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June 2014
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  • Making Sense of Medicaid Mandatory Managed Care

    MedicaidMMCcoverIllinois law requires the state to enroll at least 50 percent of its Medicaid clients in some form of coordinated care by January 2015. The Illinois Department of Healthcare and Family Services (DHFS) has designated five geographic regions of Illinois as mandatory managed care regions. Medicaid clients in those areas are either required to enroll in one of the managed care entities or they will be assigned to a managed care plan.

    Physicians who see Medicaid patients in the mandatory regions may not be able to treat or bill for services rendered to those patients unless they participate in the plan selected by the patient, or are the physician to whom the patient is assigned.

    How will this impact you? What can you tell your patients? What are the managed care entities being offered?  Consult this ISMS Issue Brief which outlines the process and provides information to share with your patients.

    Additionally, DHFS has posted a webinar regarding the Medicaid Mandatory Managed Care initiative and the tentative roll-out schedule. The webinar and related documents including maps and plan information are available at DHFS's care coordination website.

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