Sen. Rose Vents Over Health Alliance Decision
State Sen. Chapin Rose (R-Mahomet) says state regulators conspired to shut out Health Alliance on a technicality.
Rose was among the lawmakers in a legislative hearing Wednesday, questioning the decision to choose four other providers of Medicare Advantage retiree contracts.
Those with Commission on Government Forecasting and Accountability questioned why Central Management Services did not even bother to open up a Health Alliance bid to see what it would cost.
Rose said the move makes even less sense after learning the Urbana-based insurer was the low bidder.
“I mean, they left savings on the table for the taxpayers," he said. "And they don’t seem to be bothered by that. I mean the way this should work, the way the taxpayers are supposed to get fair value for their dollar, is you go out to bid, and everybody goes out to bid and everybody puts in bids as interested, and you go with the cheapest bidder – right? Well in this instance, they rigged the bids, so that certain bidders wouldn’t qualify. It only happens to be that those bidders were the lowest bidders.”
Health Alliance was left out of the list of retiree plans because it didn’t meet a series of requirements regarding the number of years’ experience in those plans.
The insurer wasn’t chosen for employee and retiree coverage in 2011, but uproar from lawmakers and court action prompted a reversal.
Rose said the Quinn administration is retaliating. He said it is a possible another hearing could be held when lawmakers return to Springfield in a couple of weeks – saying ‘the fight isn’t over.' But legislators cannot veto the state’s decision outright.
Urbana-based Health Alliance says it will file a protest with the state over its decision not to continue their HMO contract for state employees and retirees.
The state Department of Healthcare and Family Services announced Wednesday it was awarding HMO contracts for the next fiscal year to Blue Cross Blue Shield, with Open Access Plan contracts to PersonalCare and HealthLink. The state said the new contracts would save taxpayers over $100 million a year, and over one billion dollars over the next ten years.
Health Alliance CEO Jeff Ingrum argues the savings aren't really there --- in part because people who had been under Health Alliance will be required to either change doctors, or go to the more expensive Open Access Plans selected by the state, or to the Quality Care Preferred Provider plan, which offers less coverage.
"One, it will increase the costs to state workers," Ingram said. "But it will also increase the costs to the state of Illinois, because those programs are anywhere from 10 to 20 percent higher than the Health Alliance HMO program."
Ingrum says Carle, Springfield Clinic and McDonough District Hospital in Macomb had signed exclusive agreements with Health Alliance that barred them from working with other state HMO plans.
In a statement, Carle says it's studying the implications of the DHFS decision. The company calls on their patients who are Health Alliance members to "share their concerns with the state and with elected officials."
The company says it will be reviewing options "for state employees to continue accessing Carle physicians and hospital services", but that the plans and costs for such access will change if the state's decision stands.
And the state Department of Healthcare and Family Services says --- in a fact sheet on its managed care announcement --- that while Carle and other hospitals and clinics may not be available through their new HMO plans immediately, it expects them to "adjust to market needs" over time.
Carle says that Carle Foundation Hospital has a long-standing contract with Blue Cross/Blue Shield, for hospital services. But Health Alliance's Ingram says the contract is for a Preferred Provider plan, not the HMO plans which the state approved its employees and retirees in FY 2012.
State Representative Naomi Jakobsson (D-Urbana) has complained about the state's decision not to use Health Alliance next year. She says the company was not given sufficient advance notice of the decision. Jakobsson is inviting people concerned about the change to sign a petition on her legislative website.
NOTE: This story was updated to show additional comments from the Illinois Department of Healthcare and Family Services.