Insurance hearing fuels fire over issue

Insurance hearing fuels fire over issue

SPRINGFIELD — A long and sometimes contentious legislative hearing over a tentative change in state employee and retiree health care insurance served only to add more controversy to the issue.

For more than four hours, lawmakers and a roomful of angry state employees and retirees spoke out against the Quinn administration's provisional decision to remove Urbana-based Health Alliance from the list of health insurance providers, effective June 30.

One example of the growing standoff between the administration and lawmakers came when an attorney for the state Department of Healthcare and Family Services asserted that the Legislature could review but not overturn the agency's contract award.

Currently, a Blue Cross HMO has been awarded the statewide contract, although Blue Cross originally bid only to provide coverage in 38 counties. Both Health Alliance and Humana have filed protests against the tentative award to Blue Cross.

Jeanette Badrov, legal counsel for HFS, said the final contract award would be delayed by the protests and a legal review plus a 30-day period in which the Legislature's Commission on Government Forecasting and Accountability also could analyze the decision. But she said the Legislature could not reverse it.

"It is my interpretation that COGFA has no final approval authority and that if the contract to award survives the protest period then there is no bar except for the 30-day review period," said Badrov.

"We cannot award the contract until the 30-day review period expires."

Meanwhile, lawmakers ridiculed the HFS decision, saying that Blue Cross cannot meet the terms of the contract because it had no network of physicians in place on Jan. 1, 2011, as required by the state's request for proposals, and that it couldn't have one in place by July 1.

"There's this notion that somehow the market will right itself, that the providers, the hospitals, the physicians, etcetera, will get on board with this," said Rep. Chad Hays, R-Catlin. "But anybody who was here today who has any knowledge of process in terms of setting up networks has suggested that if there was a miracle on high it would take six months but that in truth it would take a lot longer than that."

Badrov responded that "markets are fluid and they do react."

"But," said Hays, "they generally don't change to a plan that doesn't exist."

Likewise, Badrov said, she was unable to explain how the agency was able to claim $102 million in cost savings by awarding the health care contract to Blue Cross. She said that the state's new procurement code limited what she could say while the contract award was under protest.

Kate Ross, associate director of human resources at the University of Illinois, urged lawmakers to attempt to reinstate Health Alliance as a provider for the sake of its 7,500 customers at the Urbana campus.

"This affects people, and there are people with serious medical conditions who are great employees and they need to have that care. But they don't have the time to wait because their care needs to happen now.

"In just the past week I've talked to employees undergoing lengthy and arduous courses of treatment for cancer, for organ transplants, employees undergoing infertility procedures, people who are receiving care for heart conditions, and they're just worried about whether they're going to have access to their doctors and the specialists that they trust, and whether they'll be able to care for themselves and their families."

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Mike wrote on April 27, 2011 at 11:04 pm

It's Badrov, not Badlov, and her information is:

Illinois Department of Healthcare and Family Services Jeanette Badrov 312.793.4792

She's crazy if she thinks the lawmakers in the state can't make laws.

"Oh, they have no approval authority" derp, derp, derp.

The first thing they need to do is put this woman out of a job. Do you hear me, Chapin?

rene120 wrote on April 28, 2011 at 6:04 am

This looks to me like a fight between insurance providers, and Blue Cross/Blue Shield has the governors office in their back pocket, and the insured are falling victims to this. It's another case of the big guys driving the little guys out! But watch out everyone--bigger is not always better!

thechampaignlife wrote on April 28, 2011 at 12:04 pm

I agree, lawmakers hold the purse strings so if they want to quash this, they can just not appropriate the funds. And how is it that BCBS got pushed into this when they only wanted 38 out of 102 counties to begin with? They should be fighting this too because it puts too great a burden on them to put together a network for 64 counties they weren't expecting in 2 months.

jjacksonporter wrote on April 28, 2011 at 7:04 am

I've heard rumor that BC/BS has long been in negotiations with Carle Physician Group, but (to no great surprise), they can't reach an agreement on costs. Carle Foundation and Carle RX are in the BC/BS system, but the greedy docs on the clinic side won't budge. Maybe these protesters should talk to their personal physicians...

tiger3276 wrote on April 28, 2011 at 8:04 am

I think that maybe some people need to get there facts straight. BCBS has no intentions on getting contracts with the dr's in this are or in Springfield for that matter, that came out last night at the meeting. Not everything that was said was put in this article because the meeting lasted four hours. What the real problem is that as of July 1, 2011 people will be without health insurance. There are pregnant women, very sick people that will have no where to go because of the crooked politicians we have in this state. The fact of the matter is that Quinn did this for Chicago and he could care less about the rest of Illinois. I think the rest of Illinois needs to get away from Chicago, band together and show Quinn and the rest of them that this is unacceptable.

retired wrote on April 28, 2011 at 12:04 pm

How about CMS makes public their scoring process so we all can see if a fair comparison was done or if the choice was pre-determined in order to "save the state money". In 30 years watching how the state purchasing process worked - NOTHING would surprise me, especially where CMS was concerned.

trouble wrote on April 29, 2011 at 7:04 am

As I understand it, HFS is the agency who has tentatively awarded the contracts. HFS is also the agency who will be reviewing the protests. Lastly, HSF will be awarding the final contracts. Where are the Checks and Balances in this system?