Medicaid

Illinois receives the lowest amount of federal funding per Medicaid beneficiary of all states. IHA advocates for adequate funding to serve Illinois’ most vulnerable populations and against drastic cuts.

Doctor with baby

The Impact of Medicaid in Illinois

3.2m Medicaid Beneficiaries
22.1% of inpatient admissions
21% of outpatient visits
  • Advocacy
  • Policy
Jul 06, 2021

IHA Summary: Medicaid Managed Care and Prior Authorization Reform Bills

This memo summarizes recent state legislation to reform clinical and reimbursement policies implemented by commercial health insurance issuers and Medicaid MCOs.

May 17, 2021

IHA Alert: Urge Your Legislators to Restore Medicaid Funding to Hospitals

Ask state legislators to urge their legislative leaders and state budgeteers to repeal the FY2013 SMART Act cuts to hospitals.

May 14, 2021

IHA Position Paper: Repeal FY2013 SMART Act Cuts, Restore Funding 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.

Mar 11, 2021

IHA Alert: Urge Senators to Co-Sponsor Medicaid Managed Care/Prior Authorization Reform Legislation

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).

Mar 10, 2021

IHA Fact Sheet: Support Medicaid Managed Care Reforms – Senate Bill 2006

IHA urges the General Assembly to enact the practical reforms in Senate Bill 2006, grounded by three key principles—transparency, standardization, and accountability.

Mar 10, 2021

IHA Position Paper: Support Medicaid Managed Care Reforms – SB2006

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. 

Mar 09, 2021

Hospital and Healthcare Transformation – Update No. 5: Transformation Program Application

HFS has released a Provider Notice announcing the Healthcare Transformation Collaboratives Program that includes the Application for Funding Healthcare Transformation Collaboratives.

Feb 19, 2021

IHA Summary: Governor’s FY2022 Budget Proposal

This memo provides details on the Governor’s FY2022 budget proposal, which does not include any Medicaid eligibility, service or rate reductions.

Jan 13, 2021

Hospital and Healthcare Transformation – Update No. 4

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.

Jan 13, 2021

Hospital and Healthcare Transformation Legislation Summary of SB 1510

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.

Nov 17, 2020

Hospital and Healthcare Transformation Update No. 3

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.

Nov 16, 2020

IHA Comments on HFS’ Hospital and Healthcare Transformation Proposal

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

Nov 09, 2020

Hospital and Healthcare Transformation Update No. 2: HFS Healthcare Transformation Proposal

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.

Nov 06, 2020

HFS Transformation Proposal – Presentation

See a Powerpoint presentation describing the Illinois Department of Healthcare and Family Services' (HFS) Nov. 6 Vision for Healthcare Transformation.

Nov 06, 2020

HFS Healthcare Transformation Proposal – Overview

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.

Nov 03, 2020

Hospital and Healthcare Transformation – Fall Legislative Preview

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. 

Nov 02, 2020

IHA Position Paper: Hospital and Healthcare Transformation Program – Investing for Health Equity

Illinois should invest in systemic hospital and healthcare transformation to eliminate health disparities and achieve health equity. IHA shares its principles for legislation.

Aug 19, 2020

Hospital Transformation: Opportunity & Challenge

IHA made this presentation to the Medicaid Legislative Work Group on August 19.

Jul 23, 2020

IHA Memo re: Medicaid Reimbursement for Inpatient Days Beyond Medical Necessity

This memo summarizes IHA’s concerns about proposed rules on a new methodology for hospitals inpatient days beyond medical necessity.

Jul 22, 2020

IHA Letter re: HFS Proposed Rules on Reimbursement for Days beyond Medical Necessity

IHA raises concerns about proposed rules on a new reimbursement methodology for hospital inpatient days beyond medical necessity.

Jan 31, 2020

IHA Comment Letter on Medicaid Fiscal Accountability Regulation

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.

Jan 31, 2020

IHA Infographic on MFAR: Protect Healthcare for Children, Seniors and People with Disabilities

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.

Feb 26, 2019

IHA Summary of Governor’s FY2020 Budget Proposal

The Governor’s FY2020 budget proposal does not contain any Medicaid rate or eligibility reductions.

