St. Anthony Hospital, Chicago, has launched a public relations campaign
ripping Illinois officials for withholding $1.4 million in supplemental Medicaid payments since August.
The 139-bed hospital says state officials are unlawfully interpreting a law that the Illinois Legislature adopted in June. St. Anthony claimed the hospital stands to lose $8.4 million a year, (PDF)
as Medicaid patients account for about half of St. Anthony's patients.
A spokesman for the Illinois Department of Healthcare and Family Services said that the payments have been withheld because St. Anthony missed an Aug. 12 deadline for all Chicago-area hospitals to sign a contract with a state-designated integrated care program—either Aetna Better Health Care or IlliniCare. The deadline was enforced to help speed reform to the state’s Medicaid system, department spokesman Mike Claffey said. The state plans further changes to how supplemental Medicaid payments are calculated, and hope to implement a new system next year.
St. Anthony, however, counters that the hospital should be exempt from the deadline because it’s already a participant in Family Health Network, a managed-care plan that the state previously designated as a “coordinated-care plan.”
St. Anthony officials said the state is mixing up the requirements for “coordinated care” and “integrated care” programs and unfairly targeting the hospital in a quest to balance the Illinois budget. A hospital spokeswoman said St. Anthony is considering its options, including a lawsuit.
Illinois Gov. Patrick Quinn earlier this year said the state’s Medicaid program needed major reforms or would collapse. He called for $2.7 billion in cuts
to the program.
“Budget reductions of this dramatic nature cannot be withstood by most safety-net hospitals, and just imagine the ripple effect that could be caused by their failures, removing the hospitals as an economic driver of the community; pushing desperate patients to other hospitals and adding to their already long ER wait times; and putting existing psychiatric patients back out on the streets,” St. Anthony President and CEO Guy Medaglia said in a news release. (PDF)
A spokesman for the Illinois Hospital Association said the organization was not of any other hospitals that had encountered the same problem but also noted the 2012 law at issue—the SMART Act—includes more than 60 provisions that affect hospital funding. IHA spokesman Danny Chun said the association has been working with state legislators on how to best implement that law.