Enrollment Timeline and Deadlines for the Illinois Medical Assistance Program - Illinois Medicaid Program Advanced Cloud Technology (IMPACT)

05/08/15

Informational Notice

To: Participating Medical Assistance Providers
Re: Enrollment Timeline and Deadlines for the Illinois Medical Assistance Program - Illinois Medicaid Program Advanced Cloud Technology (IMPACT)
This notice provides information on the timeframes and requirements for launching the new computer-based enrollment system, called Illinois Medicaid Program Advanced Cloud Technology (IMPACT). Illinois will temporarily suspend processing applications from providers seeking to participate in the Medical Assistance Program, as well as update requests from currently enrolled providers.
Beginning on August 3, 2015, Illinois will begin enrolling and revalidating Medicaid-funded providers through the new IMPACT web portal. While billing/claiming processes will remain unchanged in 2015 and 2016, failure to enroll or revalidate on time may lead to payment delays.
This notice also includes several important dates related to IMPACT implementation for providers and administrative staff.  See the IMPACT Provider Enrollment Timeline (http://www.illinois.gov/hfs/impact/Documents/IMPACTProviderEnrollmentTimeline.pdf) for more information. The dates below apply only to the types of providers that currently enroll in the provider enrollment system. Waiver program providers that enroll in systems other than with the current Medicaid system will not be affected by the activities listed below.

• Cut Off for Provider Applications & Paper Updates (May 29, 2015) – Illinois will suspend processing provider applications and paper-based updates for the Medical Assistance Program on May 29, 2015 until the IMPACT system comes online August  3, 2015. Applications for providers seeking to participate in the Medical Assistance Program may be submitted through IMPACT once the system comes online.

Cut Off for Electronic Updates (June 24, 2015) - Illinois will suspend electronic updates for the Medical Assistance Program on June 24, 2015 until the IMPACT system comes online. If necessary, providers are encouraged to update their information through the current process before June 24, 2015.  All currently-enrolled providers will be required to revalidate or update their information within 6 months of the IMPACT system coming online.

• Revalidation Period for Currently-Enrolled Providers (August through December, 2015) - The types of providers that are currently enrolled in the provider enrollment system will need to revalidate their information before the end of 2015. This applies to entities and individuals seeking to become Illinois Medical Assistance providers, including those working under Waiver Programs administered by agencies other than the Department of Healthcare and Family Services.  Additionally, revalidation must occur in a particular sequence so that associations may occur between entities and individual providers.  Facilities, Agencies and Organizations (FAOs) must revalidate first, before any individuals (Sole Proprietors or Rendering/Servicing) can associate with these entities.

More information is available at the IMPACT website (http://www.illinois.gov/hfs/impact/Pages/default.aspx).  Additional details will be posted as new information becomes available. Please check the IMPACT website periodically for updates, and contact the IMPACT Help Desk (IMPACT.Help@Illinois.gov) with questions.

Enrollment Timeline and Deadlines for the Illinois Medical Assistance Program

05/08/15

Informational Notice

To: Participating Medical Assistance Providers
Re: Enrollment Timeline and Deadlines for the Illinois Medical Assistance Program - Illinois Medicaid Program Advanced Cloud Technology (IMPACT)
This notice provides information on the timeframes and requirements for launching the new computer-based enrollment system, called Illinois Medicaid Program Advanced Cloud Technology (IMPACT). Illinois will temporarily suspend processing applications from providers seeking to participate in the Medical Assistance Program, as well as update requests from currently enrolled providers.
Beginning on August 3, 2015, Illinois will begin enrolling and revalidating Medicaid-funded providers through the new IMPACT web portal. While billing/claiming processes will remain unchanged in 2015 and 2016, failure to enroll or revalidate on time may lead to payment delays.
This notice also includes several important dates related to IMPACT implementation for providers and administrative staff.  See the IMPACT Provider Enrollment Timeline (http://www.illinois.gov/hfs/impact/Documents/IMPACTProviderEnrollmentTimeline.pdf) for more information. The dates below apply only to the types of providers that currently enroll in the provider enrollment system. Waiver program providers that enroll in systems other than with the current Medicaid system will not be affected by the activities listed below.

