Here are three things to know about the decision to stop the payments.
1. Illinois officials attribute the decision to the state budget impasse. State spokeswoman Meredith Krantz told The State Journal-Register that without an approved budget for fiscal year 2016, the Illinois Department of Central Management Services no longer has the legal authority to pay claims through the state’s three self-insured plans — Quality Care, Coventry Health Care Open Access Plan and Health Link OAP.
2. The move is unprecedented. In recent years, Illinois providers have endured payment delays of at least a year for the care of patients covered through the state’s group insurance plan, the longest delays being for patients covered by the self-insured programs, according to the report. As a result, some providers have reportedly asked for total payments up front. But, the report notes, it’s unprecedented for Illinois to stop paying claims, even temporarily, for a large group of people. Given the prospect of even longer delays, it is unknown to what extent healthcare providers may now be prompted to request or demand payments up front.
3. Although healthcare payments have stopped for the Illinois employees’ self-insured plans, Ms. Krantz made it clear that health insurance for state employees, university employees, retirees and dependents will not change, regardless of whether payment of claims are further delayed, and premiums will still be collected from members.
Check here for more information and any future updates.
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