December 15, 2020
The Department of Healthcare and Family Services (HFS) issued a Provider Notice (Dec. 11, 2020) to implement a new, state-only funded Medicaid eligibility category—Health Benefits for Immigrant Seniors. This category of assistance, which was established as part of legislation passed during the May 2020 special session (Public Act 101-0649), is available to non-citizens age 65 and older who do not meet immigration status.
Health Benefits for Immigrant Seniors provides benefits similar to those covered under the Seniors and Persons with Disabilities (SPD) program, with the exception of long-term care services (e.g., nursing facility and home and community based services). This new eligibility category became effective on Dec. 1, 2020, and individuals may apply for up to three months of backdated eligibility. Those eligible for the program will initially be covered under Medicaid fee-for-service (FFS), but HFS plans to transition this population to managed care in the future.
HFS does not receive federal matching funds for individuals eligible for Health Benefits for Immigrant Seniors. In the proposed administrative rule to implement the program, HFS states that it does not create an entitlement to medical services and coverage is only available to the extent that funds are available for the program.
The Department may take any action it deems necessary to assure payments for this Program do not exceed available funding, including but not limited to: ceasing or limiting enrollment, changing standards of eligibility that are not statutorily required, changing enrollment practices, changing eligibility time periods, and reducing available medical services.
Due to the COVID-19 pandemic, the Joint Committee on Administrative Rules (JCAR) has not met to approve the rule; however, JCAR has instructed HFS that it may adopt the proposed rule as published. The final rule will be forthcoming in the Illinois Register.
The HFS Provider Notice reminds providers of the Emergency Medical Coverage for Non-citizens program, for which the state does receive federal matching funds.
Questions regarding this memo may be directed to IHA.