Il to appeal ruling that state workers should clear Medicaid rolls

Sep 18, 2013

Illinois will appeal a ruling that says state workers, rather than an outside firm, must scrub Medicaid rolls.  A top state official made the announcement Tuesday at a hearing in Chicago. IPR'S Amanda Vinicky reports.

Since the start of the year, Illinois has kicked about 125,000 people from Medicaid, the state's health insurance program for the poor.  All of them were found ineligible: maybe they'd moved out of state, their income went up, or their kids had grown up; Medicaid only covers low-income children and their parents.

The actual business of trimming the state's Medicaid rolls was done largely by a Virginia-based firm, Maximus, under a $77 million contract. An arbitrator sided with Illinois' largest state employees' union, AFSCME, which says the job should have stayed in-house. That'd mean cancelling the contract eight months early. Director of the Dept. of Healthcare and Family Services Julie Hamos says Illinois will appeal the ruling.

"Our shared priority is to preserve the integrity of Medicaid so that it can serve our most vulnerable while eliminating waste, fraud and abuse."

Hamos says rather than cancelling the contract with Maximus abruptly, the department should gradually take over, at least partial. She says it may be most efficient to split the duties, in a hybrid system, that allows Illinois to use state workers while also using the private firms' computer software.

The move comes as Illinois is preparing to add hundreds of thousands of people onto Medicaid, as it implements the federal Affordable Care Act.