Skip to main content
  • Notice of Privacy Incident
  • Medicaid Provider Termination Alert: Revalidation deadlines are approaching. Failure by providers to revalidate will lead to termination and payment suspension. Check your account now at https://impact.illinois.gov/ to learn if your required revalidation is due this month. More revalidation information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 11/29/2023

 

Date: November 29, 2023
​To: Federally Qualified Health Centers (FQHCs); Community Mental Health Centers (CMHCs); Behavioral Health Clinics (BHCs); and Substance Use, Prevention and Recovery (SUPR) Providers
​Re: HealthChoice Illinois Admissions, Discharges and Transfers (ADT) Technology Platform Participation as Required by Federal CMS

This notice provides guidance to FQHCs, CMHCs, BHCs and SUPR providers regarding their participation in the Illinois Medicaid Program HealthChoice Illinois ADT. This is the Department’s statewide technology platform implemented in 2021 to facilitate transmission of HL7 messages from hospitals, skilled nursing facilities and other institutions to notify providers of patient admissions, discharges, and transfers and to improve care coordination and quality.

The functionality of this technology platform supports the Illinois’ 2021-24 Comprehensive Medical Programs Quality Strategy and aligns with the Federal CMS Interoperability and Patient Access Final Rule requirements that hospitals send electronic notifications of admissions, discharges and transfers to a patient’s care team.

Illinois FQHCs, CMHCs, BHCs, and SUPR providers enrolled in the IMPACT system and engaged in direct patient care or providing services to Medicaid customers must subscribe to HealthChoice Illinois ADT to receive notifications for their customers. The agency is working toward full provider participation, increasing care coordination, and improving Managed Care Organization (MCO) P4P (pay for performance) metrics to increase Medicaid customers Healthcare Effectiveness Data and Information (HEDIS) measures as established by the National Committee for Quality Assurance (NCQA).

If a provider does not have the capability to send a patient roster through a manual upload to the PointClickCare (formerly known as Collective Medical Technologies) web-based portal or through an automated SFTP upload, participation in the HealthChoice Illinois ADT platform is not required. If a provider cannot participate, please notify HFS by emailing HFS.HealthChoiceIllinoisADT@Illinois.gov with the reason by December 31, 2023. 

Several providers have chosen to obtain the ADT information through technology partnerships. Obtaining ADT information in this way is helpful; however, more detailed information can be accessed with a direct connection to the ADT platform, including: 

  • Standard notifications: 5+ Emergency Department (ED) visits in 12 months, 3+ ED visits in 3 months, inpatient admissions, inpatient discharges, ED/observation services (OBS) encounter, ED/OBS discharge.
  • Enhanced criteria for behavioral health (BH): BH related ED visits; enhanced BH criteria ED suicidal ideation/attempt or self-harm, opioid overdose Dx, mental health Dx, substance use Dx, opioid use disorder Dx, alcohol use disorder Dx.
  • CCDs (continuity of care document).
  • Viewing and authoring care insights, the ability to surface patient specific need-to-know information, empowers healthcare providers with a comprehensive understanding of their patients’ conditions and treatment plans, facilitating more informed decision-making and ultimately improving the quality of care delivered.
  • Historical patient encounter data.
  • Customer contact information.
  • Seamless communication with hospitals, specialists, and community organizations.
  • Enhanced care transitions and reduced gaps in information exchange.
  • Efficient sharing of patient data, leading to better decision-making and patient outcomes.
  • Receiving real-time notifications of customer activity outside of your Electronic Health Record (EHR) clinic.

All steps required for compliance can be found at the “Steps to Subscribe” webpage. A recommended timeline for establishing connection to HealthChoice Illinois ADT is outlined below:

·Complete the initial onboarding survey by December 31, 2023.

·All documentation for participation must be completed by February 28, 2024.

·Providers connecting through the portal or through a partnered technology choice should implement by June 31, 2024.

·Providers choosing to have the ADT data feed go directly into their EHR should have this completed by December 31, 2024.

Current participation of FQHCs, CMH providers, BHCs and SUPR providers can be found on the Participants webpage and will be updated periodically to show progress.

More information and resources related to HealthChoice Illinois ADT can be found here.  Questions regarding this notice and any requests for assistance with EHR integration should be sent to HFS.HealthChoiceIllinoisADT@Illinois.gov.

 

 

Kelly Cunningham, Administrator
Division of Medical Programs