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Wondering Why Your Medicaid Payments are a Bit Short?
Posted on: 4/25/2014

The Affordable Care Act (ACA) directs the Illinois Department of Healthcare and Family Services (DHFS) to "bump up" the payments for Medicaid Title XIX to match Medicare rates for two years for primary care services. 

You may have recently noticed an offset or recoupment on these Medicaid enhancements. That's because the uptick is limited to only Medicaid Title XIX patients or "regular" Medicaid, as noted in recently clarified guidance from the Centers for Medicare and Medicaid Services. However, between Jan. 1, 2013, and Nov. 17, 2013, DHFS erroneously paid the enhancements to patients under Medicaid Title XXI and some state funded programs, which are not eligible for enhanced payments under the ACA and, therefore, must be recouped according to federal rules.

Read related article by ISMS President Eldon A. Trame, MD. 

For more details, see DHFS' informational notice.

Questions? Contact your ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email.

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