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Provider Notice Issued 12/16/2020
Date: December 16, 2020
To: All Medical Assistance Program Providers
Re: Illinois Medicare-Medicaid Alignment Initiative Statewide Expansion New Effective Date:
July 1, 2021
Effective July 1, 2021, the Medicare-Medicaid Alignment Initiative (MMAI) program will be expanding statewide. The implementation date of the MMAI statewide expansion was moved to July 1, 2021 due to the impact of the COVID-19 public health emergency.
Working toward a July 1, 2021 implementation date, the MMAI plans have resumed contracting efforts with providers. The Department will be conducting network adequacy reviews with the MMAI plans beginning in early 2021. Providers of all specialties and localities are strongly encouraged to join the multiple MMAI plan networks as soon as possible in order to participate in the statewide MMAI program.
Expanding the MMAI demonstration statewide will provide all full dual eligible beneficiaries in every Illinois county with the opportunity to receive their Medicare Parts A and B benefits, Medicare Part D benefits, and Medicaid benefits from a single Medicare-Medicaid Plan, also known as MMAI plan.
MMAI Program
The MMAI program brings together Medicare, Medicaid and prescription drug benefits into one health plan. Most MMAI health plans also offer extra benefits such as more dental care and lower prescription co-pays. All MMAI health plans have care coordination to manage all the healthcare and long-term services and supports of enrollees.
Contracting with Participating MMAI Illinois Plans
Providers are encouraged to join the MMAI plan networks as soon as possible in order to participate in the statewide MMAI program. Contracting is also important for timely payment and continuity of care. As a network provider, you will be able to provide care to new and existing Medicare-Medicaid dually eligible patients while benefitting from simpler reimbursement systems and a team-based approach to care.
Why should I participate in MMAI as a contracted provider?
MMAI aligns with Illinois’ overall efforts to provide higher quality and more coordinated care, including:
• Better care through a clinically integrated, person-centered care model;
• Better value by supporting reimbursement models that focus on quality, not quantity, through financial incentives; and
• Better health for the individual through flexible benefits aimed at providing the right care, at the right time, in the right place.
Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at
217-524-7478 or HFS.MMAI@Illinois.gov.
Kelly Cunningham, Administrator
Division of Medical Programs