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Today’s number: 14 months

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Illinois

* We have probably discussed this before, but not as a stand-alone topic. Just one more example of why Gov. Rauner’s proposed budget (like so many budgets before him) is so phony. From CoGFA…

The Governor has requested that a total of $2.025 billion be appropriated for the State Employees’ Group Health and Life Insurance program for FY 2016. The requested FY 2015 appropriation request for the Group Health Insurance Program was $2.790 billion. […]

CMS estimates the FY 2016 liability to be $2.777 billion, a 6.8% increase from FY 2015. The CGFA FY 2016 estimate of liability is $2.803 billion, $25.9 million more than CMS.

So, the estimated liability is $2.8 billion and the requested approp is $2 billion, leaving $800 million in unpaid costs.

This is by no means a new thing…

* Consequences…

Currently, for the Quality Care Health Plan (CIGNA), the delay for preferred providers and non-preferred providers is 273 and 350 days. In FY 2016, the cycle is expected to be extended significantly… CMS has calculated the amount of time it takes to make payments to managed care providers (HMOs and OAPs) at approximately seven months, which is expected to increase to 14 months in FY 2016… PPO claims would be held up to 360 days in FY 2016, above the 273 days utilized in FY 2015. Out-of-network PPO claims would rise from 350 days currently to 380 in FY 2016.

Can you imagine waiting 14 months to get paid?

Sheesh.

More bleak news here.

posted by Rich Miller
Wednesday, Mar 25, 15 @ 11:38 am

Comments

–would you wait on your money if you got 12% tacked on–that’s the problem–no incentive for providers to demand payment or to balance the Group Health line …Rauner playing same budget games as previous Govs.

Comment by anon Wednesday, Mar 25, 15 @ 11:41 am
Avoid going to the doctor to avoid collection’s calling you

Comment by foster brooks Wednesday, Mar 25, 15 @ 11:42 am
What is the interest liability under the Prompt Payment Act for Rauner’s plan to borrow $800 million from the vendor?

About $100 million?

Comment by Juvenal Wednesday, Mar 25, 15 @ 11:44 am
Yes I can imagine what it’s like to get paid. Daycare providers have gone 90 days 4 times in last 6 years. It Stinks!!!

Comment by real one Wednesday, Mar 25, 15 @ 11:45 am
once again smoke and mirrors…I apologize to my health providers every time I go. It is embarrassing to me as well as to the state. That said, I can see negotiations with the union trying to get the health costs to the appropriated amount which would mean higher employee costs.

Comment by illinifan Wednesday, Mar 25, 15 @ 11:47 am
This is another reflection of the disdain Rauner has for state workers. Though he promised not to mess with retirees’ pensions, this is another way to hurt them.

Comment by nona Wednesday, Mar 25, 15 @ 11:47 am
This has a devastating impact on state employees’ credit ratings. It’s awful.

Comment by Soccermom Wednesday, Mar 25, 15 @ 11:51 am
Gee, for all the respect you get who wouldn’t want to be in the state insurance program? After all public workers have it so good, I keep hearing.

Comment by AnonymousOne Wednesday, Mar 25, 15 @ 11:57 am
It’s definitely in the 14 - 15 month (or higher) range for Quality Care. As mentioned in another thread, I’m dealing with a parent’s estate. Over 1/2 the QC payments to providers from December, 2013 and January, 2014 are still outstanding.

All about the State partially balancing it’s budget on the backs of it’s employees.

Comment by RNUG Wednesday, Mar 25, 15 @ 11:57 am
Our daughter who is covered by my wife’s state health insurance needs oral surgery. The MD doing the surgery would not schedule it until we paid 50% up front of what insurance will cover.

The business office manager told us they cannot afford to wait for state payments or they will close and they considered refusing any patients with State of Illinois insurance coverage.

Comment by Give Me A Break Wednesday, Mar 25, 15 @ 12:00 pm
Guessin’ someone might suggest the “corrupt bargain” era has not quite ended here in Scabistan.
Or can we assume that not payin’ work comp claims will make up the difference?
BTW if this does not confirm the desperate thirst for a strike this summer we do not know what else the readers need.

Comment by anonin' Wednesday, Mar 25, 15 @ 12:01 pm
I wonder how much employee premiums and co-pays will increase in FY16.

Comment by Jogger Wednesday, Mar 25, 15 @ 12:11 pm
I left State employment in July after nearly 2 years. My experience was like Give Me a Break’s–my dentist required 50% up front because of delays. I still get the occasional $10-$50 bill from providers for services I received a year or more ago, because CIGNA is just now paying off their share.

