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Provider Notice Issued 09/09/2022

Date:   August 9, 2022 

To:       All Medical Assistance Program Providers

Re:      Changes to the Illinois All Kids Program    

_______________________________________________________________________________________________________________________________________________________   

This notice informs providers that with Federal approval, Illinois' Department of Healthcare and Family Services (HFS) has moved all children previously in the state's All Kids Share, Premium Level 1, and Premium Level 2 Medical Assistance programs into the state's All Kids Assist Medicaid program (Title 19), effective July 1, 2022. The state's Share, Premium Level 1 and Premium Level 2 programs had previously been created as part of a separate Children's Health Insurance Program (CHIP) under Title 21 of the Social Security Act.

Effective 7/1/2022, the All Kids Program is a "Medicaid Expansion Program"

Over 190,000 children will benefit from this change. All Medicaid-eligible children, regardless of income, are now in a Title 19 Medicaid expansion program. Children who are determined presumptively eligible and children covered with all State funding because of immigration status will remain covered outside of Title 19 but receive the same comprehensive benefits as those in the All Kids Assist Medicaid Program.

Transitioning All Kids to a Medicaid Expansion program means that even after the Public Health Emergency ends, all Medicaid eligible children and children covered with all-state funding:

  • Will have coverage without any premiums or co-payments
  • Will be eligible for benefits even with current or recent private insurance (Medicaid as secondary payer)
  • May apply for three months of retroactive coverage, if needed
  • Will have coverage beginning with the month of application, if eligible
  • Will qualify for the same comprehensive benefits, including non-emergency transportation
  • Will have access to care coordination under the state's managed care program
  • Will have access to vaccines under the Vaccine for Children's Program (VFC) 
 
The Vaccine for Children (VFC) Program is a federally funded initiative that provides vaccines for children whose parents or guardians may not be able to afford them. Under this program, Title 19 children receive childhood vaccines made available to their providers by the Illinois Department of Public Health (IDPH) or VFC Program in Chicago. A separate notice on VFC will be forthcoming.


Premium Level 2 Children Moving into Managed Care 

Former Premium Level 2 children are moving into managed care as part of the transition to Medicaid Expansion coverage. Managed care enrollment packets will be mailed over the next few months. This change will simplify processes for customers and providers, ensure


comprehensive coverage for all children without financial barriers, and provide these children the opportunity to benefit from care coordination and other added benefits of managed care.   All Kids Premium Level 1, Share, and Assist, including children covered with all-state funding, are already enrolled in managed care. 

Note:  Once the Premium Level 2 cases are transitioned to managed care, All Kids children at any income level will be required to enroll in managed care unless they have one of the following exemptions: high-level private insurance (TPL), Presumptive Eligibility, or are Medically Fragile/Technology Dependent (MFTD). Those managed care exempt children will be covered under the Medicaid fee-for-service (FFS) program. 

Premium Level 2 children will be transitioned to managed care in three waves, with the last wave of children effective in managed care on January 1, 2023:

  1. Children receiving enrollment packets mailed in September will have an effective date no later than November 1, 2022
  2. Children receiving enrollment packets mailed in October will have an effective date no later than December 1, 2022.
  3. Children receiving enrollment packets mailed in November will have an effective date no later than January 1, 2023.

 Premium Level 2 families will be given the standard 30 days to choose an MCO and primary care provider (PCP) for their children. If the parent or guardian does not choose, HFS will assign the child to an MCO and PCP. The parent or guardian will have 90 days after the child initially enrolls in an MCO to change plans before being locked in for one year. After they receive an enrollment packet, a parent or guardian can research MCO networks and options by visiting:  https://enrollhfs.illinois.gov/en/enroll

 
MEDI 

MEDI now shows that Medicaid eligible children, regardless of income, are listed as: 

Case Type: All Kids Assist:  Full Coverage 

Special Information:  Title XIX



Note:  In the case where MEDI shows any of the following, providers should disregard the designations and consider the children as All Kids Assist since there are no longer Share or Premium Level programs. That is a known system issue; HFS is manually updating the cases.

Case Type: All Kids SHARE or
Case Type: All Kids Premium Level 1 or
Case Type All Kids Premium Level 2
With Special Information:  Title XXI

HFS is asking providers to inform families of the benefits of this transition and to assure them that it does not reduce, but in fact enhances, the scope of their coverage and has been implemented to simplify and improve the program for our children and families.

Questions regarding this notice may be directed to the Bureau of All Kids at 1-866-255-5437 (TTY 1-877-204-1012).

 

Kelly Cunningham, Administrator
Division of Medical Programs

 



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