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West Central Reporter

Saturday, November 23, 2024

State's Medicaid Advisory Committee to review parity rules

The Illinois HFS Medicaid Advisory Committee will meet at 10 a.m. Friday to receive an overview of mental health/substance use disorder parity rules.

Here's the meeting's agenda, as provided by the state:

Bruce Rauner, Governor

Felicia F. Norwood, Director

E-mail: hfs.webmaster@illinois.gov Internet: http://www.hfs.illinois.gov/

201 South Grand Avenue East Telephone: (217) 782-1200

Springfield, Illinois 62763-0002 TTY: (800) 526-5812

Medicaid Advisory Committee

James R. Thompson Center

100 W. Randolph

2nd Floor, 2025

Chicago, Illinois

And

201 South Grand Avenue East

3rd Floor Video Conference Room

Springfield, Illinois

August 5, 2016

10 a.m. - 12 p.m.

Agenda

I. Call to Order

II. Introductions

III. New Business

a. Behavioral Health Transformation Update

b. Legislative Update

c. Budget Update

d. Overview of Mental Health/Substance Use Disorder Parity Rules

e. Bylaws: Proposed Changes

IV. Old Business

a. Provider Enrollment Update

b. Managed Care Transformation - MLTSS Update

V. Subcommittee Reports

a. Public Education Subcommittee Report

b. Quality Care Subcommittee Report

VI. Approval of May 2016 Meeting Minutes

VII. Other Business

VIII. Adjournment

Illinois Department of Healthcare and Family Services

Medicaid Advisory Committee May 13, 2016

MAC Members Present

Kelly Carter, Illinois Primary Health Care Association

Kathy Chan, Cook County Health and Hospitals System

Arnold Kanter, Barton Management

Bill Dart, Illinois Department of Public Health, ex-officio

Janine Hill, EverThrive Illinois

Thomas Huggett, Lawndale Christian Health Center

Howard Peters, HAP Inc. Consulting

Neli Vazquez-Rowland, A Safe Haven

David Vinkler, Molina

Jan Grimes, Illinois Homecare and Hospice Council

MAC Members Absent

Tyler McHaley

Karen Brach, Meridian

Karen Moredock, Illinois Department of Children and Family Services, ex-officio

Verletta Saxon, Centerstone

HFS Staff Present

Arvind K. Goyal

Teresa Hursey

Shawn McGady

Elizabeth Diaz Castillo

Felicia F. Norwood, Director

John Spears

Catina Latham

Sylvia Lewis Ripperton

Paula O’Brien

Michelle Maher

Embarina Mendiola

Ray Marchiori

Interested Parties

Barbara Bayldon, ICAAP

Eric Boklage, Medical Home Network

Judy Bowlby, Liberty

Nick Boyer, Otsuka

Molly Braun, Fresenius Medical Care

Jessica Bullock , Presence Health Partners

Anna Carvalho, LaRabida

Sheri Cohen, Chicago Dept of Public Health

Laurie Cohen, Civic Federation

Alison Coogan, LAF

Pam Cuffle, ISDS

Scott Crawford , Home Products Healthcare

Ron Damasallskas, Harmony Wellcare

Anna Deatherage, HDIS

Sandy DeLeon, Ounce of Prevention

John Eckert, IDOA

Paul Frank, Harmony Wellcare

Daniel Frey , AIDS Foundation of Chicago

Chris Gillette , Pfizer

Jan Grimes , IHHC

Adrienne Hiegel, HAD

Christie Hines, Shield Healthcare

Mike Holmes, Sunovion Pharma

George Hovanec, Consultant

Nadeen Israel, EverThrive IL

Mary Kaneaster, Lilly

Nicole Kazee, Univ of IL Health

Brian Keane, Aetna

Terry King , UIC-DSCC

Lisa Labiak, CBHA

Phillipe Lavgent , LGS

Carol Leonard, DentaQuest

Illinois Department of Healthcare and Family Services

Medicaid Advisory Committee May 13, 2016

Donna Lindermulder, DCFS

Ricki Loav, Be Well Partners In Health

Marcia Lucket , Genetech

Laura Lutkowski, Land Of Lincoln

Chris Manion, ISDS

Bryce Marable , Lawndale Christian Health Center

Deb McCarrel, ICOY

Joe Mclaurin, Planned Parenthood of IL

Steven McRae, Sequendm Laboratories

Susan Melczer, IHA

Diane L. Montanez, North Shore University

Heather O'Donnell, Thresholds

Hetal Patel , Illinois Health Connect

Prit Patel , Greater Elgin Family Care Center

Kelly Pullman, Liberty Dental

Roy Pura , CSL Behring

Dan Rabbitt, Heartland Alliance

Patricia Reedy, IDHS/DMIT

Ken Ryan , ISMS

Ralph Schubert, Il Public Health Association

Lynn Seermon, Kaizen Health

Alvia Siddiqi, Advocate

Sharon Sidell , Be Well Partners In Health

Dave Sproat, Bristol Myers Squibb

Felicia Spivack, BCBSIL

Sally Szumlas, FHN

Luis Tinoco, Shrier Center

Gary Thurnauer, Pfizer

Dan Tullman, Lumara

Katie Tuten, Catholic Charities

Andrew Weaver , Land Of Lincoln

Sarah White, Abbott

Stephanie Whytes, Aetna Better Health

Joy Wykowski, JCW LTD.

