Chicago hospital can sue Illinois over alleged Medicaid reimbursement shortfall

A federal appellate court ruled that Chicago-based safety-net hospital St. Anthony Hospital can sue Illinois over an alleged shortfall in Medicaid reimbursements, the Cook County Record reported July 6. 

The dispute stems from Illinois moving its Medicaid program to a managed care model, according to the report. St. Anthony alleges it lost 98 percent of its cash reserves in four years because managed care organizations have repeatedly and systematically delayed and reduced Medicaid payments. 

St. Anthony opted to seek a court order forcing state officials to ensure that managed care organizations meet contractual obligations, rather than pursue arbitration with each care organization, according to the report. 

The appellate panel determined the state has the duty to make sure managed care organizations follow federal law requiring that 90 percent of Medicaid claims are paid within 30 days and 99 percent within 90 days.  

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