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Elizabeth M. Whitehorn, Director

Provider Notice Issued 09/14/2018

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Date:   September 14, 2018              

 

To:      All Medical Assistance Program Providers

 

Re:      HealthChoice Illinois – Special Needs Children & Medically Fragile Technology Dependent Waiver Populations - Implementation Update

 

 

This notice informs providers of a schedule update in the Department of Healthcare and Family Services (HFS) HealthChoice Illinois managed care expansion for the Special Needs Children populations. Enrollment of Special Needs Children is postponed from the previously published enrollment date of October 1, 2018. Providers will be notified when the revised future enrollment date is determined.  

Special Needs Children include children under the age of twenty-one (21) who: 

·       are eligible for Supplemental Security Income (SSI) under Title XVI;

·       receive Title V care coordination services through the Division of Specialized Care for Children (DSCC);

·       qualify as disabled;

·       are under the legal custody or guardianship of the Illinois Department of Children and Family Services (DCFS); or

·       formerly were under the legal care of DCFS and are receiving assistance through Title IV-E.

Additionally, Public Act 100-0990 prohibits HFS from requiring that “children made eligible for medical assistance through a home and community-based services waiver program for medically fragile and technology dependent children under the Social Security Act” enroll in or transition to the State’s managed care medical assistance program. The legislation also excludes children authorized by the Department to receive in-home shift nursing services from mandatory enrollment in managed care.

This HealthChoice Illinois enrollment expansion schedule change does not impact access to healthcare services or benefits in any way for Special Needs Children. Providers should continue to bill the appropriate State Agency for services rendered on a fee-for-service basis.

Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at 217-524-7478.

 

Teresa T. Hursey

Medicaid Director