Comment by NW Suburbs Joe Wednesday, Mar 25, 15 @ 12:11 pm
This is unconscionable. How many people (state workers–they’re people too, Bruce!) put off potentially life-saving preventative care, basically because of shame? Or how many have been denied access initially because providers know they won’t get paid on time?

Wish this could somehow be taken directly out of Rauner’s hide, personally, and the hides of those who have kicked this can down the road for years. I know, not in this life. …

Comment by Crispy Wednesday, Mar 25, 15 @ 12:12 pm
Who is thirsty for a strike? Not the unions. Maybe Rauner? But with him at the helm, the unions will play it cool. Rauner is impatient and hates unions so much that it’s more likely he’ll foolishly enforce a lockout due to his frustration. A lockout is more likely than a strike.

Comment by PolPal56 Wednesday, Mar 25, 15 @ 12:12 pm
=== I apologize to my health providers every time I go. ===

Unless I am crazy, CIGNA is collecting interest from the state under the prompt payment act.

12% per year.

If docs aren’t seeing that passed along to them, then I think it is time for someone to file a bill.

Comment by Juvenal Wednesday, Mar 25, 15 @ 12:16 pm
Just got a letter from a Debt Collection service on Monday. Found out from the Doctors office that I had a zero balance after the insurance company settles. Problem is they have automatic “FORTY WEEK” Payment delay.

Heck of a System!

Comment by WhoKnew Wednesday, Mar 25, 15 @ 12:16 pm
Does anyone know if the 2005 state law mandating unemployment for locked-out union workers applies to public-sector unions as well?

Comment by Crispy Wednesday, Mar 25, 15 @ 12:19 pm
While the float could be tough on individuals and small entities without a lower interest credit line, I’m surprised that there is so much harm claimed given the high interest rates eventually paid by the state.

Comment by Qui Tam Wednesday, Mar 25, 15 @ 12:24 pm
Sweet… State workers pay for PPO from their checks… Then they get to pay for Doctors in cash with the huge salaries they reap… Yes, it’s very appealing to work for the state..if you are independently wealthy of course….

Comment by Walter Mitty Wednesday, Mar 25, 15 @ 12:24 pm
== I wonder how much employee premiums and co-pays will increase in FY16. ==

My guess is those will go up while I’m hearing the goal is to drop coverage to the Obamacare minimum coverage level (aka Bronze).

Comment by RNUG Wednesday, Mar 25, 15 @ 12:27 pm
Once the pump is primed, if you’re getting paid 14 months late on a monthly basis, the juice is pretty sweet.

Comment by Wordslinger Wednesday, Mar 25, 15 @ 12:27 pm
This has a devastating impact on state employees’ credit ratings. It’s awful.

This is absolutely true.

Comment by VanillaMan Wednesday, Mar 25, 15 @ 12:30 pm
== I’m surprised that there is so much harm claimed ==

It’s about the cash flow. It’s about the amount tied up in arrears.

For a large business with a diverse customer base, it’s not so bad. But for the smaller providers, they may have to actually borrow money in order to have the cash flow needed to survive … and if they are in that bad of shape cash flow wise, they probably aren’t getting cheap loans.

Comment by RNUG Wednesday, Mar 25, 15 @ 12:30 pm
How long will it be before Healthlink (the OAP) has a hard time contracting doctors into Tier 1 or even Tier 2? The doctors and hospitals in Springfield are already waiting a long time for their money from a lot of their customers. The providers who are not tier 1 and 2 keep billing every month, no matter how often I send them EOBs, and explain that I won’t owe them anything after the insurance pays. Everyone so far keeps telling me that they understand, and that their bills and their delinquent bills are just automatic, and not to worry. But, yet, I read of people getting turned over to collection agencies. So, I call every time I get a bill.

Comment by mythoughtis Wednesday, Mar 25, 15 @ 12:33 pm
Mt hopeful illusion that Rauner just might be different from Quinn, Blago, and all of the miserable crew before them, has reluctantly come to an end the past few weeks, thanks mostly to Rich’s continuous reminder that this is just another fraudulent budget. When will this all end?

Comment by Skirmisher Wednesday, Mar 25, 15 @ 12:40 pm
From where does the interest money come? A provider friend told me they get interest payments but nothing on the actual bill. Seems to me they should be able to figure out a way to use some of that money source for the backlog.

Comment by Concerned Wednesday, Mar 25, 15 @ 12:45 pm
Another benefit (or harm if you’re a state employee) of Rauner’s efforts to sandbag a union contract is that it will allow him leeway to decrease benefits.

Comment by Norseman Wednesday, Mar 25, 15 @ 12:49 pm
Many Dentists is Chicago ask for 100% at time of service…period….use your credit card. Ghosts of Quinn.

