August 2017 Notices

August 11, 2017

Memorandum

Updates to Critical Access Hospital EAPG Standardized Amount

The Department of Healthcare and Family Services (HFS) released a notice regarding updates to the EAPG standardized for Critical Assess Hospitals (CAH). For those hospitals affected, new rate sheets are posted to the Department’s website: Hospital Rate Sheets Effective July 1, 2017. Hospitals can access their rate sheet by clicking on the appropriate link. An updated version of the Outpatient EAPG pricing calculator including these rates has also been posted.

Official FY 18 Hospital Access Improvement Payments Schedule
HFS issued a notice of the dates they will be making Hospital Access Improvement Payments in State fiscal year 2018. The payment schedule is outlined below and represents the full liability recognized by the State, for fiscal year 2018. The payment each month will be one month of the annual payment amount.

July 12, 2017
August 9, 2017
September 12, 2017
October 11, 2017
November 9, 2017
December 11, 2017
January 10, 2018
February 9, 2018
March 9, 2018
April 10, 2018
May 9, 2018
June 11, 2018

Renal Dialysis Centers
HFS posted a Public Notice proposing a change in the methods and standards of payment to hospitals and freestanding chronic dialysis centers. The proposed change is effective for dates of service July 1, 2015, and after. Hospitals and freestanding chronic dialysis centers will be reimbursed a $60 per treatment day add-on for outpatient renal dialysis treatments or home dialysis treatments. The proposed change will result in an annual increase in Medicaid liability of $15 million.

Community Mental Health Centers Rate Increase
HFS posted a Public Notice proposing a change in the methods and standards of payment to certified mental health centers identified in Rule 132. The services subject to the increase include but are not limited to mental health assessment, psychological evaluations, medication management, psychotherapy, and counseling. These proposed changes will increase expenditures by approximately $7 million based on current utilization patterns to the mental health rehabilitative services benefit category.

Transition of Cigna-HealthSpring Integrated Care Program (ICP) Enrollees
HFS released a notice to inform providers that Cigna-HealthSpring will no longer be part of the Medicaid Managed Care Integrated Care Program (ICP) after July 31, 2017. Only the Cigna- HealthSpring ICP plan is ending on July 31, 2017. Cigna-HealthSpring will continue to be part of the Medicare-Medicaid Alignment Initiative (MMAI) program through the end of calendar year 2017. Refer to the notice for details.

Money Follows the Person Demonstration: Illinois Pathways to Community Living Program
HFS released a notice that provides important information regarding the Money Follows the Person Demonstration: Pathways to Community Living (MFP Pathways) Program’s referrals and transitions. MFP Pathways was developed under the Money Follows the Person Rebalancing Demonstration, which was authorized by the Federal Deficit Reduction Act of 2005 and extended under Section 2403 of the Affordable Care Act. MFP Pathways supports state long term care rebalancing by assisting eligible individuals to move from qualifying long term care facilities to community settings. MFP Pathways referrals will no longer be accepted after June 30, 2017. MFP Pathways transitions to community settings will not be initiated after December 31, 2017. MFP Pathways participants who transition to the community before December 31, 2017 will receive 365 days of post-transition services. Refer to the notice for details.