Public Notice March 7, 2012

The Illinois Department of Healthcare and Family Services (HFS), in collaboration with the Cook County Board and the Cook County Health and Hospital System (CCHHS) has requested an 1115 waiver from the Centers for Medicare and Medicaid Services (CMS), effective July of 2012, to cover the current uninsured population that will become eligible for Medicaid in 2014. While this waiver application was written with a focus on Cook County, the waiver could provide for any willing county in Illinois to participate if HFS and CMS standards are met. This waiver will allow CCHHS to decrease its uninsured population and provide funds to improve the quality, coordination, and cost-effectiveness of the care it provides. The 1115 waiver would be entirely funded by local county resources and federal matching funds for eligible services.

The 1115 waiver is contingent upon federal approval. A state law change is also required to move forward with the demonstration. Key components of the proposed waiver include:

• Population: Eligible adults in Cook County with income levels at or below 133 percent of the federal poverty level could gain coverage.

• Benefits: Benchmark coverage will be comprehensive but more limited than traditional Medicaid. Benefits will include inpatient and outpatient hospital services, physician services, prescription drugs, mental health services, laboratory and x-ray services, emergency services, and emergency and non-emergency transportation services.

• Network: Services under the waiver will be delivered in a network regionally-developed by CCHHS using community partners.  HFS and CCHHS will work together to make the covered population and provider network clear to enrollees. Care coordinators will educate patients about  in-network requirements and will follow up with patients who seek care outside the network.

• Cost Sharing: Cost sharing associated with the benefits of the program will be no greater than the current cost sharing provisions in the Illinois Medicaid plan.

• Medicaid Provisions: While the Affordable Care Act (ACA) allows states to expand Medicaid before 2014 in this manner, this plan will require a waiver of Medicaid “freedom of choice,” “statewideness,” and “comparability of services” requirements.

Interested persons may review these proposed changes on the HFS Web site. 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 p.m. This notice is being provided in accordance with federal requirements found at 42 CFR 447.205.

In addition, there will be further opportunity to comment by attending the Medicaid Advisory Committee on March 16, 2012, in both Chicago and Springfield, IL.

10 a.m. – Noon

401 S. Clinton
7th Floor, HFS Side
Director's Videoconference Room

Bloom Building
201 S. Grand Avenue, East
Division of Medical Programs
Videoconference Room

Any interested party may mail or e-mail comments, data, views, or arguments concerning these proposed changes from March 7, 2012, until April 6, 2012. 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:  E-mail the HFS Webmaster

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Waiver Application Proposal (pdf)