Illinois signs comprehensive state Medicaid reform into law

Illinois Governor Pat Quinn has signed new legislation that will establish comprehensive Medicaid reform in Illinois. The new reforms are designed to allow the Department of Healthcare and Family Services (HFS) to expand coordinated care in Illinois, offer a more efficient prescription drug program and crackdown on waste, fraud and abuse. The reforms are expected to achieve savings of $624 million to $774 million over five years.

The state hopes that this savings will allow more people to maintain current services under Medicaid while decreasing the overall impact the program is having on the budget. The law will allow HFS to expand coordinated care to nearly half of state Medicaid recipients by 2015- a move that has the potential to lead to increased preventative care over the current system which often pays out after recipients have fallen ill with conditions that could have been prevented. It also authorizes the department to enhance the integrity of the eligibility process, subject to federal approval, by requiring proof of Illinois residency; tightening income verification by requiring a month’s worth of income information, instead of a single paystub; and requiring annual redetermination of eligibility.

Other reforms include more restrictions and civil penalties for recipients who abuse the system and a moratorium on eligibility expansions. HFS will also be required to study the impact of income limits and cost-sharing opportunities for medical programs available to children under the Public Aid Code where there is no parental-income threshold.

“Medicaid reform is one part of my plan to stabilize our budget. A priority of my administration is eliminating inefficiencies, so that we are saving money while delivering better services to those that most need them,” said Governor Quinn.