State to appeal order blocking health insurance contracts
SPRINGFIELD — The Illinois Department of Healthcare and Family Services says it plans to appeal a court order blocking health insurance contracts for state employees and retirees from being finalized.
The order was issued Friday by Sangamon County Judge Brian Otwell, directing the agency to stop further action on awarding or signing the self-insurance Open Access Plan contracts to PersonalCare and HealthLink.
Those insurers are the only managed-care-plan options being offered to state employees and retirees in many counties in East Central, southern and western Illinois.
The court order was issued in response to a request by Humana and Health Alliance Medical Plans to stop the contracts on a temporary basis until their lawsuits challenging those contracts can be heard.
Both companies are contending there were errors and violations of the law in the first bidding and contract awards and seeking a new bidding process.
The appeal adds even more uncertainty for state employees and retirees. They're expected to complete enrollment in new health plans by June 17 and, as of now, have no managed-care plans in which to enroll.
If the state's appeal is unsuccessful and the order stands, several options have been raised for state employee coverage — including defaulting everyone into the state's more expensive Quality Care health plan, extending current insurance contracts and conducting an emergency procurement process, but the state hasn't commented on any of those options.
"We want group insurance plan members to know that we will act promptly and explore all the options to ensure that they have managed care coverage," Healthcare and Family Services spokesman Mike Claffey said Friday evening.
State Rep. Jason Barickman, R-Champaign, called the ruling a win for thousands of central Illinois residents.
"The Quinn administration's cancellation of health care contracts with Health Alliance and Humana have left state and university employees in a lurch with less than a week remaining before they were forced to change to a plan which required driving to Peoria or Springfield to see a doctor, or be enrolled in a more expensive plan," he said.
The Quinn administration started this and now act like it's HA and Humana's fault that we the members only have a week to get enrolled in their ridiculous plans or we'll automatically be put in the most expensive HMO plan! If they had just left things the way they were, we would not be going through all of this stress and confusion!!!! HA and Humana are only trying to uncover why the state handled the bidding the way they did;and right this wrong! GIVE US BACK HEALTH ALLIANCE!!!!!!! STOP PUSHING YOUR AGENDA ON US!!!!!
I think that the best, most logical, and least painful option would be leaving everyone where they are at currently; or, if an enrollment choice has already been made, return everyone to the healthcare plan that they were enrolled in prior to 6/17. This entire process needs to be carefully examined by the courts, because something smells awful bad about this mess.
Mark my words: money and/or influence has changed hands over the course of this affair and the people of Illinois deserve to know the truth!
I totally agree that everyone should be left on their current plan until this is all settled. I can't be without insurance due to medical issues but I also can't afford to go on the Quality Care Plan because my costs would skyrocket.
I don't understand why Governor Quinn won't sign SB 178 and give some breathing room to get this mess sorted out. If there are parts of 178 he doesn't like then find a compromise, But don't force us all onto something that will cost us and the state more.
Thousands of people have to put their healthcare plans (surgeries, tests, preventive care...etc) on hold because of this mess. DHFS has to be held liable for any related injuries, damages, or deaths because of this mess they created. Do the right thing now and extend the current contract while we sort the mess out in court!
COGFA is going to have an emergency meeting tomorrow. Check out this link:
The Commission on Government Forecasting and Accountability is holding an emergency meeting tomorrow to discuss a possible 90-day extension of all current health plan contracts.
http://www.ilga.gov/commission/cgfa2006/Upload/06142011meetingAgenda.pdf
www.ilga.gov
I sure hope this is good news.
At best, it's a distraction. So the COGFA meets and passes some kind of resolution to negotiate temporary contracts. But they don't have the authority to do so, they can only sign off on changes to health insurance coverage, like switching everyone to open access plans. Probably the attorney general writes an opinion that the resolution is not enforceable, various legislators weigh in on her opinion, CMS is ordered to ignore the action and switch everyone to Quality Care (unless the state's appeal is granted), N-G prints an article each day reporting who said what the day before, and the actual people being affected by this mess are still left without coverage while the circus continues.
Am I the only one that thinks the whole mess is being handled incorrectly? It seems to me that the only approach that has any chance of succeeding is a frontal assault on the procurement process - Health Alliance suing the state for a biased contract award, which brings with it the opportunity for depositions and full discovery of the bid documents and behind-the-scenes email at DHFS and perhaps the Governor's office.
Above all, we need to know the difference in the state's cost for Personal Care OAP vs. Health Alliance HMO. That number has never been revealed, and I have a gut feeling that it's smaller than most people think.
gdf55 - I see how that could happen. Here's an email I just received from Mike Frerichs:
"While there are many moving pieces in this process and no final decisions yet reached, I do believe more information should be available tomorrow. The Commission on Government Forecasting and Accountability (CoGFA), of which I am a member, is meeting tomorrow in Chicago to discuss these matters.
On the agenda is an item to authorize the Department of Healthcare and Family Services to negotiate emergency 90-day contracts. HFS could potentially negotiate 90-day emergency contracts with current providers, like Health Alliance, to cover state employees until the lawsuit is resolved in court.
I understand that things are uncertain at this moment, but I will do my best to keep you updated as information becomes available."
Still sounds like things will be up in the air.
How can blackmailing people into signing up for the most expensive health plan be good for anybody? This whole situation is ridiculous. Just leave us where we are until all the kinks are worked out and stop this upheaval. Maybe it's time to kick some of these idiots out and get responsible people who will negotiate in good faith. This is just typical of how messed up our state is. Why do we have to give up our HMO's anyway? As a former U of I peon, I have never and will never get high retirement benefits. And I have paid higher rates for my retirement benefits than people on Social Security for my entire career. Why do you want to punish us little guys by taking away our benefits. Go after the legislators who kept borrowing from my retirement funds instead. Oh, and stop electing criminals for governor.
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