Illinois Medicaid ranks 48th of all states and Washington D.C., in spending per full-benefit enrollee. IHA advocates for adequate funding to care for Illinois' Medicaid customers.
Source: IHA COMPdata, Nov. 2023
This memo summarizes recent state legislation to reform clinical and reimbursement policies implemented by commercial health insurance issuers and Medicaid MCOs.
Ask state legislators to urge their legislative leaders and state budgeteers to repeal the FY2013 SMART Act cuts to hospitals.
Illinois hospitals have absorbed more than $800 million in reductions from 3.5% Medicaid rate cuts under the SMART Act passed in 2012.
IHA is strongly supporting legislation to reform the unfair policies and practices of the Medicaid Managed Care Organizations and state-regulated commercial health plans (Senate Bills 2006 and 177).
IHA urges the General Assembly to enact the practical reforms in Senate Bill 2006, grounded by three key principles—transparency, standardization, and accountability.
IHA urges the General Assembly to exercise its critical oversight authority by supporting initiatives in SB 2006 to improve transparency, standardization and accountability in the state’s MCOs.
HFS has released a Provider Notice announcing the Healthcare Transformation Collaboratives Program that includes the Application for Funding Healthcare Transformation Collaboratives.
This memo provides details on the Governor’s FY2022 budget proposal, which does not include any Medicaid eligibility, service or rate reductions.
On Jan. 13, 2021, the General Assembly overwhelmingly passed IHA supported legislation, Senate Bill 1510, to authorize the Hospital and Healthcare Transformation program. See IHA's memo.
On Jan. 13, 2021, the General Assembly passed IHA supported legislation, Senate Bill 1510 (House Amendment 3), to authorize the Hospital and Healthcare Transformation Program.
On Nov. 16, IHA submitted comments to the Medicaid Legislative Work Group on the Hospital and Healthcare Transformation proposal released by the Dept. of Healthcare and Family Services on Nov. 13.
IHA appreciates the opportunity to comment on the Hospital and Healthcare Transformation Plan proposed by the Dept. of Healthcare and Family Services and released to the public on November 13, 2020
On Nov. 6, 2020, the Illinois Dept. of Healthcare and Family Services released its Vision for Healthcare Transformation. This memo provides an initial summary of the proposal.
See a Powerpoint presentation describing the Illinois Department of Healthcare and Family Services' (HFS) Nov. 6 Vision for Healthcare Transformation.
On Nov. 6, 2020, the Illinois Department of Healthcare and Family Services (HFS) released its Vision for Healthcare Transformation. See an overview of its proposal.
See an update on the discussions taking place in the Illinois General Assembly on the process and criteria to be used under the Hospital and Healthcare Transformation program to allocate funds.
Illinois should invest in systemic hospital and healthcare transformation to eliminate health disparities and achieve health equity. IHA shares its principles for legislation.
IHA made this presentation to the Medicaid Legislative Work Group on August 19.
This memo summarizes IHA’s concerns about proposed rules on a new methodology for hospitals inpatient days beyond medical necessity.
IHA raises concerns about proposed rules on a new reimbursement methodology for hospital inpatient days beyond medical necessity.
IHA formally commented on the proposed Medicaid Fiscal Accountability Regulation. The proposed rule will threaten access to quality healthcare for the 2.9 million Illinoisans on Medicaid.
IHA provides facts on Illinois' Medicaid program, which is the state's healthcare safety net for 43% of all Illinois children and 461,584 Illinois seniors or persons with disabilities.
Today, a comprehensive legislative package of Medicaid managed care reform bills developed and strongly backed by IHA was introduced in the Illinois General Assembly.
Senate Bill 1697/House Bill 2715 is a comprehensive approach to needed managed care reforms for fairness and accountability.
Senate Bill 1807/House Bill 2814 is a comprehensive approach to needed Safety Net and Critical Access Hospital managed care reforms.
Senate Bill 1703/House Bill 2730 will help assure access to care for Medicaid beneficiaries by providing a fair process to review and correct improper Medicaid MCO payment denials.
The Illinois Health and Hospital Association commends the General Assembly for overwhelmingly approving Senate Bills 1773 and 1573.
IHA urges members to publicly thank their local legislators who voted "Yes" on Senate Bills 1773 and 1573 to continue the Hospital Assessment Program.
IHA urges the General Assembly to approve SB 1773 and SB 1573, bipartisan legislation to redesign Illinois’ Hospital Assessment Program and enhance Medicaid managed care performance transparency.
