State Filing on Medicaid Delays Asks Court to Reconsider – Better Government Association

The state’s position appears to counter a recent legislative hearing conducted to address the concerns of health care providers, now required to arbitrate disputes against private insurance companies on every delayed or denied reimbursement. Seventeen state lawmakers attended that joint hearing, in which three safety-net medical providers testified the insurers are boosting their profits by deploying bureaucratic dodges and opaque billing error codes to skirt the federal rule, make partial payments, pay years late or deny claims without explanation.
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Goodgulf Greyteeth
1 year ago

“The Medicaid insurers’ annual reports for last year show they earned substantial profits from their Illinois contracts.” Well, of course they did. Illinois taxpayers pay the private-sector MCO’s so much that the MCO’s simply don’t care about fraud and waste among SEIU’s tens of thousands of Medicaid home health care aides. They don’t have to. Why worry about the millions upon millions of dollars paid to in-home health aides (friends-n-family of the disabled) that result from personal assistants “working” many more hours than are allowed by the MCO’s service plans? If you can bank a healthy profit and not worry… Read more »

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