Providers across Illinois are getting calls and emails from Medicaid payers requesting that they quickly sign a Letter of Intent (LOI). You may be one of them. Medicaid plans include Meridian, Molina, Family Health Plan Wellcare (Harmony), BCBS and Illinicare, among others. After conducting an exploration, we learned that the State of Illinois will be changing the entire structure of the Medicaid program effective 1/1/2018.
As we understand it, the first round of RFPs went out a few weeks ago, and the next round is due April 10th. The final round is due May 10th, and decisions will be made in June. All plans who are applying for that second RFP are now trying to get hospitals to sign an LOI to show they have a network. The LOI is just a promise that you will negotiate in good faith to try to come to contract terms.
The big change? 2018 Medicaid will just have a small number of plans available to all beneficiaries statewide. All Medicaid beneficiaries will be moved in to managed Medicaid.
As we see it, you have a few weeks to decide which plan you want to partner with, if any. You can choose to sign an LOI for all of them or none of them, and let them fight it out at the RFP level. If you have a plan you feel you can work with, though, you may want to sign an LOI for that plan and give them a leg up on their competitors. We often try to negotiate better reimbursement or terms in the RFP process, but in our past experience, Medicaid plans do not have anything to offer that you cannot get during the regular contracting period. The few LOIs we have reviewed do not promise anything on behalf of the plans and don’t give us anything to negotiate.
If you don’t like this change, and we don’t see why you would, you may want to send a note to the State. The site states “consistent with the State’s norms for a purchase of care process, there is no time period dedicated to public comment as part of this RFP.” We still encourage you to send questions and comments to HFS: Illinois Department of Healthcare and Family Services Division of Medical Programs Bureau of Managed Care 201 South Grand Avenue East Springfield, IL 62794.