Provider Notice issued 03/18/15

Facility Notification of Redeterminations of Eligibility

This Notice informs providers of an interim process that will notify certain long term care (LTC) facilities when their residents are scheduled for their annual “Redetermination” of Medicaid eligibility. The Department of Healthcare and Family Services (HFS) will continue to work to develop a permanent process to provide facilities with Redetermination notifications. Until a permanent process is implemented, providers who want to be notified about forthcoming redeterminations and participate in this process need to follow the instructions described below.

The facility must provide the facility name, the name of a facility designated contact person, facility telephone number and the facility email address of the designated representative who will be responsible to receive a list of facility residents with scheduled Redeterminations in the upcoming month. To ensure the residents’ privacy, the email address provided must be a facility specific email for the designated representative and not a general or personal email address. This information must be emailed to HFS Bureau of Long Term Care (BLTC) at: HFS.LTC@illinois.gov with “Redetermination List Contact” in the Subject line. To ensure HIPAA compliance and the continued receipt of this list, providers must immediately notify HFS BLTC regarding changes in the designated representative or other changes in facility contact information.

The resident list will be sent by secure email and any attachments will be password protected. The password will be sent separate from the list or provided by telephone.

The list of residents will be based on the latest Department of Human Services information and may not reflect those residents whose admissions have not yet been processed by DHS or have recently moved to the facility.

The March 26, 2014 Provider Notice provides details on the Illinois Medicaid Redetermination Project (IMRP), including the redetermination process and contact information for IMRP. Providers calling the IMRP unit should identify themselves as a provider in order to receive assistance from staff that are specialized to assist long term care providers.

In addition, the Managed Care organization the resident is enrolled with, may be contacting the facility, resident, or their authorized representative to coordinate efforts to complete the redetermination process.

James M. Parker, Acting Administrator

Division of Medical Programs