Friday, May 24, 2013

Women should get pap test on a regular basis

Regular screening for cervical cancer is important. That is why women should get a pap test.

The pap test can detect abnormal cells. A pap test allows for early detection and treatment. Talk to your Primary Care Provider (PCP) at your medical home about getting a pap test. It is a covered service for HFS clients.

Illinois Health Connect can help you find an OBGYN if you don't have one. Talk to your doctor about how often you should get a pap smear and have a general check-up.

The Human Papillomavirus (HPV) is the leading cause of cervical cancer. HPV is the most common sexually transmitted disease.

It is important to get the HPV vaccine. This vaccine is recommended for all females and males ages 9-26. Ask your PCP about getting the HPV vaccine. It is a covered service for HFS clients.

There is another option if you do not qualify for the HFS medical card. The Illinois Breast and Cervical Cancer Program offers free screening and treatment.

Thursday, May 23, 2013

Free online training with CME availabe from EDOPC Project

The Enhancing Developmentally Oriented Primary Care (EDOPC) Project offers free online training with CME credits.

There are five online courses that offer CME credits. These courses are specifically geared toward providers in Illinois in terms of billing and reimbursement.

EDOPC online courses offering CME are: Coordinating Care Between Early Intervention and Primary Care Medical Home, Developmental Screening and Referral, Domestic Violence Effects on Children, Identifying Perinatal Depression in the Well Child Visit, and, Social, Emotional and Autism Concerns.  

Tuesday, May 21, 2013

Missing a check or an EOB? Call these numbers!

The State of Illinois Comptroller issues payments for claims sent to the Illinois Department of Healthcare and Family Services (HFS). While the checks come from the comptroller, HFS mails the explanation of benefits (EOB) remittance forms to providers.

This can result in a provider's office getting a check, but not the EOB that explains how to account for the payment. Or sometimes the opposite happens, where an office has the EOB, but does not have the check.

To request a duplicate EOB, contact HFS at 217-782-5897. In order to complete the request, it is necessary to give HFS the voucher number listed on the check. Providers can enroll to receive electronic remittance through the HFS MEDI System.

It is possible to inquire on the status of payments online using the comptroller's website. This database lists each payment that was issued or is pending for each tax identification number per fiscal year.

To inquire about a missing check, contact the comptroller at 217-782-6000.

Monday, May 20, 2013

HFS Care Coordination Expansion Notice

On May 15th, HFS released a notice to update you on the Department’s continued roll-out of care coordination initiatives, including both provider-based models (Managed Care Community Networks and Care Coordination Entities) and traditional managed care models (Health Maintenance Organizations).

The Medicaid reform law [PA 96-1501], requires that by January 1, 2015, at least 50 percent of the individuals covered under Medicaid be enrolled in a risk-based care coordination program.  The department of Healthcare and Family Services (HFS) took the first step in implementing this law by starting the Integrated Care Program (ICP) in May 2011. ICP serves approximately 36,000 seniors and persons with disabilities in the counties of DuPage, Kane, Kankakee, Lake, Will and Suburban Cook who are eligible for Medicaid but are not eligible for Medicare.  ICP is expanding in 2013 to the Rockford Region, Central Illinois Region, Quad Cities Region and Metro East Region.

Also in 2013, HFS, in partnering with the Centers for Medicare & Medicaid Services (CMS) will introduce the Medicare-Medicaid Alignment Initiative (MMAI) in Greater Chicago and Central Illinois. HFS and CMS will contract with health plans to coordinate the delivery of services for individuals who have both Medicare and Medicaid.  There are different health plans in each region that will be responsible for managing and paying for the services for both ICP and MMAI clients.

HFS encourages providers serving the target population to contract with the health plans. If you are a provider outside the counties listed in this notice but you provide care to individuals residing in the counties which will soon be served by a Managed Care Organization (MCO), you are still encouraged to join the MCO networks.  Joining their networks ensures your patients can continue to receive the healthcare services you are providing and reassures clients they will not have to change providers.


Being a provider within these networks means:
• You are providing continuity of care for the most at-risk Medicaid clients; and
• MCOs payments may come sooner than HFS payments
The only way to ensure payment for patients enrolled in these programs is to contract with the health plans.

