CARBONDALE - Carbondale Clinic, owed more than $1.2 million by the state in backlogged Medicaid payments, received a check last week for $400,000 with a promise of an additional payment in the next 10 days.

CEO Allan Norman was notified that financial help was on the way after a story appeared in The Southern Illinoisan, detailing the clinic's concerns about a lack of Medicaid payments.

"We've been told that a $200,000 payment will be made within the next week, and with the other $400,000, that will make approximately one-half of what is owed to us," Norman said. "We couldn't get any information at all from the state until the article broke in the newspaper. And then as soon as the article appeared in the paper, we were contacted by state officials and told that we would be getting half of what we are owed."

Despite the latest payment, Norman said the current method of disbursing payments is "a poor way to do business."

"When you're looking at the magnitude of this problem, it has a significant effect on our ability to pay our vendors, including our local vendors," Norman said. "It's sort of a trickle-down effect. For instance, if we can't pay our office supply vendor, then it puts them in a bind.

"It gives us a black eye essentially in our ability to pay our bills. And some of our vendors are not as patient as we have to be

with the state."

Norman said the current payment cycle with the state is the "worst by far" that he has seen in his 31 years with Carbondale Clinic.

Two regional healthcare providers - Carbondale Clinic and Shawnee Health Service - were owed more than $2.6 million combined by the state in late payments. Before the latest payment Carbondale Clinic had not had a substantial Medicaid payment since a April. Most payments are more than 120 days past due, although a state spokesperson said the average claim is 59 days.

State officials claim medical providers with a higher number of Medicaid patients receive payments faster. Norman said 15 to 20 percent of the patients at Carbondale Clinic are Medicaid recipients while a spokesperson at Shawnee Health Service said 70 percent of its patients are Medicaid, but state payments to both facilities routinely run 120-plus days behind.

State Sen. David Luechtefeld, R-Okawville, and Rep. John Bradley, D-Marion, were involved in lobbying efforts with the governor's office on behalf of several medical facilities, including Carbondale Clinic, in an effort to secure delinquent Medicaid payments.

Bradley said he got involved because many of his constituents from Williamson County and Franklin County use the clinic.

Luechtefeld said he was contacted by Norman about the $1.2 million owed by the state and was also informed that the clinic couldn't borrow any more money to help meet day-to-day expenses - including payroll.

"I'm not taking any credit; it was the story that appeared in the newspaper that did it. It wasn't going to happen with just me," Luechtefeld said. "I contacted the governor's office, and they said they'd look into it and then the story appeared in the paper the next day and they called me back and said they were going to send them some money. It was just a chain of events, but what got the state to come up with some money is the bad publicity that they don't want."

Luechtefeld stressed that what is happening in Southern Illinois with Medicaid payments is only a fraction of what is happening statewide.

"Carbondale Clinic got part of what was owed to them, but the sad part is that while they got their money it means that somebody else didn't get what is owed to them," Luechtefeld said. "Just look at what is happening here in Southern Illinois and then magnify that by thousands of times around the state."

Carol Knowles, a spokesperson with the comptroller's office, said that the Medicaid "rollover" for the 2005 fiscal year is the largest in the state's history, exceeding the $1.9 billion in 1994 by more than $1 billion.

"It's a problem that is growing," said Knowles.

When asked about the state's payment schedules, Knowles said attempts are made to pay facilities that have a higher percentage of Medicaid patients on a quicker rotation. But she added that a 200-day delinquency is "not uncommon."

Kathleen Strand, communication director for the Department of Heath Care and Family Services, contradicted the elapsed time for Medicaid payments and said the state is currently showing a turnaround of 59 days for payment. Many hospitals with high Medicaid loads are paid quickly, she said.

"That's factoring in all Medicaid providers," said Strand. "The larger numbers are a comparison of a very small percentage of Medicaid providers to a very large number of providers. We have actually brought the numbers down from what used to be an average of 125 days."

John Reed, administrator of Weber Medical Clinic in Olney, said the state is $700,000 in arrears and no payments have been received since last December.

Reed said along with the financial impact the state's slow pay has cost his facility one doctor with another expected to leave next month.

"We lost an ob-gyn, which is very difficult to replace, and we're going to lose another doctor," he said. "And we're reluctant to try and recruit because the way the situation is right now we don't have anything to offer anybody. We don't know when we're going to get healthy financially and if we do how long it will last. There are a lot of doctors in this area contemplating closing their practices."

Reed also took exception with the claim by Strand that the state is on an average 59-day billing cycle. Reed said that claim is derived from the time a bill is submitted to the comptrollers' office and not from the time a bill is submitted to public aid. He said bills are routinely held up in the public aid office for months.

"I don't know how anybody could make that claim with a straight face," Reed said.

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