Medicaid Managed Care Program Update - IPHA

[Pages:2]Medicaid Managed Care Program Update

Implementation of HealthChoice Illinois, the new statewide Medicaid managed care program, is moving forward rapidly. Health department personnel should watch for several Provider Notices from HFS over the course of the next few months. Provider Notices can be found at:

Also check the HFS Care Coordination website regularly for updates:

The HFS RFP website also has a lot of good information about the new statewide Medicaid managed care program:

A summary of HealthChoice Illinois is provided in this Provider Notice Issued 10/27/2017:

Starting January 1, 2018, the new MCOs will be: Blue Cross Blue Shield of Illinois Harmony Health Plan IlliniCare Health Plan Meridian Health Molina Healthcare of Illinois CountyCare Health Plan (Cook County only) NextLevel Health (Cook County only)

HFS has recently published a Transition and Expansion Mail Schedule that can be found on the HFS Care Coordination website: ScheduleFinalOct162017.pdf.

Samples of the letters that will be sent to eligible Medicaid clients are also on the HFS Care Coordination website. The first round of letters were sent during the week of October 30, 2017.

According to the HFS Provider Notice issued 10/27/2017, "Individuals who are now enrolled with a FHP/ACA, ICP, or MLTSS managed care health plan will transition to the new program on January 1, 2018. If an individual is currently enrolled with one of the health plans selected and listed above, the individual will remain with that current plan in the new program. Managed care clients currently enrolled in a health plan that is not part of the new program will be transitioned to one of the newly awarded health plans. All clients will receive notice of the transition and their plan assignment for January 1, 2018. Regardless of which health plan a client is in on January 1, 2018, all clients will have 90 days with the option to switch to another plan."

"Eligible Medicaid clients who are not currently participating in managed care will be provided with a 30day enrollment choice period in early 2018 and will need to select a new health plan. These clients will begin receiving services in the newly selected health plan on April 1, 2018. Regardless of which health plan a client is in on April 1, 2018, all clients will have 90 days with the option to switch to another plan." HFS has implemented a simplified and uniform credentialing process for HealthChoice Illinois plans. The process will be based on the provider information contained in the IMPACT system. However, each MCO may still request additional information that is not part of the credentialing process but may be needed for implementation within its specific operational system. For more information about this simplified credentialing process, please see the HFS Provider Notice that was issued on 10/30/2017: . If your health department has not already started the process of contracting with all 5 of the statewide MCOs, then you need to start that process immediately. Keep in mind that the MCOs are contracting with a wide variety of provider types statewide, so they will be processing an extremely large volume of provider contracts in a very short time frame. If you delay contracting, then your health department's contract may not be completed by the time that you need to start billing. IPHA is working with the Illinois Association of Medicaid Health Plans (IAMHP) and each MCO to help facilitate contracting with public health departments. IAMHP has information and resources for providers on its website: . IAMHP also provides a quarterly newsletter, you can subscribe to receive the newsletter here: IPHA members that have questions regarding Medicaid managed care or contracting with the MCOs, may contact Philip Talley, ptalley@. General questions about billing Medicaid, Medicare, and private insurance may be emailed to: insurancebilling@.

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