In addition to ICP and MMAI, in 2013 the Department is implementing another initiative under Medicaid reform - the Innovations Project for Seniors and Adults with Disabilities. Under this initiative, the Department has already selected six (6) initial Care Coordination Entities (CCEs) to provide care coordination services to seniors and adults with disabilities who have the most complex health and behavioral health conditions. The CCEs will operate in many of the same counties as ICP and MMAI and will be a health plan option for eligible enrollees. The State requires that these CCEs include participation from hospitals, primary care providers and mental health and substance abuse providers in order to facilitate the delivery of appropriate health care and other services, and to manage needed transitions in care among providers and community agencies for these vulnerable populations.


Currently, the Illinois Health Connect (IHC) Program will continue to operate as a statewide mandatory health plan choice for those individuals that are not required to participate in ICP, MMAI or a CCE. In some counties, individuals that are required to participate in IHC can opt out of IHC and select a Voluntary Managed Care Organization. As the expansion of these new health plans progresses, the counties where Illinois Health Connect operates will change. To learn more about Illinois Health Connect, Integrated Care and the Voluntary Managed Care Organizations, please visit the:

HFS Managed Care webpage. http://www2.illinois.gov/hfs/ManagedCare/Pages/default.aspx

HFS thanks you for your continued service to our most vulnerable population and urges you to participate in the ICP, MMAI and CCE Programs.  For a list of MCOs and CCEs participating in Care Coordination Expansion and the geographic areas they are serving, please refer to the attachment of this notice.  If you have questions, contact the Department’s Bureau of Managed Care at 217-524-7478.

Contact information for each health plan and the geographic areas they are serving for ICP is:

Integrated Care Program Expansion Rockford Region – includes Winnebago, Boone and McHenry Counties
Aetna Better Health
One South Wacker, Suite 1200
Chicago, Illinois 60606
1-866-212-2851
Prompt for Providers – Press 2, then select 5 to speak to a Provider Services Representative
Community Care Alliance of Illinois
*Kili Chivers
322 S. Green St. Suite 400
Chicago IL 60607
Office: 312-491-1956 ext. 644
kchivers@fhnchicago.com  *one of the initial six Innovation project plans
IlliniCare Health Plan
Humberto Torres, VP Network Development and Provider Relations
999 Oakmont Plaza Drive, Suite 400
Westmont, IL 60559
866-329-4701 x 47827
E-mail: htorres@centene.com
General request to join inquiries: ILContracting@centene.com

Integrated Care Program Expansion Central Illinois Region – includes McLean, Logan, DeWitt, Sangamon, Macon, Christian, Piatt, Champaign, Vermilion, Ford, Menard Counties
Health Alliance Medical Plans
Maxine Wallner
Director, Contracting & Provider Services
301 S. Vine Street
Urbana, Illinois 61801-3347
Direct: 217-337-8117
Toll-free: 1-800-851-3379, ext 8117
maxine.wallner@healthalliance.org
Molina Healthcare of Illinois
Nancy Wohlhart
1520 Kensington Dr., Suite 212
Oak Brook, IL 60523
E-mail: Nancy.Wohlhart@molinahealthcare.com
630-203-3905 (Office)
312-343-7940 (Cell)

Integrated Care Program Expansion Central Illinois Region – includes Tazewell, Knox, Peoria and Stark Counties
Health Alliance Medical Plans
Maxine Wallner
Director, Contracting & Provider Services
301 S. Vine Street
Urbana, Illinois 61801-3347
Direct: 217-337-8117
Toll-free: 1-800-851-3379, ext 8117
maxine.wallner@healthalliance.org
Molina Healthcare of Illinois
Nancy Wohlhart
1520 Kensington Dr., Suite 212
Oak Brook, IL 60523
E-mail: Nancy.Wohlhart@molinahealthcare.com
630-203-3905 (Office)
 312-343-7940 (Cell)
Meridian Health Plan
Mari Jo Nissen
222 N. LaSalle Street, Suite 930
Chicago, IL 60601
312-705-2900 ext 2161
Marijo.nissen@mhplan.com

Integrated Care Program Expansion Quad Cities Region – includes Rock Island, Mercer and Henry Counties
HealthSpring of Illinois
Andrew Galbierz
Network Operations Administrator
9701 W. Higgins Rd, Suite 360
Rosemont, IL 60018
(847) 993-1966
Andrew.Galbierz@healthspring.com

