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April 2013 

 

Greetings from HFS Director Julie Hamos

Welcome to another periodic edition of HFS e-news to keep you updated on program changes. To register for future editions, please visit HFS E-News Online Registration or download for others who might be interested by visiting: hfs.illinois.gov/enews. If you are a Medicaid client, this newsletter is not the official notification of any changes that may impact you, and you do not have to respond in any way. This is general information for the public.

Thank you,

Julie Hamos

Rate Increases for Primary Care Physicians

The Affordable Care Act (ACA) provides for enhanced payments for certain Medicaid primary care services provided by certain qualified primary care providers. In order to receive the enhanced payments, the provider must file a simple Attestation Form (pdf) that is available on the HFS website.

We urge physicians to file their Attestation Forms early. The effective date for physicians, for whom the form is received no later than June 30, 2013, will be January 1, 2013, (retroactively). After June 30, 2013, the effective date for the enhanced payments will be the date the Attestation Form is received by HFS (not retroactively). These are temporary enhanced rates that are available from the federal government until January 1, 2015. Additional information about the increased payments is available on the HFS website at ACA PCP Rate Increase Provider Notice (PDF).

We also want to remind physicians that HFS is paying your bills on time, and will continue to pay on time – generally within 30 days.

ABE Coming to Illinois!ABE Application for Benefits Eligibility

As part of the new Integrated Eligibility System (IES), the State will be adopting a new client-facing website to apply for benefit eligibility for Medicaid, Supplemental Nutrition Assistance Program (SNAP), Cash Assistance and coverage under the new subsidized marketplace of commercial health insurance created as part of Health Care Reform. We will call this website ABE (Application for Benefits Eligibility), when it goes live in October, invoking a familiar Illinois theme.

Update on Illinois Health Insurance Marketplace

The Illinois Health Insurance Marketplace (formerly known as the Health Insurance Exchange) will begin open enrollment on October 1, 2013, and insurance coverage will begin on January 1, 2014. Required by the Affordable Care Act, the Marketplace will be an online shopping website where consumers can compare private health insurance plans and select the plan that is best for them and their families. Every plan will cover the comprehensive benefits that are typically offered in small employer plans, such as hospitalization, doctor visits, preventive care, and prescription drugs. Low- and middle-income consumers may qualify for financial help to make premiums and cost-sharing more affordable.

Illinois does not have the legislative authority to run a State-Based Marketplace, so Illinois will be assisting the federal government in its implementation. The federal government is currently building the Marketplace website, and setting up a call center. In the spring, insurers will submit plans to the Illinois Department of Insurance for review, and a competitive grant application will be published for “Assisters” (mostly community-based organizations) to help consumers apply for, and enroll in, the Marketplace plans. The Assisters will follow a “no wrong door” policy and help consumers apply for Marketplace plans, Medicaid, and Comprehensive Health Insurance Plan (CHIP) (All Kids). A robust outreach and education campaign will begin at the end of the summer to create a “culture of coverage,” and make sure consumers are ready for open enrollment in the fall. On March 29, 2013, Illinois submitted the Illinois Outreach and Education Plan (pdf)

Update on Affordable Care Act Legislation:  SB 26

Under the Affordable Care Act, SB 26 would expand Medicaid coverage to about 342,000 low-income Illinois citizens who are currently excluded from Medicaid: adults without dependent children. SB 26 has passed the Senate and is now awaiting action in the House. The HFS website includes a copy of the legislation, fact sheets and list of supporters. If your organization is serving people without health insurance – whether a hospital, clinic, public health department, homeless shelter, social service organization and more – you should be interested in this legislation. Please contact your legislator today! 

Please feel free to ask questions or share comments by e-mailing: hfs.webmaster@illinois.gov