The state would start with a pilot program that would require Medicaid patients in two contiguous counties to join HMOs, according to pending legislation that was tucked in a so-called budget implementation bill and has passed the Illinois Senate. Neither county was disclosed. The bill's fate is uncertain in the Illinois House. Although the current Medicaid program requires patients to sign up for a specific physician under a form of managed care known as primary care case management, there is no requirement that patients sign up for an HMO. Doctors and hospitals have long opposed forcing Medicaid patients to enroll in HMOs because they believe it would threaten patient access to medical-care providers.

 They also say HMOs have no proof their program saves money. "Because Illinois Medicaid payment rates are so low and the base rate has been frozen for the past dozen years, savings have already been squeezed out of the Medicaid program," said Ken Robbins, president of the Illinois Hospital Association.

Doctors fevered over Medicaid HMO proposal --


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