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Dupage Policy Journal

Wednesday, December 25, 2024

Nybo wants health care providers kept in the loop on state's new Medicare program

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State Sen. Chris Nybo (R-Elmhurst) went to bat for health care providers at a hearing of the Senate Appropriations I Committee and the Special Committee on Oversight of Medicaid Managed Care.

During the hearing on Dec. 8, the Republican Caucus Whip wanted to know from Healthcare and Family Services Director Felicia Norwood about the process of master contracts and providers who felt slighted in contract negotiations  on costs associated with the state's new Medicaid Managed Care program, HealthChoice Illinois, contracts.

“My understanding was that the master contract for the providers was finalized in September, but a group of providers were concerned because they thought additional changes to the master contracts were being negotiated between MCOs (managed care organizations) and the department after the contracts had been finalized and executed,” Nybo said, noting he wanted an update.


“Is there any truth to their belief that additional changes were being made after it was finalized,” Nybo asked.

“We certainly haven’t made any changes after it had been finalized,” Norwood said, adding that in February the department posted a first draft of the master contract on the department website. “Over the seven months or so, we had hundreds of comments come in from quite a few individuals; and in many cases, we incorporated feedback from those proposed comments into the contract.”

Norwood said no “measurable changes” were made and all providers had “more of an opportunity then they ever had to comment on the contract,” which was officially signed Oct. 15.

 The senator wanted assurance that providers would be happy in the end.

“If providers are concerned there have been additional changes to the master contract that they have had the opportunity to discuss with you or raise any concerns with you, you would certainly be open to meeting with providers who are concerned with that possibility, right?” Nybo asked.

Norwood agreed, but noted when all is said and done “you can’t include everything a provider wants in a contract,” specifically noting one provider who offered 69 comments.

“Director, I am not going to quibble with the substance of what’s in the master contract; I am just concerned with the process,” Nybo said, adding he was led to believe contracts were finalized without providers' full approval and he would circle back with providers who expressed concern.

Ten minutes later, the senator again confronted Norwood.

“I did have the opportunity to check with the providers who are concerned with the master contract issue director, and they tell me it is still an issue,” Nybo said.

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