IlliniCare Health Plan
Humberto Torres, VP Network Development and Provider Relations
999 Oakmont Plaza Drive, Suite 400
Westmont, IL 60559
866-329-4701 x 47827
E-mail: htorres@centene.com
General Request to Join Inquiries: ILContracting@centene.com
Integrated Care Program Expansion Metro East Region – includes Madison, Clinton and St. Clair Counties
Meridian Health Plan
Mari Jo Nissen
222 N. LaSalle Street, Suite 930
Chicago, IL 60601
312-705-2900 ext 2161
Marijo.nissen@mhplan.com
Molina Healthcare of Illinois
Nancy Wohlhart
1520 Kensington Dr., Suite 212
Oak Brook, IL 60523
Nancy.Wohlhart@molinahealthcare.com
630-203-3905 (Office)
312-343-7940 (Cell)

HFS CONTACT INFORMATION:

E-mail: hfs.webmaster@illinois.gov  Internet: http://www.hfs.illinois.gov/

 

Friday, May 10, 2013

VFC Illinois providers must get signed up with I-CARE

The Illinois Department of Public Health (IDPH) I-CARE administrators and Vaccines For Children (VFC) Illinois staff are urging all VFC providers to sign up with the I-CARE immunization registry immediately.

By June 2013, VFC Illinois will be merged with I-CARE and all VFC ordering will be done online through I-CARE. VFC Chicago providers will merge with I-CARE at a later date.

I-CARE registration forms are available on the IDPH website.

If you have any questions regarding I-CARE, send email to dph.icare@illinois.gov . If you have any questions about the VFC program, call Linda Kasebier at 217-785-1455.

Wednesday, May 8, 2013

ILHITREC is offering to offset cost of HIT Bootcamp course

The University of Illinois-Chicago is offering a Health Information Technology (HIT) course that will provide a foundation for selecting, implementing and using HIT to improve quality, efficiency and care coordination.

The HIT Bootcamp is a nine-week online course, beginning on June 7 and concluding on August 9. Registration opens on May 8. The cost of the course is $1,500. The Illinois Health Information Technology Regional Extension Center (ILHITREC) is offering to underwrite $500 of the cost for this class.

For more information, send email to Phillip McCann at pmccann@niu.edu or call ILHITREC at 815-753-1136.

Monday, May 6, 2013

All adults should get a Tdap shot

Pertussis, diphtheria and tetanus are bacteria-based diseases. They can cause major illness. The Tdap vaccine protects you from them.

All adults should get a Tdap shot. It is a covered service for all HFS clients.

The protection from a Tdap shot fades over time. That's why adults should get one even if they got one as a child. You can get Tdap any time after a recent tetanus shot.

Pertussis and diphtheria spread from person to person. Tetanus enters the body through wounds. Pertussis is also called whooping cough. It is especially important for adults who are around infants to get a Tdap shot. This includes parents, grandparents, other adult caregivers. Pertussis can cause serious illness in infants.

Talk to your Primary Care Provider at your medical home about the Tdap vaccine. Local health departments and pharmacies also offer Tdap. If you need help finding a provider who offers Tdap, call Illinois Health Connect at 1-877-912-1999. This call is free.

Friday, May 3, 2013

Providers can get add-on fee for dispensing birth control through 340B program

The Illinois Department of Healthcare and Family Services (HFS) will begin issuing an add-on payment to providers who dispense highly-effective birth control methods through the 340B federal drug pricing program.

Effective with dates of service on or after July 1, 2012, HFS will issue a $20 dispensing fee add-on. In order to receive the add-on, providers must identify 340B purchased drugs by reporting modifier "UD" in conjunction with the appropriate procedure code and actual acquisition cost for the birth control method. Providers should not add the dispensing fee to their cost. HFS will add the $20 dispensing fee to the provider's final reimbursement.

HFS is finalizing the programming necessary to pay the dispensing fee. Once the programming is completed, HFS will process a separate for any 340B claims properly billed and adjudicated retroactive to July 1, 2012.

Corresponding provider notices for local health departments, nurses and school-based/linked health centers were also posted regarding the 340B dispensing fee for highly-effective birth control.