16 Comments - NIU Grad - Tuesday, Feb 4, 20 @ 11:07 am: I hope it’ll get more of a focus in the Budget Address, along with a detailed path forward. - Costly MRI - Tuesday, Feb 4, 20 @ 11:17 am: ==emergency meeting with the CEOs== Why can’t Illinois’ middlemen just do their jobs? - cover - Tuesday, Feb 4, 20 @ 11:18 am: Doesn’t anybody in the Governor’s office read Capitol Fax? The Cook County Public Guardian gave multiple public warnings of impending disaster in the week before the DCFS kids were scheduled to move to managed care. - Stuff Happens - Tuesday, Feb 4, 20 @ 11:22 am: Is there an easy way to check your own status? I ask because I have two children affected by this, and them losing insurance would be a qualifying event to put them on my own insurance (which is what we wanted to do, but we have to wait until open enrollment). - NoGifts - Tuesday, Feb 4, 20 @ 11:30 am: Is this the same medicaid program people on the healthcare exchange are pushed into? - @misterjayem - Tuesday, Feb 4, 20 @ 11:31 am: “OK, fine, but if the system is so good then why did that Sunday meeting even have to take place?” Must have been one of their regularly scheduled ‘everything is going super-great’ Sunday meetings, Rich. – MrJM - Da Big Bad Wolf - Tuesday, Feb 4, 20 @ 11:37 am: Meanwhile, wealthy seniors who need nursing home care are putting all their assets in “irrevocable trusts” so that they can get on Medicaid earlier and their children can cash out. Maybe instead of denying people who truly need Medicaid we should look at that. - Retired Educator - Tuesday, Feb 4, 20 @ 11:49 am: We seem to have a lot of glitches lately. I think glitch is a code word for incompetence. - dbk - Tuesday, Feb 4, 20 @ 12:16 pm: –”due to a ‘glitch’”: what exactly does that mean? Shouldn’t someone present at the Senate hearing request clarification? “Glitch” covers a multitude of sins. This reminds me of the software debacle from the final years of our previous governor. And Iowa, and the roll-out of the ACA’s online enrollment software way back when. Kicking the can down the road to April - when 17,000 additional children currently under the state’s care will be added - is just kicking the can. We need a major re-think - ideally, of the whole idea of dumping these children into MCOs in the first place. Not at all a good look for the administration - I’m surprised and deeply disappointed. - Almost retired - Tuesday, Feb 4, 20 @ 12:41 pm: The meeting that HFS had with MCO CEOs on Sunday that supposedly fix things unfotunately displays the potential fact that HFS higher ups don’t understand how their own system works at the patient level. The mistakes that left about 2,500 youth uncovered probably involved the enrollment broker which is different than the MCOs. You tell your choice to them on the phone or they automatically assign one to a plan. Having a disabled adult on medicaid and having ran a care coordination program for medicaid recipients, mistakes at the enrollment broker level are not unusual. On Monday morning, when the uncovered youth went to their doctors or pharmacy I am not sure how the MCOs execs and the higher ups changed the information for these kids in every billing system and health care admission system to show that these youth are covered. The meeting was a “show” meeting. Children and parents would have been told on Monday morning at the Doctor’s office that they weren’t covered. I am curious why HFS and/or DCFS didn’t set up a crises hotline run by their own staff who would trouble shoot and help these parents and insure these vulnerable youth had their healthcare. I would be curious if the per person per month payment to MCOs happens for these youth for the full month of February. I think there is the possiility that higher ups at HFS view something like this as just collateral damage involved with changing the system. - Michigander in DuPage - Tuesday, Feb 4, 20 @ 1:07 pm: I think it’s important to note that it’s not just the population of adopted and former foster children who were enrolled into Managed Care effective Feb. 1. The enrollment also included “special needs” children, defined on the HFS website (https://www.illinois.gov/hfs/MedicalProviders/cc/Pages/defaultnew.aspx) as those children receiving SSI, served by the UIC DSCC Core Program and those with a physical disability. These children often have complex medical needs and need specialty care. The MCOs are contracted to provide Care Coordinators who help families navigate and not only find providers within the MCO network, but assure that referrals are in place and prior authorizations received. I have heard multiple reports of families who have had difficulty contacting care coordinators. - Oswego Willy - Tuesday, Feb 4, 20 @ 1:14 pm: === OK, fine, but if the system is so good then why did that Sunday meeting even have to take place?…=== There’s a Kaffee quote about a transfer that keeps flashing in my head as I read Rich’s question. Governor’s own. I’m confused as to what this administration sees as important or why are things in a crisis, due to… a glitch? - RogueOne - Tuesday, Feb 4, 20 @ 1:25 pm: I found it very telling that HFS didn’t mention cost savings as a goal for moving this vulnerable population to MCO plans during the hearing today. Even HFS can’t hide behind using “glitch” as a reason for this disaster. Legislators stated they don’t want to end up at another hearing in May after the upcoming April rollout gets screwed up as well. Ohio forced all of their MCOs to resubmit contracts after substantial pricing issues were found in their Medicaid program. I’m sure if HFS were allowed to audit benefit claim level data, we would see the same pricing issues across our MCOs. - comfortably numb - Tuesday, Feb 4, 20 @ 2:31 pm: “Glitches” - hmmm - that sounds to me kind of like “in the weeds” which was a phrase often uttered in response to the mere mention of potential issues or problems that Upper Mgt. had not, and thus did not want to, contemplate. Those weed things just mess up fluffy concept paper,dot point slides, and mirage of competent systems thinking. Managed Care implementation in Illinois has been and remains an empty pretense under both parties. Consider the implementation in any of the programs meant to care for vulnerable populations - these or even worse - the big one top dump of LTC, MH, drug/alc. Per usual, only DD spared no-weeds-allowed dump. - revvedup - Tuesday, Feb 4, 20 @ 5:40 pm: DHS, HFS, and MCOs: “We held a weekend meeting to coordinate our untimely and incorrect response to problems we caused. I mean, we can’t call programmers in on overtime; it cuts into our profits, as well as DHS/HFS budgets. The kids will be fine until we get around to finishing the work sometime later in the week.” - madajen - Thursday, Feb 6, 20 @ 3:01 pm: I just went through this transition with my 2 adopted special needs kids, both of whom have multiple medical challenges - and it is a nightmare. One area that has not been addressed by any writer so far is that while our kids were transitioned, no new insurance cards were sent to us, nor is there any easy way for providers to cross reference using existing Medicaid ID #s. So, when I took both kids to Rush for bloodwork, it took 45 minutes just to register them, despite the fact that all of their many specialists and their PCP are at Rush, and they are both in the lab system due to previous bloodwork. It is an absolute mess. 2 days later I went to pick up medication for my son who has severe epilepsy and had a very similar problem. The kicker for me is that while BCBS Community Health had no record of my daughter - her meds went through at no cost. For my son, who WAS in the BCBS system, the pharmacy could not see what his insurance was. Pure incompetence. I have had to request insurance cards for both of them, even though we were promised new cards and welcome packets prior to February 1. Sorry, comments for this post are now closed.