Date: March 29, 2018
To: All Medical Assistance Program Providers
Re: HealthChoice Illinois Expansion - Schedule Update
This notice informs providers of a change in the Department of HealthCare and Family Services (HFS) HealthChoice Illinois managed care program expansion schedule affecting a specialized segment of Medicaid members and providers.
Effective immediately, the HealthChoice Illinois program for dual-eligible individuals receiving long term care and who are not enrolled in the Medicare-Medicaid Alignment Initiative (MMAI) or individuals receiving waiver services in the expansion counties has been postponed. This change effects only individuals receiving services in one of the following programs and who recently selected or were assigned to a health plan in the HealthChoice Illinois program in the expansion counties for an April 1, 2018 or later effective date.
· Community Care Program (Elderly Waiver)
· Home Services Program (Division of Rehabilitation Services Waivers)
· Supportive Living Program (SLP Waiver)
· Nursing home or long term care facility (non-MMAI dual eligible)
Enrollments with HealthChoice Illinois health plans for the programs listed above, will not take effect on April 1, 2018 as originally anticipated. Instead, as of April 1, 2018, individuals under this managed care enrollment postponement will continue to receive services in the HFS Fee-For-Service program and will continue to access their long term care and waiver services with their HFS medical card. These individuals will not use their HealthChoice Illinois health plan member ID that they may have previously received in the mail. In addition, the HFS MEDI System will reflect that the individual is in the HFS Fee-for-Service program and no health plan assignment in HealthChoice Illinois will be present as of April 1, 2018.
The HealthChoice Illinois expansion schedule change does not change these individual’s access to healthcare services or benefits in any way. Providers will continue to bill the appropriate State Agency for services rendered.
When the HealthChoice Illinois program begins for individuals receiving long term care or waiver services in the expansion counties, Client Enrollment Services (CES) will mail each individual a new HealthChoice Illinois enrollment packet. This packet will provide each individual with information about their health plan choices and 30 days to pick a health plan at that time.
The HealthChoice Illinois expansion schedule change ensures a smooth transition of this population into HealthChoice Illinois at a later, to be determined, date. The Department will issue a new provider notice when managed care enrollment for these individuals receiving long
term care or waiver services begins in the expansion counties. As stated in the March 28, 2018 Provider Notice, rescheduling of these individuals does not delay the April 1st general statewide expansion of HealthChoice Illinois.
Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at 217-524-7478.
Felicia F. Norwood