Date: October 26, 2017
To: All Medical Assistance Providers
Re: Succeeding in the New Managed Care Program Series (#4): How HFS and the health plans will communicate transition details to clients
This is the fourth in a series of notices to help providers succeed with the upcoming enhancement of the Managed Care Program at the Department of Healthcare and Family Services (HFS).
The new Managed Care Program is named “HealthChoice Illinois.”
Beginning on January 1, 2018, newly selected health plans under HealthChoice Illinois will have a contract to begin managing Medicaid client care in every Illinois County (Overview Notice), phased-in according to the program expansion mail schedule. Upgrades built into the program will also help providers participate more easily.
Helping Clients Transition
During the transition to HealthChoice Illinois, the Department will reach out to every participating Medicaid beneficiary directly with information about their status. HFS asks for provider help with this process.
Letters were sent to all those currently enrolled in a FHP/ACA, ICP, or MLTSS managed care health plan to explain their options and opportunities. Sample letters have been posted online, along with their mailing schedule, under the heading “HealthChoice Illinois Transition Information.” The chart below provides a broad overview of how a beneficiary’s current status is likely to be affected:
Client’s Status Probable Transition
Current plan remaining Stay with plan Jan. 1, then 90-day option to change
Current plan exiting Assigned to a new plan Jan. 1, then 90-day option to change
Not in managed care 30-day choice period in early 2018, enrolled beginning April 1, then 90-day option to change.
Other aspects of a beneficiary’s status may affect their transition. For more details on differences among client transitions, please see the Department’s overview notice. This also lists the health plans that will be participating in HealthChoice Illinois and health plan options for dual eligible beneficiaries.
Plans will also be separately communicating individually with their clients to help emphasize this information.
HFS designed HealthChoice Illinois to ensure that beneficiaries fully understand their options, and we understand there will be concerns and questions which will need to be addressed. Provider assistance is greatly appreciated.
Articles in the Department’s Succeeding in the new Managed Care series:
#1. What is my relationship with health plans that weren’t awarded a contract for the new program? (Exiting Health Plans notice)
#2. Five key ways the new managed care will mean less work for providers (Benefits notice)
#3. Simplified credentialing: Cutting back on your overhead costs (Credentialing notice)
#4. How HFS and the health plans will communicate transition details to clients
#5. How you can help your patients understand what they need to know about this transition
Additional information regarding HealthChoice Illinois may be found on Department Website
Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at 217-524-7478.
Felicia F. Norwood