Comment by scott aster Wednesday, Mar 25, 15 @ 12:53 pm
@FKA So that’s another 800 million that Rauner is lying about in his budget. Does that make Rauner’s proposed FY16 budget a massive disgrace too?

Comment by PublicServant Wednesday, Mar 25, 15 @ 1:14 pm
== So that’s another 800 million that Rauner is lying about in his budget. ==

Actually, it’s a lot more than that. All the missing $800M would do is keep the State paying over a year behind. At some point the State needs to get current, which would require a whole additional year’s worth of appropriation.

Comment by RNUG Wednesday, Mar 25, 15 @ 1:58 pm
This will push more providers to demand payment from the employee or retiree. They will simply say, “You wait on the state to pay you.”

Comment by Ugly Rumours Wednesday, Mar 25, 15 @ 2:08 pm
== This will push more providers to demand payment from the employee or retiree. ==

That was the case in the late 1980’s / early 1990’s when the State was running about a year behind …

Comment by RNUG Wednesday, Mar 25, 15 @ 2:17 pm
I have Healthlink and use Springfield Clinic and never have a problem with late payment notifications. I guess Springfield Clinic likes the 1% per month return on money owed to them. Thanks.

Comment by Mouthy Wednesday, Mar 25, 15 @ 2:28 pm
Anecdotally, the payment problem seems to be the worst at dentists (which are not covered by CIGNA) and my personal experience bears that out. Our “family dentist” gets paid by Delta Dental about 8-9 months late. The oral surgeon we use for wisdom teeth removal has for the past several years required cash up front.

Comment by Arthur Andersen Wednesday, Mar 25, 15 @ 2:41 pm
Old problem with plenty of blame to go around, but Rauner just made it a bit worse with his budget proposal. Another reason that if we’re going to get healthy, more than severe cuts are needed.

Comment by walker Wednesday, Mar 25, 15 @ 2:48 pm
*Can you imagine waiting 14 months to get paid?*

Try 3 years, and counting, for the back pay owed to some state workers.

Comment by Anonymous Wednesday, Mar 25, 15 @ 2:50 pm
If your dentist is in-network and is requiring payment up front, this is in violation of their contract with the state. You should contact CMS benefits division and report this. Out-of-network dentists can do this, but not in-network.

Comment by Just Me Wednesday, Mar 25, 15 @ 2:51 pm
Hey Rich - This isn’t news. It’s been 6-18 months for years. Ask any long time state employee.

Comment by Weltschmerz Wednesday, Mar 25, 15 @ 2:59 pm
This is ironic:

http://insurance.illinois.gov/HealthInsurance/PromptPay.asp

Comment by Soccermom Wednesday, Mar 25, 15 @ 4:14 pm
I am a state vendor and wait more than 14 months to get paid. I am fed up and ready to stop doing business with Illinois!

Comment by Let'sMovetoTexas Wednesday, Mar 25, 15 @ 4:17 pm
@Soccermom, once again, the state fails to lead by example.

Comment by The Dude Abides Wednesday, Mar 25, 15 @ 4:25 pm
Maybe Springfield could come up with a workable budget with real numbers if CEO Rauner spent more time trying to be a Governor and less time being a union hating business type.
(Granted, the GA would also have to act like adults)

Comment by Bulldog58 Wednesday, Mar 25, 15 @ 4:25 pm
Once more, I totally get that this causes some problems for State employees. But with everything else swirling around, I’d suggest they don’t complain about their healthcare. It’s excellent. (and earned)

Comment by A guy Wednesday, Mar 25, 15 @ 4:40 pm
As long as the topic is insurance, I use the Medicare Advantage offered from United Healthcare. I am required to pay upfront at the chiro, but not my family doctor. Medicare will pay if the subluxation shows improvement (in about half a dozen appointments). They will not pay if it is a repetitious, maintenance thing. The logic confuses me as an old injury hurts just as bad as a new one. If any of you have a subluxation you know how it hurts. I am confused.

Comment by howard Wednesday, Mar 25, 15 @ 8:11 pm
Could someone please confirm the unemployment question concerning the lockout ? Thanks

Comment by Peoria democrat Wednesday, Mar 25, 15 @ 10:26 pm
Rauner is not going to institute a lockout. Realize that 95% of state employees are unionized. He would take such a big PR hit for shutting down government. Expect Rauner to negotiate in such bad faith that the unions will be forced to take an action that he hopes will viewed negatively by the public. He would enjoy seeing a strike so he could blame the corrupt union bosses for shutting the government down and depriving the citizens of vital state services.

Comment by Norseman Wednesday, Mar 25, 15 @ 10:53 pm