11:24 am:

    The WBEZ story is somewhat misleading, I doubt intentionally, but the the system is confusing. There are two separate federal programs at play here, Vaccines for Children (VFC),which WBEZ doesn’t reference, for kids on Medicaid, and CHIP which is separate from Medicaid, but still subject to managed care delays in payment from the same groups who manage the Medicaid program.

    Doctors get VFC vaccines to give to kids on Medicaid and it is basically a free vaccine and the docs can bill Medicaid for the office visit etc. CHIP is like health insurance, but still handled by the same folks who handle Medicaid, the doc bills the insurance company for the vaccine and office visit.

    What happened was the docs were confused about the two programs and were giving vaccines to CHIP kids that were only supposed to be for VFC kids. End result is the fed’s want their VFC money back for the misdirected VFC vaccines.

    So yes, both state and federal governments are over complicating getting poor kids vaccines, but what is not being discussed is the docs just not providing vaccines to the CHIP kids after they were told they couldn’t use the VFC vaccines for them. My kid’s pediatrician had signs in her office directing CHIP patients to the local health department for vaccines. I’m sure this is due, in part, to the delays in the state paying CHIP insurance claims, but I guess that is just the nature of our health care system, profit over patient care.


  8. - Michelle Flaherty - Thursday, May 9, 19 @ 11:31 am:

    – So former Republican Gov. Bruce Rauner stopped the financial bleeding with a major policy shift that led some doctors to stop vaccinating low-income children.–

    What Rauner did was terrible.
    But the doctors who stopped vaccinating poor kids should be ashamed of themselves.
    The med association likely pays more in lobbying costs than it cost to vaccinate these kids.


  9. - a drop in - Thursday, May 9, 19 @ 12:37 pm:

    ” For the First Time, Fewer
    Physicians are Owners Than Employees”

    So it maybe wasn’t their call to provide the vaccines without payment.


  10. - SAP - Thursday, May 9, 19 @ 2:44 pm:

    If anybody needed it, here is proof that Governor Rauner was a threat to the health and well-being of the people of Illinois.


  11. - Anonymous - Friday, May 10, 19 @ 12:53 pm:

    If Medicaid or private HMO patients are being sent to free clinics for vaccines, then the HMOs should be prosecuted for fraud. Their per member per month payment is for all covered services, including vaccinations. Taking payment and then sluffing off kids to free clinics is theft.


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