BGA Sues for Illinois Medicaid Contract Records

Milking Medicaid: A new state contract covers the health care of 36,000 vulnerable children. But documents detailing the contractor’s performance are a “trade secret,” officials say.

The Illinois Department of Healthcare and Family Services won’t release data on the performance of its new YouthCare contract. The Better Government Association has sued for access.

The Better Government Association has filed a lawsuit in Springfield against the state’s healthcare agency after officials denied records of routine performance presentations from a top Medicaid provider.

State officials denied the request after executives of the contractor — a subsidiary of national healthcare giant Centene Corp. — said disclosure of the quarterly performance presentations they make to state officials would put the company at a competitive disadvantage.

The Centene subsidiary, Meridian Health Plan of Illinois, Inc., collected $210 million under the YouthCare contract over the last 12 months, a spokesperson for the Department of Healthcare and Family Services said on Monday.

Agency Director Theresa Eagleson did not immediately respond to a request for comment. A spokesperson said agency officials could not discuss pending litigation.

The YouthCare program provides payments for the medical and psychiatric treatment of roughly 20,200 youths who are wards of the Illinois Department of Children and Family Services, as well as 15,700 former DCFS wards.

The contract has rolled out in phases as some foster parents complained they could not fill prescriptions or even schedule regular check-ups for children with serious medical conditions.

Last year, Meridian began producing for state officials quarterly slideshows with basic data about its performance in delivering care. The slides are meant to outline whether Meridian is meeting timeliness and quality standards, and what it’s doing to overcome problems.

But when the BGA asked last month to see those slideshows, state officials turned them over almost completely redacted — with entire slides blacked out.

The contractor’s performance data constituted “trade secrets,” HFS explained in its denial letter to the BGA.

Meridian “claims that disclosure of this information will place it at a competitive disadvantage in future marketing and bidding situations, and therefore, will cause (it) economic injury,” HFS Assistant General Counsel Kiran Mehta wrote in the denial letter.

In May, the BGA launched the first part of an ongoing series titled “Milking Medicaid,” that revealed how the five private insurance companies running the state’s Medicaid program, including Meridian, benefited from the COVID-19 lockdown.

The BGA lawsuit, filed in Springfield on Thursday by the Loevy & Loevy law firm, seeks to unseal Meridian’s quarterly slideshow presentations.

HFS offered no evidence that the slides would cause competitive harm to Meridian, the BGA asserted in its lawsuit. Instead, state officials made the “vague claim” that the “vendor objects to the release of this information.”

The public has a vital interest in performance data about the taxpayer-funded medical care of juvenile state wards, the lawsuit added.

Cook County Public Guardian Charles Golbert, whose office provides court representation to more than 7,000 juvenile wards, said the YouthCare performance data should be public.

“It is outrageous that you need to sue to get this information,” Golbert told the BGA. “This is medical care for the state’s foster children that is being paid for by taxpayers. It is cynical and disingenuous for YouthCare to claim it is a trade secret whether or not they are living up to their obligations to DCFS children.”

Centene did not respond to a request for comment Monday on the BGA’s lawsuit or the YouthCare contract.

DCFS — the agency that oversees the children — told the BGA on Monday it does not have copies of Centene’s performance slideshows, and takes no steps to evaluate the contractor’s overall performance.

“We are advocating for the children in our care, and making sure that individual kids are getting the health care they need. We are not monitoring YouthCare’s performance at a larger level,” DCFS spokesman Bill McCaffrey said.