Feb 15, 2019

IHA's Medicaid Managed Care Legislation & Advocacy Strategy

Today, a comprehensive legislative package of Medicaid managed care reform bills developed and strongly backed by IHA was introduced in the Illinois General Assembly.

Feb 15, 2019

Support Medicaid Managed Care Organization Fairness and Accountability

Senate Bill 1697/House Bill 2715 is a comprehensive approach to needed managed care reforms for fairness and accountability.

Feb 15, 2019

Support Safety Net and Critical Access Hospital MCO Reforms

Senate Bill 1807/House Bill 2814 is a comprehensive approach to needed Safety Net and Critical Access Hospital managed care reforms.

Feb 15, 2019

Support the Right to a Fair Review of Improper Medicaid MCO Denials

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.

Feb 28, 2018

IHA Statement re: General Assembly Votes on Hospital Assessment Program

The Illinois Health and Hospital Association commends the General Assembly for overwhelmingly approving Senate Bills 1773 and 1573.

Feb 28, 2018

Tip Sheet: Thank Your Legislators Who Voted Yes on Hospital Assessment Program

IHA urges members to publicly thank their local legislators who voted "Yes" on Senate Bills 1773 and 1573 to continue the Hospital Assessment Program.

Feb 22, 2018

Fact Sheet on SB 1773 and SB 1573: 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.

Feb 22, 2018

IHA Summary of Governor's FY2019 Budget Proposal

Many of the Governor's proposed savings would require legislative action or changes to employee contracts.

Jan 17, 2018

Illinois is Getting Shortchanged

Illinois receives less federal funding per Medicaid beneficiary than any other state and has one of the lowest Medicaid matching rates in the country.

Aug 28, 2017

State DSH Allotment Reductions

IHA in a letter outlined strong concerns with a proposed rule establishing new policies to implement Medicaid state disproportionate share allotment reductions.

Jun 30, 2017

Litigation Update 6

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.

Apr 28, 2017

AHA Transformation Strategy Brief

The AHA Task Force on Ensuring Access in Vulnerable Communities examined ways in which the access to and delivery of care could be improved.

Dec 22, 2016

Pass-Through Payments

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.

Sep 13, 2016

DSH Payments Third-Party Payers

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. 

Aug 12, 2015

Litigation Update 5

The House's Revenue Committee heard testimony on the Rauner Administration's plans to issue Medicaid payments in compliance with several consent decrees.

Aug 05, 2015

Litigation Update 4

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.

Aug 03, 2015

Litigation Update 3

During the state budget impasse, the Department of Healthcare and Family Services will make payments to providers serving Medicaid beneficiaries who are children.

Jul 24, 2015

Litigation Update 2

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.

Mar 09, 2021

Hospital and Healthcare Transformation – Update No. 5: Transformation Program Application

HFS has released a Provider Notice announcing the Healthcare Transformation Collaboratives Program that includes the Application for Funding Healthcare Transformation Collaboratives.

Jan 29, 2020

Integrated Health Homes – Comments Requested

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.

Jan 13, 2020

Medicaid Releases Psychiatric Rate Add-ons

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.

Dec 10, 2019

New Hospital Requirements for Child Reporting Effective January 1, 2020

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.

Nov 08, 2019

DCFS & HFS Managed Care Transition Plan for DCFS Youth – Member Assistance Requested

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.

Jun 20, 2019

Medicaid Newborn Case Add-ons: Corrections and Open Cases

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.

Aug 29, 2018

Integrated Health Homes-Update #1

This memo summarizes the latest information on Integrated Health Homes as shared by the Dept. of Healthcare and Family Services.

Jun 21, 2018

IHA Update: Illinois Medicaid 1115 Waiver

This memo provides several new Medicaid-related behavioral health updates.

May 22, 2018

Telehealth Recommendations Requested by HFS

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.

Jan 26, 2018

Telehealth Coalition

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.

Sep 12, 2016

Medicaid 1115 Demonstration Waiver Proposal

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.

Aug 26, 2016

1115 Waiver Proposal Summary

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.

Aug 04, 2016

HHS Transformation Medicaid Waiver

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.