The Illinois Department of Healthcare and Family Services met Dec. 1 to discuss the Medicaid Redetermination Project.
Here is the meeting's agenda, as provided by the department:
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 Public Education Subcommittee Meeting Thursday, December 1st, 2016 10:00 a.m. to 12:00 p.m. 401 S. Clinton St., Chicago – 1st Floor Video Conference Room 201 S. Grand Ave. East, Bloom Bldg., Springfield – 3rd Floor Video Conference Room Agenda 1. Introductions 2. Approval of the Meeting Minutes from October 13, 2016 3. Ethics Training 4. Proposed Meeting Schedule for 2017 5. Care Coordination Update 6. Medicaid Redetermination Data in HB2731 - Update 7. ABE/IES Update ? IES Phase Two 8. Open Discussion and Announcements 9. Adjourn For anyone who cannot attend in person but wishes to participate by conference call, please confirm your attendance by responding to the HFS Website via e-mail at HFS.webmaster@illinois.gov or by phone at 312 793-5270 or 312 793-2932. This will help us to ensure the distribution of meeting materials and record your presence accurately. You will receive meeting instructions and the access code when you confirm. The conference call telephone number is 1-888-494- 4032. This notice is also available online at: http://www2.illinois.gov/hfs/PublicInvolvement/BoardsandCommisions/MAC/News/Pages/default.aspx DRAFT DRAFT DRAFT Illinois Department of Healthcare and Family Services Public Education Subcommittee Meeting October 13, 2016 401 S. Clinton Street, Chicago, Illinois 201 S. Grand Avenue East, Springfield, Illinois Committee Members Present HFS Staff Kathy Chan, Cook County Health & Hospitals System Jacqui Ellinger Margaret Stapleton, Shriver Center Lauren Polite Sue Vega, Alivio Medical Center John Spears Sherie Arriazola, TASC Amy Harris-Roberts Erin Weir, Age Options Arvind Goyal Nadeen Israel, EverThrive Illinois Mark Huston John Jansa, WKG Advisory Bertha Wallace Brittany Ward, Primo Center for WC Karen Hall Ramon Gardenhire, AFC Margaret Dunne Hardy Ware, East Side Health District (by phone) Veronica Archundia Connie Schiele, HSTP (by phone) Sergio Obregon, CPS (by phone) Committee Members Absent Interested Parties Alison Stevens, IHC Carol Leonard, Denta Quest Alap Sham, IAFP Dan Rabbitt, Heartland Alliance Amy Sagen, UI Health Carrie Chapman, LAF Michael Lafond, Abbott Shannon Ackenhauser, LCNJ Sandy DeLeon, Ounce of Prevention Alicia Donegan, Age Option Lynn Seermon, Kaiser Health Sheri Cohen, Chicago Department of Public Health Dione Creal, CHS Enrique Salgado Jr., WellCare Health Plans Interested Parties (by phone) Jennifer Pinkwater, American Academy of Pediatrics Andrea Davenport, Meridian Health Plan Kelly Carter, IPHCA Susan W, Melczer, Illinois Health and Hospital Association Kim Burke, Lake County Health Department and Community Health Center Paula Campbell, IPHCA Judy Bowlby, Liberty Dental Plan Kristin Hartsaw, DuPage Federation on Humans Services Reform Lynne Warszalek, Stickney Health Department Ariel J. Thomas, Metropolitan Chicago Breast Cancer Task Force Andrew M. Weaver, Land of Lincoln Legal Assistance Foundation Heather Scalia, Humana DRAFT DRAFT DRAFT Illinois Department of Healthcare and Family Services Public Education Subcommittee Meeting October 13, 2016 1. Introductions Chairwoman Kathy Chan, from CCHHS, conducted the meeting. Attendees in Chicago and Springfield introduced themselves. 2. Review of Minutes Margaret Stapleton made a motion to approve the minutes from the June 9th and October 13th meetings, and it was seconded by Sue Vega. The minutes were unanimously approved by the 12 members of the committee. 3. Care Coordination Update Amy Harris-Roberts provided the care coordination report. She indicated that over 60% of 2.2 million clients have enrolled in care coordination within the five mandatory manged care regions: Rockford, Central Illinois, Metro East, Quad Cities, and the greater Chicago area. She said that all ACE and CCE plans have completed the transition into MCOs. Nadeen Israel thanked HFS for securing a smooth transition, especially for counties that only had one option. Ms. Harris-Roberts indicated that Health Alliance would no longer participate in the ICP or FHP manged care programs after December 31, 2016. She noted that information about managed care for Medicaid enrollees is now available on the HFS website, https://www.illinois.gov/hfs/MedicalProviders/cc/Pages/TotalCCEnrollmentforAllPrograms.aspx She also reported that an online complaint portal which medical providers can use to register concerns about MCOs will soon be launched. She announced that, during the Quality Care Subcommittee meeting, scheduled for November 1st, 2016, HFS will discuss the topic of Auto Assignment Algorithm Outline. More information can be found at: https://www.illinois.gov/hfs/SiteCollectionDocuments/QC%20Agenda%20110116.pdf Amy also provided her