PROPOSED CHANGES IN METHODS AND STANDARDS FOR ESTABLISHING MEDICAL ASSISTANCE PAYMENT RATES STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES CLARIFICATION
This notice provides additional information and clarification to the original public notice issued on June 30, 2016. The Illinois Department of Healthcare and Family Services (HFS) is proposing a change in the methods and standards by which the Department will reimburse providers. The proposed change is effective for dates of service on or after July 1, 2016 through June 30, 2017 and is addressed below.
As an ongoing effort to provide access to care and quality services, the Department is proposing to increase reimbursement rates for specific psychiatric and behavioral health services rendered by a physician, advanced practice nurse or a licensed community mental health center. These services include but are not limited to mental health assessment, psychological evaluations, medication management, psychotherapy, and counseling.
The reimbursement changes will apply to mental health rehabilitative services provided in or by community mental health centers as well as the physician benefit categories. These proposed changes will increase expenditures by approximately $27.5 million based on current utilization patterns. $25,650,000 applies to the mental health rehabilitative services benefit category and $1,350,000 applies to the physician benefit category.
The proposed change is subject to approval by the federal Centers for Medicare and Medicaid Services and may be modified or revised during the approval process.
The original notice and this clarification may be viewed at the DHS local offices (except in Cook County). In Cook County, the notice and clarification may be reviewed at the Office of the Director, Illinois Department of Healthcare and Family Services, 401 South Clinton Street, 1st Floor, Chicago, Illinois. Comments received regarding this notice shall be published on the HFS web site at http://www.illinois.gov/hfs/info/legal/PublicNotices/Pages/.
This notice is being provided in accordance with federal requirements found at 42 CFR 447.205.
