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Provider Notice issued 07/17/12

(SMART) Act Changes and its Affect on Managed Care Organizations

To:​ Participating Advanced Practice Nurses, Chiropractors, Community Mental Health Providers, Dentists, Department of Alcohol and Substance Abuse Providers, Durable Medical Equipment Suppliers, Federally Qualified Health Centers (FQHCs), Encounter Rate Clinics (ERCs), Home Health Agencies, Hospice Agencies, Hospitals, Local Health Departments, Long Term Care (LTC) Facilities (Nursing Facilities, Institutes for Mental Disease, Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)), Pharmacies, Physical, Occupational, and Speech Therapists, Physicians, Podiatrists, Rural Health Clinics (RHCs), and School Based/Linked Health Centers​
​Date: ​July 17, 2012
​Re: (SMART) Act Changes and its Affect on Managed Care Organizations​

As a result of Public Act 097-0689(pdf), referred to as the Save Medicaid Access and Resources Together (SMART) Act, effective July 1, 2012, HFS is be implementing several changes to services, including but not limited to reimbursement reductions, limitations on services, reductions in services, and prior approval changes. However, until further notice, no changes will be made affecting Enrollees in Managed Care Organizations (MCOs).

Changes for Enrollees in Aetna Better Health, Family Health Network, Harmony Health Plan, IlliniCare Health Plan, Inc. or Meridian Health Plan will be implemented at a later date. MCOs will continue to provide covered services as their current contracts require. HFS will amend the contracts with the MCOs in the near future. Questions regarding covered services for MCO Enrollees should be directed to the appropriate MCO. Contact information for the MCOs is as follows:


Contact Number

Aetna Better Health


Family Health Network


Harmony Health Plan


IlliniCare Health Plan, Inc.


Meridian Health Plan


Questions regarding this notice may be directed to the Bureau of Managed Care at


Theresa A. Eagleson, Administrator

Division of Medical Programs


Illinois Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director