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Policy Update
Provider Revalidation
The Federal Centers for Medicare & Medicaid Services requires all actively enrolled providers to revalidate or renew their Medicaid provider agreement at least every five years (42 CFR 455.414). There has been much discussion recently about the revalidation requirement for Medicaid Providers. We hope the information below will encourage you to revalidate in a timely manner.
Providers were first informed of the upcoming revalidation process via a provider notice dated August 5, 2024. The first round of provider notifications will be distributed beginning September 3, 2024, and the remaining notifications will be distributed periodically according to the revalidation cycle dates in IMPACT. Providers will receive two notifications, with the first being distributed 90 calendar days prior to the Revalidation Cycle end date, and the second being distributed 30 calendar days prior to the Revalidation Cycle end date. All providers will be able to see their projected revalidation due date on the basic information page of their enrollment beginning August 21, 2024. Providers cannot submit revalidations prior to their revalidation cycle.
Click here to see a list of all long term care providers and the month in which they must revalidate.
Updated SLP Preadmission Screening Resource Guide
The SLP Preadmission Screening Resource Guide has recently been updated but the overall processes and requirements have NOT changed. The main difference is the removal of the Department of Human Services, Division of Rehabilitation Services (DRS) staff involvement with the completion of the SLP Initial Screen and DONs for individuals under the age of 60. CCUs will be completing these preadmission screenings statewide for individuals under the age of 60 for nursing home & SLP admissions. Click here for the updated Process Resource Guide.
Governor Pritzker issued Executive Order 2024-02 to address the needs of aging Illinoisans.
The Executive Order creates a new position, the Chief Planning Officer, within the Illinois Department on Aging to lead the development and implementation of a multi-year, multi-sector plan for aging. The plan will serve as a decade-long blueprint to support healthy aging in Illinois as well as set clear, measurable objectives for evaluating public and private sector progress. The plan will be delivered to the Governor and General Assembly by December 31st, 2025, with an additional status report by December 31st, 2026. Read more here.
Cost Reports
All Long-term Care facilities enrolled in the Medicaid program must file a Financial and Statistical Report for Long-term Care facilities. This form is commonly called a Cost Report and is filed in the Bureau of Health Finance within 90 days after the end of the facility's fiscal year. To review the Cost Report instructions, click here.
Redetermination Update
In August, DHS is moving away from the Redetermination HFS 2381 Form A (ex parte’ automated, requires no action by the customer) and Form B (requires manual completion and return by the customer). Both forms are being incorporated into a new HFS 2381C Medical Redetermination Notice. The language will be dynamic, meaning based on what the State can verify or not will determine the content. Each individual in the household (HH) will be determined for ex parte’ eligibility. Those that are eligible will still appear as members of the HH, but will not have to complete or return any information related to them. However, if anyone in the HH is not eligible for ex parte’, further instructions (completion of the form, due date, supporting documentation, etc.) will be included in the notice.
Customer and Stakeholder Listening Sessions: Medicaid Managed Care Experience
HFS will be holding feedback sessions to hear from customers and stakeholders to inform our upcoming procurement process for the HealthChoice Illinois (HCI) managed care plan. The RFP design work is anticipated to begin around November 15th, 2024, with an RFP published Summer 2025. The new contract opportunity for HCI will begin January 1, 2027. To learn more, click here or review the schedule here.
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