Many of the Governor's proposed savings would require legislative action or changes to employee contracts.
Illinois receives less federal funding per Medicaid beneficiary than any other state and has one of the lowest Medicaid matching rates in the country.
IHA in a letter outlined strong concerns with a proposed rule establishing new policies to implement Medicaid state disproportionate share allotment reductions.
Federal District Court Judge Joan Lefkow ordered the State to make Medicaid payments on a more timely basis to ensure access to care for Medicaid beneficiaries.
The AHA Task Force on Ensuring Access in Vulnerable Communities examined ways in which the access to and delivery of care could be improved.
In a letter to the Centers for Medicare & Medicaid Services (CMS), IHA expressed concern that a proposed rule would further constrain many states’ transition of their Medicaid programs.
IHA asked CMS for clarification on a proposed rule on Medicaid disproportionate share hospital payments and the treatment of third-party payers in calculating uncompensated care.
The House's Revenue Committee heard testimony on the Rauner Administration's plans to issue Medicaid payments in compliance with several consent decrees.
The Rauner Administration has decided that all Medicaid providers statewide should be paid for services provided to all Medicaid beneficiaries—children and adults—during the budget impasse.
During the state budget impasse, the Department of Healthcare and Family Services will make payments to providers serving Medicaid beneficiaries who are children.
The state must continue to make all Medicaid payments for all healthcare services provided to Medicaid beneficiaries who reside in Cook County, according to an agreed-upon court order.
Illinois HFS issued a Provider Notice informing hospitals of a new add-on payment to psychiatric inpatient claims for certain long-acting injectable antipsychotic drugs.
On May 12, 2023, HFS issued a Public Notice announcing the Department is seeking a five-year 1115 Demonstration extension to secure additional Medicaid resources and spending flexibilities.
On June 12, IHA submitted a comment letter on the Dept. of Healthcare and Family Service’s (HFS) 1115 demonstration waiver proposal.
On Sept. 16, the Illinois Dept. of Healthcare and Family Services (HFS) issued a Provider Notice reminding hospitals of the mandatory preadmission assessment processes for long term care facilities.
The Illinois Dept. of Healthcare and Family Services will launch Phase Two of the state's Pre-admission Screening and Resident Review (PASRR) system redesign on April 18.
A March 7 webinar will address the statewide transition of the federally mandated Pre-admission Screening and Resident Review process to a new web-based management system.
The Dept. of Healthcare and Family Services (HFS) has a new vendor, Maximus, to transition the Pre-admission Screening and Resident Review (PASRR) process to a new web-based management system.
An IHA memo covers changes to the Medicaid COVID-19 Fee Schedule primarily impacting virtual check-ins and e-visits and a correction to the Medicare Physician Fee Schedule.
IHA is seeking comments on the Illinois Dept. of Healthcare and Family Services Public Notice proposing to begin Medicaid coverage for Integrated Health Home services on Apr. 1.
The Dept. of Healthcare and Family Services updated its Practitioner Fee Schedule with psychiatric service add-on payments, which were delayed. See IHA's memo on eligible procedure codes.
On Nov. 14, 2019, SB391 passed the General Assembly in Veto Session with additional child-related hospital care coordination required for compliance by Jan. 1, 2020. IHA summarizes the new rules.
HFS and DCFS have delayed full implementation of mandatory managed care for Youth in Care of DCFS, Former Youth in Care, and other Special Needs Children from Nov. 1, 2019 to Feb. 1, 2020.
IHA worked with HFS to establish a standard process for hospitals to resolve long-standing newborn enrollment issues. See our memo (password required) for instructions on submitting data to HFS.
This memo summarizes the latest information on Integrated Health Homes as shared by the Dept. of Healthcare and Family Services.
This memo provides several new Medicaid-related behavioral health updates.
IHA recommendations on Medicaid telehealth practice and reimbursement promote broad telehealth expansion. Our recommendations came at the request of the Department of Healthcare and Family Services.
IHA and a diverse group of stakeholders sent a letter to the Governor's office outlining Medicaid regulations that are limiting quality care and cost savings through telehealth.
With a Medicaid section 1115 waiver, the state would use federal funds to shift behavioral health patients from institutional to community care settings and enhance community-based services.
Several IHA-backed initiatives, including integrating behavioral health and physical health, are in the State's draft of its federal health transformation Medicaid section 1115 waiver proposal.
State officials are working to transform how health and supportive services are provided to people with behavioral health conditions. Their plan will likely include a Medicaid 1115 waiver proposal.