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Proposed Changes In Methods And Standards 

 

State of Illinois
Healthcare and Family Services

Proposed Changes in Methods and Standards for Establishing Medical Assistance Payment Rates for Certain Non-Institutional Services

The Department of Healthcare and Family Services (HFS), in conjunction with the Illinois Department of Human Services' Division of Developmental Disabilities, proposes to change the methods and standards by which certain Medicaid waiver services are reimbursed under the Illinois Medical Assistance Program. These changes are being made in conjunction with a renewal of the adult waiver for persons with developmental disabilities and to implement two new children's waivers that will provide services to developmentally disabled children residing in their home and developmentally disabled children who receive residential services. All of these changes are effective for dates of service on or after July 1, 2007.

The renewal of the waiver for adults with developmental disabilities will continue with the same rate methodologies for various services provided under the waiver. However, new services under the adult waiver include training for unpaid caregivers, which will be reimbursed at usual and customary rates, and counseling for unpaid caregivers, which will be reimbursed at $29.82 per hour. Effective for dates of service on or after July 1, 2007, the service of Respite Out of Home will be eliminated.

Services available under the two new children's waivers will be similar to services provided under the adult waiver and will use same rate methodologies. However, the Children's Residential Waiver will establish child group home rates. The child group home rate will be based on individual provider cost reports.

A description of each billable service, under any of the waivers for developmentally disabled adults or children, is available at DHS local offices or at the Web site, as described below. Annual spending on the two new children's waivers will be approximately $17.2 million.

Time, place and manner in which interested persons may comment on the proposed changes

Any interested party may submit comments, data, views, or arguments concerning these proposed. All comments must be in writing and should be addressed to:

Bureau of Program and Reimbursement Analysis
Division of Medical Programs
Healthcare and Family Services
201 South Grand Avenue East
Springfield, Illinois 62763-0001
E-mail address: bpra@illinois.gov

Interested persons may review these proposed changes on the Internet at HFS Public Notices. Local access to the Internet is available through any local public library. In addition, this material may be viewed at the DHS local offices (except in Cook County). In Cook County, the changes may be reviewed at the Office of the Director, Healthcare and Family Services, 100 West Randolph Street, Chicago, Illinois. The changes may be reviewed at all offices Monday through Friday from 8:30 a.m. until 5 p.m. This notice is being provided in accordance with federal requirements found at 42 CFR 447.205.

DD Medicaid Waivers Proposed FY 2008 Rate Sheet Effective July 1, 2007 (pdf) (html)