Home > Legislative > Slow and Steady Progress

Slow and Steady Progress

Today we filed our amendment for our recoupment bill which puts a time limit on how far back an insurance company may take back a payment for services already rendered. Physicians have brought cases to our office reaching back as far as 8 years and totaling hundreds of thousands of dollars. We expect to have our amendment heard in committee first thing next week and a vote to be called on the House floor by the end of that week. Also, we made sure that a friendly Senate sponsor would pick up our bill once it left the House chambers so we look forward to working with Senator Steans in the very near future.

Many of the insurers are remaining opposed to our recoupment bill (despite promises to remove their opposition) because they object to being required to take cases of suspected fraud or misrepresentation to court once their time limit has passed. They would instead prefer to make the determination of guilt themselves and not have to prove anything to a third party. Seeing that insurance companies consider nearly every recoupment a misrepresentation of some form, any legislation allowing them to do so would result in no time limit at all.

Workers’ Compensation is still in the news due to Rep. John Bradley’s proposal to simply do away with the entire system altogether. There was an attempt to call his proposal for a vote in the House today, but due to a procedural play the bill may be stalled another day or two. If you are looking for more information on the Workers’ Compensation situation, Crain’s Chicago Business Journal had a pretty good summary about two weeks ago that I might refer you to.

And finally for a slightly different change of pace, I thought I would share the following infographics:
The United States of Awesome
The United States of Shame

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  1. Dr. Jason Godo
    April 9, 2011 at 2:59 pm

    Rob,
    Thanks for all the hard work and updates with this site. I was just in a conference with the ACA Vice-President and was able to sit and talk with him concerning Illinois and the July 1st, 2011 Aetna chiropractic manager ASH (American Speciality Health) network. As of July 1st we will have to sent documentation to get visits approved through this network. (This is very, very similar to ACN with UnitedHealthcare.)
    The VP stated that filing a complaint on the following points to the Illinois attorney general would be very beneficial since the doorway before the implementation of this requirement with ASH has not happened. The following points to mention are: 1) the ASH network is limiting the scope of practice of the state law in Illinois by only allowing chiropractors to treat in the ASH guidelines of musculo-skeletal injuries and not as a complete physician. 2) Aetna participants/patients have not been told of the changes to his/her policy concerning the ASH and chiropractic care. The VP thought that was a contract violation on Aetna’s behalf to its participants paying for their insurance.
    Let me know what I can do to help. I do not know exactly what to do to get this letter across to the attorney general, but if we do quickly, then Aetna will have to respond and perhaps stop the process……
    Thank you,
    Dr. Jason Godo
    773-895-0556

  2. April 9, 2011 at 3:17 pm

    Thanks Doctor, I appreciate the feedback. As you might be aware, the ICS is already involved with a lawsuit against Aetna on behalf of chiropractors here in the state and some of their practices. http://ilchiro.org/displayindustryarticle.cfm?articlenbr=43573

    I’ve already forwarded your suggestions to our legislative team and our attorney. Thank you for the heads up and for being proactive on behalf of your profession!

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