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Saint Anthony Hospital Challenges the State of Illinois' Unlawful Withholding of Its Supplemental Medicaid Payments

Hospital Claims Pattern of Unfairly Targeting Safety-Net Hospitals by the Democratic Administration of the Illinois Department of Healthcare and Family Services

CHICAGO, Nov. 5, 2012 /PRNewswire/ -- Saint Anthony Hospital, a safety-net, acute care hospital that serves a low-income, working class population in the southwest and west sides of Chicago, has challenged the Illinois Department of Healthcare and Family Services (HFS) claiming it has unlawfully withheld its supplemental Medicaid payments. The hospital is further concerned by a larger pattern of policy interpretation and promotion by the HFS that is unfairly targeting safety-net hospitals and could literally cause their failure, having a devastating ripple effect on the health and wellbeing of the communities that they serve.

"The democratic leadership in the State of Illinois has suggested that it understands the plight of those challenged in these tough economic times, and the importance of providing fair access to health care for all," said Guy A. Medaglia, president and chief executive officer of Saint Anthony Hospital. "Yet the actions by the HFS speak to the contrary, prioritizing State budget goals over health care for its citizens by enacting and enforcing unfair and punitive policies targeting safety-net hospitals, who are often a last line of defense to help those in our communities who need health care the most."

According to a detailed case it published today on www.FightForFairCare.org, Saint Anthony Hospital reports how HFS began withholding its supplemental Medicaid payments in August, claiming the hospital was not in compliance with the SMART Act because it did not have a contract with an HFS "Integrated Care Program" contractor. The SMART Act was adopted by the Legislature on June 12, 2012 to address State funding issues in the Medicaid program. The Act amended the Public Aid Code to require hospitals to participate in a "Coordinated Care Program" to be able to receive supplemental payments under Medicaid. HFS claims that SAH is not in compliance because it did not have a contract with either of the HFS "Integrated Care Program" contractors. Saint Anthony Hospital claims that this interpretation of the SMART Act – confusing a "Coordinated Care Program" with a health plan selected as an "Integrated Care Program" – is not only counterintuitive, but unlawful.

The case published by Saint Anthony Hospital also explains that the State's illogical interpretation of the SMART Act underscores a growing problem with HFS targeting safety-net hospitals, sharing examples such as the State's proposed 7 percent rate reduction to Medicaid payments earlier this year, and several proposed laws and policies still being considered by the HFS that paint a bleak financial picture for challenged communities. These include a recently proposed 30-day readmissions penalty, a proposed hospital-acquired condition policy that was later blocked and the proposed Medicaid rate reform, which alone could cost Saint Anthony Hospital more than $20 million per year. 

"Budget reductions of this dramatic nature cannot be withstood by most safety-net hospitals, and just imagine the ripple effect that could be caused by their failures, removing the hospitals as an economic driver of the community; pushing desperate patients to other hospitals and adding to their already long ER wait times; and putting existing psychiatric patients back out on the streets," said Medaglia. "The budget of the State of Illinois cannot be balanced on the backs of the underserved – the people of Illinois are tired of this and are ready to hold the administration responsible to the promises they've made."

About Saint Anthony Hospital
For more than 100 years, Saint Anthony Hospital has served more than 410,000 residents of the primarily Latino and African-American communities in the Southwest and West Chicago communities. Saint Anthony Hospital is a "hospital without walls," providing quality health and wellness services, and a wide variety of free bilingual community health education/outreach programs. Saint Anthony Hospital staff work with community-based organizations, schools, parishes and other agencies to offer health education, early childhood and mental health services. More information is available at www.SAHChicago.org.

SOURCE Saint Anthony Hospital

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