To: All Medical Assistance Program Providers
Re: Illinois Medicare-Medicaid Alignment Initiative Statewide Expansion July 1, 2021
This notice announces the Department expanded the Medicare-Medicaid Alignment Initiative (MMAI) program statewide effective July 1, 2021. This expansion was detailed in previous provider notices dated December 16, 2020, February 23, 2021, and April 30, 2021.
The MMAI webpage includes an updated MMAI Participating Plans by Countytable that identifies which health plans are available for opt-in enrollment, passive enrollment, or both. Passive enrollment means that if a customer does not choose a health plan, the customer will be auto assigned into a health plan selected by an algorithm. The statewide expansion of the MMAI program is being phased in over multiple cohorts. Two passive enrollment cohorts have already been completed with September 1st and October 1st effective dates. These two cohorts contained customers who were eligible to enroll in the MMAI program only and did not involve customers already enrolled in an LTSS HealthChoice plan.
The final two passive enrollment cohorts will be done in August for a November 1st effective date and in September for a December 1st effective date. Within these two cohorts, we will identify MMAI eligible customers already enrolled in a LTSS HealthChoice plan and passively enroll the customers into an MMAI plan. Customers also have the choice to opt out of the MMAI program at any time.
Contracting with Participating MMAI Illinois Plans
Providers are encouraged to join the MMAI plan networks as soon as possible to participate in the statewide MMAI program. Contracting is important for timely payment and continuity of care. As a network provider, you will be able to provide care to new and existing Medicare-Medicaid dually eligible customers while benefitting from simpler reimbursement systems and a team-based approach to care. IMPACT enrollment is required for any provider who renders services to Medicaid members for Medicaid covered services through the MMAI program.
Please contact the representatives listed below to learn more about how you can become an MMAI network provider.