Government Relations Update April 2018 The House and Senate returned after their Primary elections and spring break to a busy schedule. April 13 is the committee deadline for substantive legislation, and April 27 is the third reading deadline for both chambers.

The primary election is over and Democrats and Republicans are gearing up for what promises to be the most expensive gubernatorial election in U.S. history ($120 million contributed by the two nominees thus far). JB Pritzker won with 45% of the vote on Tuesday and will be the Democratic Party's nominee for governor this fall. Governor Bruce edged challenger State Rep. Jeanne Ives by 2.8 percent (51.4 percent to 48.6 percent) in what was a much closer race than expected even a few months ago. Both sides have already begun posturing for what promises to a very rough and tumble race. For Attorney General, Democratic State Sen. Kwame Raoul will face off against Republican Erika Harold. In the General Assembly, a few notable incumbents were defeated by primary challengers. State Rep. David Reis (Republican Spokesman on the House Insurance: Health & Life Committee) lost his primary to challenger . On the Democratic side, State Rep. Dan Burke lost to Aaron Ortiz, and State Sen. lost to . Lots of open seats now have their respective candidates.

Medicaid Managed Care: The rollout continues as HealthChoice Illinois, the state’s largest public procurement, aims to place up to 80% of Illinois’s Medicaid population in managed care. Initially, Cook County, its suburbs, and much of Northern Illinois experienced a bumpy January when MCO patients were told not to change anything, and were promptly re-auto-assigned to MCOs that weren’t even part of the provider’s practice. The reported “churn” in this re-auto-assignment process, coupled with narrow provider networks and not filling prescriptions has continued downstate as the rollout went “live” on April 1st. Multiple providers, across specialties and across the state have expressed similar concerns and frustrations about HFS and the Medicaid managed care rollout. Unfortunately, HFS directing providers (including large systems!) to their complaint portal is not the solution. HFS testified before the Senate Human Services Appropriations Committee the week of March 12 and there was no indication of any concerns in their remarks.

Though HealthChoice Illinois is in its infancy, many organizations and provider groups have concerns that HFS is abdicating its role as regulator. Media reports, House Appropriations-Human Services Committee hearings, and the Illinois Auditor General have already exposed numerous critical issues with HealthChoice Illinois.

Staff from IAFP, ICAAP and ISMS will meet on April 23rd regarding the Medicaid managed care rollout. Here are a few proposed strategies: • Dr. Huggett serves as vice-chair of the Medicaid Advisory Committee and has offered to submit an agenda item raising these concerns at the next meeting, scheduled for May 4th. Dr. Alap Shah has graciously agreed to attend the meeting as IAFP’s voice. • SIU is working to outline their concerns and be present at the Springfield location. • Our three associations (IAFP, ISMS, and ICAAP) have tried to work with the IL Assn of Medicaid Health Plans (IAMHP) to set up a webinar for providers. After many failed attempts and no traction, we’re going to pursue this avenue with HFS • If anyone has experienced issues that IAFP could include in what needs to be addressed in the webinar, please send them to Gordy [email protected]. We recognize there are a myriad of issues but we’re hoping to compile a list of “top 20 questions.”

As repeated background resources, here are a couple links for reference: HFS’ Medicaid Advisory Committee if you would like to receive HFS’ provider notices, link here IAMHP’s HealthChoice IL manual Auditor General’s report Government Relations Update April 2018

Pending Legislation: Cook-Witter has tracked close to 300 bills for IAFP, in addition to almost 100 amendments to those bills. Gordy has worked to cull the list into a handful that are likely to be controversial and/or have a chance of passing. The list is below:

HB0274 h Michelle Mussman PHARMACY-BIRTH 04/10/2018 House Placed on Calendar 2nd Reading - Short Debate CONTROL **** HB 274 Health Care Licenses Committee Hearing Apr 10 2018 10:00AM Stratton Building Room D-1 Springfield, IL HCA 1 Health Care Licenses Committee Hearing Apr 10 2018 10:00AM Stratton Building Room D-1 Springfield, IL **** HA 1- Oppose 04/10/18. Oppose 02/15/17.

