Increase Medicaid Reimbursement Rates for Pediatric Specialists
Please Support HB 2343
April, 2009
The health of very sick children insured by Medicaid is at great risk because these children have difficulty finding a pediatric specialist that will care for them at the rate that Illinois Medicaid reimburses: just under 35 cents for every $1 they spend. While these children may hold an ALL KIDs card, they often cannot get an appointment with a specialist or if they can, they must drive several hours to get to a doctor who will see them.
In addition, there is a critical shortage of pediatric specialists both at the state and national level. Illinois’ ability to attract and retain these essential specialists in is jeopardized by seriously inadequate Medicaid reimbursement. Failure to attract these specialists and keep them here hurts ALL Illinois children, not just those covered by Medicaid.
The We Care for Illinois Kids Coalition has been working with our partners in the General Assembly to help the children who desperately need specialty care and the physicians who have continued to care for their patients despite suffering serious, unsustainable financial losses each year.
As of February 1st, a slight rate increase took effect for pediatric specialists. While we appreciate this increase, physicians will still be reimbursed just under 35 cents (up from 33 cents) for every dollar they spend to care for children insured by Medicaid. Continuing to inadequately fund treatment by specialists prevents essential access to medical care and threatens the life and health of our children. We need a more sustainable solution.
Last year, under the sponsorship of State Representative Susana Mendoza, Majority Leader Barbara Flynn Currie, and joined by 20 of their House colleagues from both sides of the aisle, we supported HB 5331. This bill would have phased in modest payment increases to these physicians, resulting in rates that would cover 66% of a doctor’s costs.
As the 2009 session of the Illinois General Assembly begins, and under the administration of a new Governor, the We Care for Illinois Children Coalition is committed to continuing to seek absolutely essential funding for pediatric specialty care.
We ask you to serve as our champion and stand with us on behalf of the children who need these specialty services, and the fine physicians who care for them. Please support HB 2343. HB 2343 was referred to the Senate Insurance Committee on April 24.
For more information about this critical issue, contact Susan Hayes Gordon at 773-314-3789.
Organizations Supporting
HB 2343
La Rabida Children’s Hospital, Chicago
University of Chicago Comer Children’s Hospital
Children’s Memorial Hospital, Chicago
American Academy of Pediatrics, Illinois Chapter
Health and Disability Advocates
Illinois Maternal and Child Health Coalition
Illinois Hospital Association
Illinois State Medical Society
Children’s Hospital of Illinois, Peoria
Northwestern Memorial Hospital
Voices for Illinois Children
Mount Sinai Hospital, Chicago
Advocate Health System
Chicago Medical Legal
Partnership for Children
Ounce of Prevention Fund
Rush Medical Center
Children's Memorial Faculty Practice Plan
Illinois Medical Group Medical Association
Resurrection Health Care, Chicago
Sargent Shriver National Center on Poverty Law
