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Elizabeth M. Whitehorn, Director

Notice of Public Information

State of Illinois Healthcare and Family Services Notice of Public Information

Proposed changes in methods and standards for establishing medical assistance payment rates for certain services

The Illinois Department of Healthcare and Family Services (HFS) proposes to change the methods and standards by which certain services are reimbursed under the Illinois Medical Assistance Program.

  • The Illinois Title XIX State plan will be amended to incorporate changes pursuant to new federal requirements of the Social Security Act as amended by the Patient Protection and Affordable Care Act of 2010.  Effective January 1, 2013, states are required to provide qualified primary care physicians payments at rates not less than the Medicare rates in calendar years (CYs) 2013 and 2014.  States will receive 100% FMAP for increased expenditures equal to the difference between the Medicare rate and the State plan rate as of July 1, 2009 for these services.  The provision applies to certain evaluation and management (E & M) services and vaccine administration services delivered by physicians with a specialty designation of family medicine, general internal medicine or pediatric medicine. 

  • The department anticipates amending the Illinois Title XIX State plan to calculate the inpatient payments for government-owned hospitals by using an inflator that will stabilize the amount of federal funds received for Medicaid services provided at those hospitals. 

Time, place and manner in which interested persons may comment on the proposed changes:

Any interested party may submit comments, data, views or arguments concerning these proposed changes.  All comments must be in writing and should be addressed to:

Bureau of Program and Reimbursement Analysis
Division of Medical Programs
Healthcare and Family Services
201 South Grand Avenue East
Springfield, Illinois   62763-0002
E-mail address:  hfs.bpra@illinois.gov

Interested persons may review these proposed changes on the Internet at:

http://www.illinois.gov/hfs/info/legal/PublicNotices/Pages/default.aspx. 

Local access to the Internet is available through any local public library.  In addition, this material may be viewed at Department of Human Services local offices (except in Cook County).  In Cook County, the changes may be reviewed at the Office of the Director, Illinois Department of Healthcare and Family Services, 401 South Clinton, 7th Floor, Chicago, IL.  The changes may be reviewed at all offices Monday through Friday from 8:30 a.m. until 5:00 p.m.  This notice is being provided in accordance with federal requirements found at 42 CFR 447.205.