HB4165 h Gregory Harris CMS-DHFS-ACA 04/10/2018 House Held on Calendar Order of Second Reading - PROTECTIONS Short Debate **** HA 1 - Support 03/15/18. Monitor 2/6/18.

HB4297 h Camille Y. Lilly TOBACCO PRODUCTS- 03/06/2018 House Held on Calendar Order of Second Reading - UNDER 21 Short Debate **** Support 02/01/18.(see also SB 2332.)

HB4383 MCO-DISENROLLMENT 03/09/2018 Senate Referred to Assignments REQUIREMENTS (Heather A. Steans)

**** SUPPORT 03/07/17.

HB4475 SCH CD-INFLUENZA 03/21/2018 House Assigned to Elementary & Secondary Education: VACCINE INFO School Curriculum & Policies Committee **** HB 4475 Elementary & Secondary Education: School Curriculum & Policies Committee Hearing Apr 10 2018 10:00AM Stratton Building Room 413 Springfield, IL HCA 1 Elementary & Secondary Education: School Curriculum & Policies Committee Hearing Apr 10 2018 10:00AM Stratton Building Room 413 Springfield, IL HCA 2 Elementary & Secondary Education: School Curriculum & Policies Committee Hearing Apr 10 2018 10:00AM Stratton Building Room 413 Springfield, IL **** HA 1, 2 Support - 04/06/18.

HB4515 Daniel Swanson PHYSICIAN-DISCIPLINE 04/10/2018 House Placed on Calendar 2nd Reading - Short Debate EXEMPTION **** HB 4515 Health Care Licenses Committee Hearing Apr 10 2018 10:00AM Stratton Building Room D-1 Springfield, IL **** WATCH (Lyme Disease) 02/26/18.

HB4643 Daniel J. Burke PHYSICAL THERAPY- 04/10/2018 House Placed on Calendar 2nd Reading - Short Debate DIAGNOSIS **** HB 4643 Health Care Licenses Committee Hearing Apr 10 2018 10:00AM Stratton Building Room D-1 Springfield, IL **** Oppose 02/08/18.

HB5769 Deb Conroy DRUGS-PRIOR 04/10/2018 House Placed on Calendar 2nd Reading - Short Debate AUTHORIZATION FORM **** SUPPORT (IPS Bill) 02/27/18. (see also HB 4995.)

SB2332 s Julie A. Morrison TOBACCO PRODUCTS- 02/20/2018 Senate Placed on Calendar Order of 3rd Reading UNDER 21 February 21, 2018 **** Support 02/01/18.(See also HB 4297.)

SB3015 David Koehler SCH CD-ASTHMA 03/14/2018 Senate Postponed - Education MEDICATION **** SB 3015 Education Hearing Apr 10 2018 1:30PM Capitol 212 Springfield, IL **** SA 2 - Support 04/06/18. SA 1-03/15/18. Monitor 02/26/18.

IAFP co-signed onto the following fact sheets and letters:

Letter to Legislators re: Medically Fragile Children Letter to IDPH re: Immunization Advisory Committee Government Relations Update April 2018

Prior Authorization Fact Sheet (HB 5769) Community-Law Enforcement Partnership for Deflection and Addiction Treatment Fact Sheet (SB 3023) Tobacco 21 Fact Sheet ((HB4297/SB2332) Direct Access to Physical Therapists Fact Sheet (HB 4643) Lactation Rooms in County Courthouses (SB 3503) Amendments to Heroin Crisis Act Fact Sheet (HB 68) IAFP comments on Alternatives to Opioids Act (SB 336)

AAFP Recent Documents AAFP Letter to House Ways and Means Committee on Opioid Epidemic Relief - March 14, 2018(4 page PDF) Joint Letter to Congress on Market Stabilization - March 6, 2018(2 page PDF) AAFP Letter to CMS Regarding the Request for Information on CLIA - March 6, 2018(4 page PDF)

Thanks for your interest in advocacy! Please ask any questions you may have.

Gordy [email protected] 708-278-6921 cell