Meeting Minutes

I. Call to Order: The regular quarterly meeting of the Medicaid Advisory Committee was called

to order May 13, 2016 at 10:05 a.m. by chair Kathy Chan. A quorum was established.

II. Introductions: MAC members and HFS staff were introduced in Chicago and Springfield.

III. New Business

a. Legislative update: Shawn McGady, Office of Legislative Affairs

• HB5736 – extends All Kids to October 1, 2019, which is also the date that the federal

maintenance of effort expires; passed House, on 3rd reading in the Senate, Governor

is expected to sign

• SB464 – would tie MCO enrollment to managed care rates in FY14, amendment

failed in Senate Tuesday evening, Director and staff have spoke with Sen. Koehler to

continue to monitor managed care program to ensure that things are running

correctly, will be good stewards of managed care dollars

• Working with interest groups on other legislation

b. Managed Care Transformation update: Michelle Maher

• Holding steady at 2.1M, approximately 64% of clients with comprehensive MA

benefits

• ACE transitions – all done except for Smart Plan Choice

• MLTSS – HFS is on track for July 1, 2016 go live, voluntary enrollments, mailings will

start second week of June

Illinois Department of Healthcare and Family Services

Medicaid Advisory Committee May 13, 2016

• HFS has begun additional provider meetings on provider claims issues – hospitals,

nursing homes, community mental health, IADDA with SU providers; HFS firmly

committed at managed care hearing that they want to work with plans and

providers to ensure smooth transition from FFS to managed care.

c. Provider Enrollment update: Teresa Hursey, Administrator, Division of Medical

• Moving well, verified about 30,000, brought in another 17,000 new providers

• Encourage remaining 150,000 that have not verified to complete process

• Prompted by federal mandate

• If providers do not complete by end of September, will be disenrolled from

Medicaid and unable to bill until the process is complete

• Will not be a one-time process; revalidation has required much more information

than what was in the legacy system

d. Overview of Mental Health /Substance Abuse Disorder Parity Rules: Kelly Cunningham

was not present and will revisit this topic next MAC meeting.

IV. Old Business:

a. MCO Redetermination Process: Michelle Maher / John Spears

• IPHCA did a survey of the FQHCs about whether the FQHCs were receiving

regular rede info from MCOs

• CountyCare has been doing a good job and sending excel spreadsheets on a

regular basis to PCPs

• Not being shared consistently by other health plans – Maximus report shows

that 80% of the cases cancelled are due to lack of response; after 3 months,

about 25-30% of cancelled cases come back to Medicaid

• Some plans are saying that HIPAA is the reason that they can’t share

information

• Can HFS systematize/standardize the rede info to providers?

V. Subcommittee Reports

a. Public Education Subcommittee Report: Kathy Chan reported on the April 14th meeting

of the Public Education subcommittee which included a presentation on, IES Phase II, as

well as redeterminations.

b. Quality Care Subcommittee Report: Kelly Carter reported on the May 6th meeting of

the Quality Care Subcommittee which included a Presentation from Coordinated Health

Interventions for Childhood Asthma Gaps in Outcomes Collaboration II, Diabetes

Initiative by Dr. Goyal, updates on Managed Care Transformation and Diversity LTSS.

Illinois Department of Healthcare and Family Services

Medicaid Advisory Committee May 13, 2016

(Covered under IV a.)

VI. Approval of January 2016 Meeting Minutes: Howard Peters made a motion to approve the

January minutes; the motion was seconded by Arnold Canter motion carried unanimously.

VII. Other Business: Director Norwood’s Report: At budget announcement, five initiatives

mentioned among the health and human services agencies

• Population health and prevention – IDPH

• Education and self-sufficiency – Education (Beth Purvis)

• Moving from institutions to community – IDHS

• Paying for value, quality, and outcomes – HFS

• Data analytics across HHS continuum – Dept of Health Information Technology (Hardick

Bhatt)

Getting ready to have stakeholder involvement, will also include DOC, DVA, ISBE, DCFS –

common denominator and interest of administration is BH and driving a comprehensive

strategy that impacts everyone from children to to adults; HFS would like to use MAC as part

of the stakeholder process – more to come soon

VIII. Adjournment: Howard Peters made a motion to adjourn the meeting, which was seconded

by Janine Hill and passed without objection by the committee. The meeting was adjourned

at 12:00 p.m.

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