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September 2015
In this Issue

  • Illinois’ Long History of Balancing Budget on the Backs of Physicians Gets New Chapter

    If you count state employees among your patients, you already know that Illinois’ pockets are nearly empty when it comes to paying you for medical services. Our state government has long relied on the tactic of delayed payments as a means to balance the books; for several years now, reimbursement delays for public employees covered under the state’s self-insured plan (roughly 146,000 workers, retirees and families) have averaged about nine months to a year.

    Unfortunately, the news just got worse:  Recent reports indicate the Prairie State will cease all reimbursements within its self-insured employee health plan until the budget impasse is resolved. 

    Not all state employees are covered through the self-insured option.  Roughly half receive coverage through a managed care plan, and claims payments for this group (approximately 158,000 patients) are not yet encountering similar delays or stoppages.  However, it looks like this funding could soon dry up too:  The state’s premiums paid to the managed care plans are already delayed by several months, and will go unpaid in the near term.

    ISMS is deeply concerned about the direct harm all this imposes on medical practices.  Certain regions with large numbers of state employees are experiencing severe strain. Even practices that have for years weathered payment delays may be forced to make difficult decisions in the coming months as reimbursements dry up altogether for an unknown period of time.

    Our message to our elected officials is clear: We urge the General Assembly and Governor Rauner to agree on a budget that includes full funding for state employee health care.

    We are closely monitoring this issue and exploring options for member relief.  Our Member Advocacy Division is always a phone call away at 800-782-4767 ext. 1470.

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