CHICAGO (WREX) — Gov. JB pritzker has signed legislation aimed at improving the application for Medicaid and decreasing the number of Medicaid claims.
The backlog for the state approving Medicaid claims grew to has high as 120,000 people. That number has dropped by 20 percent according to Pritzker’s administration, but still sits at 95,000 people waiting to hear back from the state.
The new law takes effect immediately and centralizes claims from providers to Managed Care Organizations, or MCOs. The legislation requires MCOs to make Medicaid payments within 30 days and make expedited payments to health care providers serving large Medicaid populations, like long-term care facilities where more than 80 percent of residents receive Medicaid.
MCOs must also continually update their roster of providers within 30 days.
The new law also mandates a full review of the Medicaid redetermination process to identify changes that will allow more patients to be renewed automatically.
Additionally, income eligibility for Medicaid will now only require one pay stub. Copays will be relaxed so HFS is not required to charge the maximum copay under current federal standards.
“Several years of work are behind this sweeping reform bill, but it took the leadership that the Governor brought in to DHS and HFS to finally pass this bipartisan, groundbreaking Medicaid reform measure,” said Sen. Dave Syverson (R-Rockford). “As a result of these reforms Illinois will be able to deliver healthcare more seamlessly, leading to better health outcomes.”