• Cut Off for Provider Applications & Paper Updates (May 29, 2015) – Illinois will suspend processing provider applications and paper-based updates for the Medical Assistance Program on May 29, 2015 until the IMPACT system comes online August  3, 2015. Applications for providers seeking to participate in the Medical Assistance Program may be submitted through IMPACT once the system comes online.

Cut Off for Electronic Updates (June 24, 2015) - Illinois will suspend electronic updates for the Medical Assistance Program on June 24, 2015 until the IMPACT system comes online. If necessary, providers are encouraged to update their information through the current process before June 24, 2015.  All currently-enrolled providers will be required to revalidate or update their information within 6 months of the IMPACT system coming online.

• Revalidation Period for Currently-Enrolled Providers (August through December, 2015) - The types of providers that are currently enrolled in the provider enrollment system will need to revalidate their information before the end of 2015. This applies to entities and individuals seeking to become Illinois Medical Assistance providers, including those working under Waiver Programs administered by agencies other than the Department of Healthcare and Family Services.  Additionally, revalidation must occur in a particular sequence so that associations may occur between entities and individual providers.  Facilities, Agencies and Organizations (FAOs) must revalidate first, before any individuals (Sole Proprietors or Rendering/Servicing) can associate with these entities.

More information is available at the IMPACT website (http://www.illinois.gov/hfs/impact/Pages/default.aspx).  Additional details will be posted as new information becomes available. Please check the IMPACT website periodically for updates, and contact the IMPACT Help Desk (IMPACT.Help@Illinois.gov) with questions.

Reimbursement Rate Reductions Effective May 1, 2015 through June 30, 2015 (From HFS)

05/01/15

Informational Notice

To: Enrolled Physicians and Advanced Practice Nurses  

Re: Reimbursement Rate Reductions Effective May 1, 2015 through June 30, 2015

As a result of Public Act 099-0002 (pdf), the department is required to reduce reimbursement rates paid to providers for certain services delivered on or after May 1, 2015 through June 30, 2015 by 16.75 percent. 

This rate reduction includes all services provided by a physician, mid-level or ancillary staff services billed under the physician’s NPI and services rendered by an advanced practice nurse, except the following codes:

99213    Office or Other Outpatient Visit, Established Patient, Expanded Focus
99214    Office or Other Outpatient Visit, Established Outpatient. Detailed to Moderate Complex
99381    Initial Evaluation Healthy Infant less than one Year; Preventative
99382    Initial Evaluation Healthy Child, one Year through four Years; Preventative
99383    Initial Evaluation Healthy Child, five Years through eleven Years; Preventative
99384    Initial Evaluation Healthy Adolescent 12 through 17 Years; Preventative
99385    Initial Evaluation Healthy. 18-39 Years; Preventative
99391    Periodic Re-Evaluation Establish Infant, Preventative less than one Year
99392    Periodic Re-Evaluation Healthy Child one through four Years; Preventative
99393    Periodic Re-Evaluation Healthy Child 5 through 11 Years; Preventative
99394    Periodic Re-Evaluation Healthy Adolescent 12 through 17 Years; Preventative
99395    Periodic Comprehensive Preventive.  Evaluation Management; 18-39 Years

In addition, dispensing fees for practitioner dispensed 340B and family planning drugs will be reduced by $1.00. 

There are no changes in the procedures for billing the department. Providers should continue to bill their usual and customary charge for each procedure code. A revised fee schedule reflecting the rate reductions is posted to the HFS website. 

These reductions apply to fee-for-service reimbursement.  If services are being provided under a Managed Care Organization (MCO) or Managed Care Community Network
(MCCN) contract, please refer to those contractual terms.

Any questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 1-877-782-5565.

Felicia F. Norwood
Director