800.765.8775

Alert: Illinois Medicaid Releases Sole Source Provider RFP for Incontinence Supplies

Brooke Phillips, CWCMS
Editor | Shield HealthCare
02/02/16  5:36 PM PST
Illinois Incontinence Supplies RFP

*Note: RFP due date updated to reflect extensions by HFS

What Is Illinois’ Incontinence Supplies RFP?

On January 8, 2016, the Illinois Department of Healthcare and Family Services (HFS) released a Request for Proposal (RFP) to select a single supplier that would provide all incontinence supplies to the state’s fee-for-service Medicaid beneficiaries. Due April 22, 2016*, this Incontinence Supplies RFP requires medical supply vendors to bid for the rights to be the sole provider of mail order incontinence supplies to the residents of Illinois. Shield HealthCare supports the effort to reduce incontinence costs, but not at the expense of the patient-doctor-provider relationship.

The contract pricing established with the winning vendor will also be provided to managed care organizations (MCOs), although “MCOs will not be mandated to utilize the Vendor.” In 2014, more than 400 providers delivered more than 323,000 incontinence orders to Medicaid patients upon the order of their physicians. In comparison, HFS now intends to thrust this entire population across the State of Illinois onto one company—and if this initiative is successfully enacted, your physician has no choice but to agree.

Shield HealthCare’s Position

Shield HealthCare finds it odd that this RFP was posted without advanced notification and with a very short turnaround period on the Illinois Procurement Gateway site, rather than on the Illinois Medicaid  site – where it would have been more visible to healthcare professionals and providers.

We presume that the state fiscal condition is the primary reason for the RFP, although greater savings can be obtained by reducing expenditures that make up a much more significant part of the state budget. HFS has multiple options to help reduce expenditures that would not require a change as significant and as disruptive to incontinence patients as contracting with a sole source provider. Because HFS is not prohibited from an adjusting fee schedule, Shield HealthCare encourages HFS to work collaboratively with Illinois providers to find a fiscally-responsible and affordable solution. Our concerns include:

  • Awarding a contract to one provider does not align with Governor Rauner’s pro-business position. In fact, anti-competitive contracting is unsupportive of small business.
  • A sole source provider arrangement will create a monopoly, deny patient choice, and will likely compromise the quality of care as a result.
  • Physicians’ patients will not have recourse if they experience a problem with product quality or service from the sole contract winner.
  • If the winning vendor does not carry all the appropriate products, they will likely force this vulnerable population of Medicaid beneficiaries to switch products without obtaining approvals from the physicians.
  • One supplier will likely not be able to accurately service 30,000 or more orders per month.
  • Delays in access will impact the health of disabled and elderly beneficiaries and may result in increased patient discomfort and likely an increase in emergency room visits.
  • Lack of access to properly fitted products may increase the risk of beneficiaries ending up in higher cost-of-care settings, such as hospitals, due to improper self-care.
  • One provider will create service inefficiencies, therefore placing an increased burden on discharge planning professionals.

Call to Action

We believe the state’s decision to move to a sole source provider arrangement will negatively impact Illinois Medicaid Beneficiaries, their physicians, health care providers and small businesses across the state. We urge you to contact your legislators and tell your story and the reasons you oppose this RFP initiative.

Who to contact:

You can use these talking points developed by the Great Lakes Home Medical Association here.

If you have questions or concerns, please contact your local Shield Healthcare representative at EMorrow@shieldhealthcare.com or MSchmidt@shieldhealthcare.com. We encourage you to reach out to your local legislators, House or Senate Members and Governor ASAP before it’s too late.

Comments

Post Comment