SJ0043 97TH GENERAL ASSEMBLY

SJ0043 LRB097 20154 KTG 65555 r

SENATE JOINT RESOLUTION

WHEREAS, In an effort to address unsustainable growth in the Medicaid program and to improve the care provided to Medicaid enrollees, a bipartisan group of legislators worked with the Department of Healthcare and Family Services to craft comprehensive Medicaid reforms in early 2011; and

WHEREAS, Governor Quinn referred to these reforms as a "landmark achievement" when he signed them into law on January 25, 2011 after they had passed the Senate by a vote of 58-0-1 and the House of Representatives by a vote of 111-4-2; and

WHEREAS, Included in these landmark reforms were provisions to require Medicaid applicants to submit one month of income data and proof of Illinois residency when applying for Medicaid coverage; and

WHEREAS, The Department of Healthcare and Family Services has not implemented these key reforms due to communication from the Centers for Medicare and Medicaid Services indicating that the residency and income verification may violate Medicaid Maintenance of Effort (MOE) provisions contained in the Patient Protection and Affordable Care Act; and

WHEREAS, The Department of Healthcare and Family Services has not requested a waiver to formally ask for the implementation of these reforms despite requests from members of the General Assembly to request such a waiver; and

WHEREAS, One of the reasons provided by the Department of Healthcare and Family Services for not submitting a waiver for the income and residency requirements contained in the Medicaid reforms is a lack of agency manpower to submit such waivers; and

WHEREAS, In an effort to work with the Department of Healthcare and Family Services to address staffing issues, Senate Bill 1762 was passed in November of 2011 and signed into law as Public Act 97-649 to provide flexibility outside of the Personnel Code to allow the Department to hire employees with experience in administration, information technology, and healthcare financing to facilitate implementation of Medicaid reforms; and

WHEREAS, Also included in the landmark Medicaid reforms was a provision to place a 2-year moratorium on the expansion of Medicaid eligibility, thus enacting a 2-year moratorium through January 25, 2013; and

WHEREAS, Despite this moratorium, the Department of Healthcare and Family Services officially submitted a waiver request to the federal government in January of 2012 to expand Medicaid eligibility in Cook County to individuals currently not eligible for Medicaid coverage; and

WHEREAS, The implementation of all of the landmark bipartisan Medicaid reforms remains a key to addressing the ever expanding backlog of unpaid Medicaid bills, which according to the Department of Healthcare and Family Services could reach $21 billion by the end of FY 2017; and

WHEREAS, numerous other reforms also remain to be implemented, including coordination of care for high risks moms and babies, creation of a Medicaid transparency portal, payment recapture audits, use of durable medical cards, civil remedies for fraud, copayment requirements for unauthorized use of emergency rooms, enhanced third-party liability provisions, and the creation of a specialty drug program for high cost medications; therefore, be it

RESOLVED, BY THE SENATE OF THE NINETY-SEVENTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, THE HOUSE OF REPRESENTATIVES CONCURRING HEREIN, that we recommend that the Department of Healthcare and Family Services formally file a Medicaid waiver to implement the income and residency requirements and all other provisions of Public Act 96-1501 that may require a waiver; and be it further

RESOLVED, That the Department of Healthcare and Family Services should timely submit to the Centers for Medicare and Medicaid Services any and all State Plan amendments necessary to implement all reform provisions included in Public Act 96-1501; and be it further

RESOLVED, That we urge the Department of Healthcare and Family Services to fully implement all previously enacted reforms to address the unsustainable growth in the Medicaid program and to improve the quality of care provided to program participants; and be it further

RESOLVED, That suitable copies of this resolution be presented to the Governor, the Director of the Department of Healthcare and Family Services, and to the members of the Illinois Congressional delegation.