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Elizabeth M. Whitehorn, Director

Proposed Changes In Methods And Standards

State of Illinois Healthcare and Family Services

Proposed Changes in Methods and Standards for Establishing Medical Assistance Payment Rates for Certain Services

As the single state Medicaid agency, the Illinois Department of Healthcare and Family Services (HFS) provides notification of changes proposed by the Illinois Department of Human Services (DHS), in the methods and standards by which certain services are reimbursed under the Illinois Medicaid program. These changes are being made in order to assure that reimbursement for services rendered by these classes of providers are consistent with the State's fiscal year 2009 budget while maintaining access to necessary medical services. Unless otherwise noted, these changes become effective on October 1, 2008.

Home- and community-based services.  The DHS proposes to change the rates of reimbursement for certain home- and community-based waiver services provided to persons with a developmental disability. On or after October 1, 2008, State reimbursement for the following services (DHS program numbers in parentheses) will be decreased by 2.40 percent: developmental training (DT) (31U, 31A); supported employment programs (SEP) (36G, 36U, 39G, 39U); at‑home day program (37U); individual service & support advocacy (ISSA) (50D); home‑based services (HBS) HBS‑service facilitation (55A), HBS-nursing (55N, 55P); HBS-counseling for unpaid caregivers (55C); behavioral health therapies (57G, 57U, 58G, 58U); community supported living arrangements (CSLA)/community integrated living arrangement (CILA) (65H).

In addition, on or after October 1, 2008, State reimbursement for community integrated living arrangements (CILA) (60D); children’s group homes (CGH) (17D); temporary intensive staffing day and residential (53D, 53R) purchase of service (POS) CILA services (61D); community living facility (CLF) (67D); will be decreased by 1.96 percent. It is estimated that these changes will result in a decrease in annualized State expenditures of $14.6 million.

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

Any interested party may submit comments, data, views, or arguments concerning these proposed changes in reimbursement methods and standards. 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 62763-0001

E-mail address: bpra@illinois.gov

Interested persons may review these proposed changes on the Internet at HFS Public Notices. Local access to the Internet is available through any local public library. In addition, this material may be viewed at the DHS local offices (except in Cook County). In Cook County, the changes may be reviewed at the Office of the Director, Healthcare and Family Services, 100 West Randolph Street, Chicago, Illinois. 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.