Illinois Medicaid Transition

Education

MCO Resources

Illinois Association of Medicaid Health Plans HealthChoice Information Resource – This material includes an overview of Illinois Managed Care and specific information and links about each participating plan like provider portal instructions, pre-authorization links, billing instructions, and important contacts.

Rollout Timeline

Phase

Effective Date

Patient Population and Activities

Client Communication

Pre

1-Nov-17

FHN & CCAI members in Cook County will transition to County Care

Letters already sent to patients in FHN & CCAI plans in Cook County

CountyCare


Plan Partnerships for Phase I

1-Jan-18

FHN & CCAI members in Collar Counties and Rockford Region will transition to IlliniCare.


Aetna Collar and Rockford patients will transition to Meridian.Aetna Cook County patients will transition to County Care


Humana ICP plan ending December 31, 2017 members will be auto assigned.

FHN  CCAI and Illinicare Letters


Aetna and Meridian Collar Letters. Aetna Cook Letter.


Humana Letter

Phase I

1-Jan-18


Current MCO enrollees in mandatory and voluntary MCO plans that were awarded under the new plan will transition to their current MCO’s new contract plan.


Discontinued plan members will be transitioned to their announced partner and when no partner has been announced will be auto-enrolled to a new MCO.



Auto-enrollment is effective January 1 followed by 90 day plan switch allowed. Clients can call when they receive the enrollment information to request a plan change from the auto-enrollment prior to the January 1 effective date.

Communication starts Oct. 30 - Nov. 30, 2017



HFS Transition Notice - Same Plan (Spanish)

MLTSS HFS Transition Notice - Same Plan (Spanish)


HFS Transition Notice - New Plan (Spanish)

MLTSS Member Transition Notice - New Plan (Spanish)

Phase I

1-Jan-18

IHC patients will become FFS as of January 1, 2017 until enrolled with MCO in Phase II.

Client Communication

Phase II

1-Apr-18

Newly eligible Managed Care Medicaid clients throughout the whole state will be sent full enrollment packet with 30 day choice period and auto-enrollment default primary care provider and plan on the letter. Earliest effective date will be April 1, 2018 followed by 90 day plan switch allowed.

Client communication scheduled Jan. 8- Feb. 16 draft letters available – (draft brochure, packet plan letter, tips sheet,

Comparison chart)

Phase III

1-Jul-18

Enrollment of the special needs children and DCFS.

Communication planned for May 7 – 16, 2018

 

 

Credentialing

Medicaid Provider Enrollment – IMPACT Update for MCO Credentialing                                                                                    

As part of the new Medicaid MCO contract HFS will be using IMPACT information to credential providers during the Medicaid provider enrollment and update process.  This will replace the prior credentialing required by each Medicaid Managed Care Plan in Illinois.  You may have already noticed a new question during the IMPACT enrollment of a provider.  The new question is located on the enrollment checklist inquiring the status of the provider’s liability insurance and policy coverage limit insurance.  Bureau of Primary Health Care suggests deemed providers respond to the question as follows:                                                                                                                                     


Name of Insurer:                                                                         
                                                                               

Health Resources and Service Administration (HRSA)                                                                                           

5600 Fishers Lane, Rockville, MD 20852                                                                                                                 


Coverage Amount:                                                                      
                                                                               

No Cap                                                                                                                                                                            

                                                                                                                                                                                                       

HFS plans to add a question about office hour information to IMPACT enrollments in March.  In the interim, MCOs are expected to collect information on their provider networks as well as provider hospital affiliations. 

 

HFS Communication

                

IPHCA Springfield Office
500 S. Ninth St., Springfield, IL 62701
(217) 541-7300


IPHCA Chicago Office

542 S. Dearborn St., Suite 300, Chicago, IL  60605
(312) 692-3000


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