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  3. Medicaid Redetermination Project
  4. Project Details for Assisting Clients

Project Details for Assisting Clients  

 

The Departments of Healthcare and Family Services (HFS) and Human Services (DHS) are initiating an enhanced eligibility verification project with the official name of the “Illinois Medicaid Redetermination Project” (IMRP) and the unofficial name of EEV (Enhanced Eligibility Verification). The purpose of this project is to process the backlog of cases that require immediate redeterminations and ensure that going forward, redeterminations will be processed in a timely manner, so that eligibility for Medicaid coverage is verified on an annual basis. This note will provide some background information on the project in case of inquiries from clients or to otherwise answer questions.

Background

The Illinois Medicaid Redetermination Project arose from an emergency procurement authorized by the Save Medicaid Access and Resources Together (SMART) Act of May 2012, to secure services of a Vendor to assist in the verification of income, assets and residence for Medicaid eligibility through use of data matching resources.
On September 13, 2012, the State entered into a contract with MAXIMUS Health Services, Inc., who in turn subcontracted with HMS for the data matching component. This document summarizes the key program components, including:

Scope of Work

Illinois Medicaid Redetermination Program Schedule

Date Activity
January 2, 2013 MAXIMUS-operated Illinois Medicaid Redetermination Program reviews and assesses initial test cases and addresses issues
January 21, 2013 Full hotline and recommendation processing for medical-only cases
February 1, 2013 MAXIMUS begins review of cases that also include SNAP or other benefits
February 4, 2013 State begins to receive medical-only case redetermination recommendations
March 2013 Long Term Care eligibility rdetermination forms are sent out by MAXIMUS
February 1, 2014 Maximus begins operation of Max-IL that will make automated recommendations based on current case information and electronic cross matches. A new pre-populated rede form is introduced for most medical only redes. Central state rede hub workers begin processing redes.

IMRP Hotline Information

A client who has been asked to submit information to the Illinois Medicaid Redetermination Project should submit the data as shown below. Data can also be taken to local DHS office (or sent to the HFS Bureau of All Kids) but responding directly to the Redetermination Project in the stated time frames will decrease likelihood of recommendations being made for case cancellation due to missing, conflicting or outdated information.

While the IMRP is very focused on maintaining business continuity, the situation of most concern is where a client is required to submit information within 10 business days. Failure to respond timely is cause for cancellation of eligibility. Clients will need to pay attention to any deadlines in correspondence and respond to the redetermination or requests for additional information promptly.  A client should contact IMRP if their case is cancelled and they believe the cancellation is in error. Information that gets to the Call Center late will be routed to the correct in order to reduce the risk of process break-downs. 

Illinois Medicaid Redetermination Program Hotline Information

Hours of Operation:

Holidays: The IMRP Hotline will be closed on the following holidays:

Phone Number:

Mailing Address:

E-mail Address:

Submitting Documents: