May 10 Update: Illinois Health Connect encourages providers to take advantage of the online attestation option, which is now available only as a MEDI application. HFS has indicated that the Provider Participation Unit (PPU) is not currently processing the HFS 2352 forms and is simply collecting them at this time. Providers who wish to mail the forms to PPU are encouraged to send them via certified mail.
Update: HFS announced on March 27 that it has developed an online option for provider attestation for the increased rates for primary care services. This feature allows providers to submit their attestation electronically.
Primary care physicians need to complete an attestation form to qualify for the increased rates for primary care services that the Illinois Department of Healthcare and Family Services (HFS) will pay as a result of the Affordable Care Act.
The rate increase will cover dates of service between January 1, 2013 and December 31, 2014. However, in order for the fee increase to be retroactive to January 1, physicians must complete form HFS 2352 before June 30, 2013. Attestations completed after June 30 will be effective the date HFS receives the attestation form.
Providers eligible to receive the enhanced rates are primary care physicians with a specialty designation of family medicine, general internal medicine or pediatric medicine. A qualifying physician must either be board certified, or be a physician who has furnished primary care services that equal at least 60 percent of the Medicaid codes paid during the most recent calendar year.
HFS has until March 31 to submit its State Plan Amendment to the Centers for Medicare and Medicaid Services (CMS). Once the HFS plan is approved, HFS will complete the necessary programming to begin payments.
The enhanced rates will be paid as an add-on through an adjustment process, and the adjustment add-on will be sent separately from the payment for service. HFS will post a separate fee schedule for the two-year fee increase on the Medicaid Reimbursements page of the HFS website when the schedule is available.
Eligible primary care services are evaluation and management codes (99201-99499) and vaccine administration codes (90460-90461, 90471-90474). As HFS does not pay vaccine administration using those codes, HFS needs approval from CMS to develop a crosswalk to the vaccine administration codes HFS currently reimburses.
Questions about the attestation process or form HFS 2352 should be directed to the HFS Provider Participation Unit via email at hfs.ppu@illinois.gov or phone at 217-782-0538.
