The Illinois Department of Healthcare and Family Services (HFS) is a key resource for important provider notices and policies. Updates from IHA policy experts will also be posted here.
HFS has two new provider notices: 1) announcing the HFS CARES program reporting template is available; 2) Repricing Hospital Outpatient Claims Billed with COVID Diagnosis and Procedure Codes.
HFS issued a Provider Notice to advise providers that the previously delayed statewide expansion of the Medicare-Medicaid Alignment Initiative (MMAI) is now scheduled to begin July 1, 2021.
HFS issued a Provider Notice (Dec. 11, 2020) to implement a new, state-only funded Medicaid eligibility category—Health Benefits for Immigrant Seniors.
On Oct. 15, the Dept. of Healthcare and Family Services issued a notice with updates on Medicaid behavioral health service reimbursement and care coordination plans for 2021.
HFS posted a Provider Notice alerting hospitals of the completion of the annual Safety Net Hospital determination.
HFS has posted a Provider Notice announcing that the HFS CARES Portal is now open for CURE Fund applications.
HFS posted a Provider Notice updating information regarding its upcoming deployment of an online portal that will allow providers to bill for COVID-19 testing services for patients.
HFS posted a Provider Notice on the completion of the annual Disproportionate Share Hospital determination, as well as the annual Medicaid Percentage and Medicaid High Volume Adjustments.
HFS issued a provider notice, advising hospitals that certain outpatient claims containing COVID-19-related coding will be reprocessed.
HFS issued a provider notice, stating that the updated due date for the July 2020 hospital assessment tax is now August 14, 2020.
IHA was advised by HFS and all five MCOs that banking information for several hospitals is necessary for the MCOs to execute payment of the Hospital Assessment Directed and Pass Through payments.
This is a list of hospitals which need to provided banking information to MCOs to facilitate assessment payments.
IHA raises concerns about proposed rules on a new reimbursement methodology for hospital inpatient days beyond medical necessity.
The Dept. of Healthcare and Family Services has issued two important notices on the ORP edit and LARC HCPCS codes.
In May through June 2020, the Department of Healthcare and Family Services issued several notices that may or will impact hospitals.
All hospital OP services billed to HFS and MCOs must be billed uniformly on an institutional claim and will be reimbursed under EAPG, effective for claims with “From” DOS on or after July 1, 2020.
This memo summarizes an HFS proposed rule on reimbursement to hospitals for stays beyond medical necessity and IHA’s concerns.
HFS has issued a notice regarding SFY 2021 outpatient high volume hospital determination. All appeals must be submitted by July 23, 2020.
HFS released a notice that identifies a correction process for the Quarter 2 2020 managed care organization hospital access program payments (MCO-HAP).
The Illinois Department of Healthcare and Family Services (HFS) has posted a new document, FAQs for Hospital Professional Billing Transition to the Institutional Claim Format.
HFS: all hospital OP services billed on a professional claim and paid under the Practitioner Fee Schedule will be billed on an institutional claim and reimbursed at EAPG, effective July 1, 2020.
The Department of Healthcare and Family Services (HFS) has issued several notices that may impact hospitals.
CMS issued partial approval of the Section 1135 request to waive certain federal Medicaid, CHIP, and HIPAA regulations during the COVID-19 public health emergency.
HFS posted the rate year 2021 Determination for Disproportionate Share, Medicaid Percentage Adjustment and County Trauma Center Adjustment payments in a notice on its website.
To expand access to coverage during COVID-19, HFS submitted formal requests to CMS to modify the CHIP eligibility and enrollment processes.
See several new updates concerning COVID-19 and hospital and health system behavioral healthcare.
Governor Pritzker issued an Executive Order and HFS issued Emergency Rules (89 Ill. Adm. Code 140.403(e)) and a Provider Notice, all focused on telehealth coverage and reimbursement.
The Department of Healthcare and Family Services (HFS) has issued several notices that may impact hospitals. IHA also sent memos to members concerning some of these notices.
Between September and mid-November 2019, HFS issued several notices that may impact hospitals. IHA sent memos to members concerning some of these notices.
The Illinois Dept. of HFS informed IHA that implementation of the Ordering/Referring/Prescribing (ORP) requirement has been delayed to Jan. 1, 2020.
HFS posted a new provider notice regarding Federal Fiscal Year 2020 Safety Net Determination.
On Sept. 23, 2019, HFS released two notices: 1) Attending Provider NPI Requirements Delay to November 1, 2019; and 2) Ordering/Referring/Prescribing Provider Enrollment and Provider Directory.
HFS posted the Rate Year 2020 DSH, MPA and MHVA determination and rates on its website. HFS will not mail these notification letters. Please review your calculations in detail.
The Report of Birth functionality in the Application for Benefits Eligibility Partner Portal is now live. The HFS notice includes frequently asked questions.
HFS has issued several notices that may impact hospitals. IHA has sent memos to members concerning some of these notices.
Hospitals are urged to review their policies and procedures to assure that they are complying with the updated Physician Certification Statement.
To further reduce the backlog of hard copy claims, the Hospital Billing and Payment Support Unit will only take telephone inquiries Tuesdays and Thursdays from 8:30 to 4.
HFS has posted a notice indicating that it has mailed each hospital the facility’s inpatient and outpatient assessment remittance notices for FY2020.
This document outlines specific Medicaid payments that are contingent on providing inpatient obstetrical services.
The Illinois Dept. of Healthcare and Family Services released notices on numerous issues, including ABE, NPI requirements, APR-DRG and EAPG, and MMAI.
The Illinois Dept. of Healthcare and Family Services (HFS) has informed IHA that it will delay until October 1, 2019 implementation of the ordering, referring, prescribing (ORP) requirement.
The Illinois Dept. of Healthcare and Family Services announced it will use Grouper Version 3.13 of the Enhanced Ambulatory Patient Groups (EAPG) payment system.
The Dept. of Healthcare and Family Services has posted rate year 2020 determinations for DSH, MPA and CTCA payments in a notice on its website.
The Illinois Dept. of Healthcare and Family Services released notices on numerous issues, including Integrated Health Homes, NPI requirements and non-emergency ambulance transfers.
The Illinois Dept. of Healthcare and Family Services released notices on a Hospital Assessment payment extension, FFY2019 DSH and Safety Net determinations and other issues from Aug-Oct.
The Illinois Dept. of Healthcare and Family Services released notices on assessments, reimbursement systems, laboratory services and a standardized "provider roster" from May through early August.
The Illinois Department of Healthcare and Family Services has posted a new provider notice regarding Updated Pricing Calculators, related to the redesigned Hospital Assessment Program.
HFS has informed IHA that the state has also received approval from CMS to pay the Fee-for-Service ACA payments.
HFS notice regarding changes applicable to fee-for-service payments effective with dates of service on and after July 1, 2018.
HFS has clarified a new requirement for hospitals to report Modifier 90 on certain outpatient claims for reference laboratory service.
HFS notices and notifications released in March and April.