McSweeney eyes broader managed care reform

Rep. David McSweeney, R-Barrington Hills, who authored a bipartisan bill boosting reimbursement rates for durable medical equipment suppliers with Rep. Greg Harris, D-Chicago, is interested in broader reforms to Gov. Bruce Rauner’s expansion of Medicaid managed care.

“You have to start somewhere,” McSweeney said of his durable medical equipment bill, in an interview with Health News Illinois.

The proposal sets a floor on reimbursements and prohibits managed care organizations from signing sole-source contracts with providers of medical supplies and equipment. It also requires the Department of Healthcare and Family Services to create minimum quality standards.

McSweeney said he does not expect the legislation will come up during the veto session this fall. Instead, he thinks it could be one of several bills next year dealing with Medicaid managed care.

“There will be a lot of discussion about redoing the entire program,” McSweeney said.

McSweeney said he supports managed care organizations, but believes the recent expansion of managed care relies too heavily on decreasing provider rates.

“When you simply cut reimbursement rates you end up with subpar care,” he said. “But you also end up with higher costs in the future because you eliminate competition.”

Samantha Olds Frey, executive director of the Illinois Association of Medicaid Health Plans, said that “mutually agreed upon contracts” between durable medical equipment businesses and health plans save Illinois taxpayers money.

“Medicaid health plans want to pay the appropriate rate for quality healthcare services that meet our member’s needs,” she added. “In some cases it means health plans pay more and sometimes it means they negotiate better savings for Illinois taxpayers.”

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