Aetna threatens to terminate Medicaid contracts if Illinois funding ‘crisis’ persists

Aetna Better Health, the managed care subsidiary of Hartford, Conn.-based Aetna, filed a notice of intent to terminate its four Medicaid contracts with Illinois due to $698 million in outstanding payments.

Advertisement

Here are four things to know.

1. Illinois’ more than two-year budget gridlock resulted in $2 billion in owed Medicaid payments to healthcare organizations. State lawmakers ended the stalemate Thursday by overriding a budget veto by Republican Illinois Gov. Bruce Rauner.

2. Aetna Better Health’s notice stated if it “is compelled to exercise its termination rights under the state contracts, it would do so with the hope that those terminations would ultimately be unnecessary upon an interceding, mutually agreeable resolution of the pending Medicaid-funding crisis before year end — either through a fiscal year 2018 budget or through state compliance with this court’s orders.”

3. If Aetna Better Health terminated its contracts, 235,000 Illinois Medicaid beneficiaries would be required to move to another health plan.

4. In response to passage of a state budget Thursday, Aetna spokesperson T.J. Crawford told Becker’s Hospital Review the company will “continue to monitor and evaluate our options.” 

More articles on payer issues:
Children’s Minnesota out of network with BCBS; 66k policyholders affected by contract dispute 
11 payer-provider contract disputes, resolutions in June
Why Geisinger stays in the ACA exchanges, Aetna and Medtronic team up & more — 13 payer key notes

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.