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Elizabeth M. Whitehorn, Director

MMAI Implementation Status

The Medicare-Medicaid Alignment Initiative (MMAI) is a groundbreaking demonstration of the Illinois Department of Healthcare and Family Services (HFS) and the federal Centers for Medicare and Medicaid Services (CMS) to reform the way healthcare is delivered to clients eligible for both Medicare and Medicaid services (called “dual eligibles”). The MMAI demonstration project will be available to provide coordinated care to more than 135,000 Medicare-Medicaid enrollees in the Greater Chicago area and throughout central Illinois.

HFS and CMS are jointly reviewing readiness for implementation of the MMAI, which had been scheduled to begin opt-in enrollment in February 2014. To ensure a smooth implementation and coverage for clients, HFS and CMS have decided to delay implementation for one month. Opt-in enrollments will now be effective March 1, 2014, and the earliest passive enrollments will be effective June 1, 2014. This will ensure all data systems are ready to accept and process enrollments and provide for a seamless transition for enrollees.

In addition, HFS and CMS have determined that certain health plans will not be ready to provide services in certain counties on March 1, 2014. The chart below reflects the status by health plan and county for initial implementation. HFS and CMS will re-review health plan networks for future inclusion in May 2014.

MMAI County Plan Participation March 1, 2014

Greater Chicago

MCO Cook DuPage Kane Kankakee Lake Will
Aetna P P P TBD Dropped P
BCBS P P P P P P
IlliniCare P P P P P P
Humana P P P P P P
HealthSpring P P P Dropped P P
Meridan P TBD P Dropped TBD P

Central Illinois

MCO Knox Peoria Tazewell McLean Logan DeWitt Sangamon Macon Christian Piatt Champaign Vermillion Ford Menard Stark
Health Alliance P P P P P P P P P P P P P P P
Molina P P P TBD P P TBD TBD P P P P P P P

Key

P Passed county (some counties may require more targeted monitoring for a limited number of provider types)
TBD Will have opportunity to submit network again on May 1st for possible inclusion in the program
Dropped Plan has formally withdrawn from participation in the county