contact information to follow-up regarding any additional concerns: Amy.Harris-Roberts@Illinois.gov 4. Illinois Medicaid Redetermination Project (IMRP) Enhanced Eligibility Verification (EEV) Update John Spears reported that the statistics regarding the redetermination process continue to be consistent with previous months. He mentioned that the Broadway redetermination office has moved, explaining that this affected production for couple of days. Mr. Spears noted that the IMRP reports continue to be published on the HFS web site: https://www.illinois.gov/hfs/MedicalClients/medrede/Pages/default.aspx Mr. Spears said that, at this time, HFS has not determined a new IES Phase Two Go-Live Date. The Department continues evaluating many factors in order to establish a new date. Consequently, the redetermination process will remain the same. Members of the committee asked to be provided with a more detailed IMRP report. 5. The Illinois Rx Portal Website In response to a request from committee members, Mark Huston provided an overview of the new Illinois Rx Portal Website, and discussed a handout with the committee which is attached. He indicated that this will serve as a web-based collection of tools for prescribers and pharmacies created to support the new Pharmacy Benefits Management System (PBMS) which will be online in 2017. This is part of the new Medicaid Management Information System (MMIS) upgrade and will allow for faster and more efficient processing of fee-for service pharmacy claims. DRAFT DRAFT DRAFT Illinois Department of Healthcare and Family Services Public Education Subcommittee Meeting October 13, 2016 Mr. Huston clarified that the new portal is intended for providers serving the needs of clients who are enrolled in the Medicaid fee-for-service program and that it does not apply to Care Coordination and Managed Care Organizations (MCOs). The Illinois Rx Portal will be used for the following functions: ? Submit prior authorizations (PA) requests and upload any supplemental information needed ? View the status of submitted PAs, including reasons for denial ? Look up participant eligibility, drug history, and PA history ? View the Preferred Drug List (PDL) ? Submit pharmacy claims and receive a real-time approval or denial notification HFS will provide updates through the ILLINOIS Rx Portal website about the new system, including: features, requirements for registration, frequently asked questions as well as, training and webinar opportunities. 6. ABE/IES Update IES Phase Two Jacqui Ellinger indicated that as previous announced, unfortunately, the launching of IES Phase Two did not Go-Live as planned. She said that after finding errors in batch process, the project team evaluated the possible consequences, and made the decision to postpone. She added this was a prudent decision that had to be taken in consideration of the potential consequences upon clients and the project as a whole. Jacqui said there have been several repercussions because the legacy system was off-line for couple of days in order to accommodate the transition to IES. Once the determination was made to postpone, the legacy system had to be restored to operate as it had before. Ms. Ellinger indicated that, in order to comply with new federal standards and regulations, the state of Illinois is implementing enhanced security features for the ABE Partner Portal and (previously known as the Provider Portal). Currently, the ABE Partner Portal is used by AKAAs and MPE providers, as well as Application Assistors at Stroger Hospital, to submit medical and MPE applications to the state through the Partner Portal user account. She added that, due to the sensitive personal information stored in each Partner Portal ABE account, users will need to complete Multi-Factor Authentication (MFA) every time they visit the ABE Partner Portal. Lauren Polite reported that overnight, on October 12th, new enhancements were deployed to increase the security to the ABE Partner Portal. 7. Open Discussion and Announcements The committee made several recommendations to be taken into consideration for future meetings: - Nadeem Israel and Sue Vega asked to add a “narrative to the IMRP report”. - John Jansa asked if the Children’s Enrollment Report can be expanded in order to include other populations, such as ACA Adult group, pregnant women, disabled individuals, AABD. - John Jansa asked with regard to language access, and readability, if HFS can provide a report regarding the requests that the MCOs are receiving in terms of English as a Second Language (ESL), interpreters, and translations of written communication. - John Jansa asked if HFS can provide a report about how successful the MCOs are when they have to reach out to members. Do the MCOs meet the timelines, and what do the numbers show? - Sue Vega asked if there have been any candidate appointment to the MAC. Finally, Chairperson Kathy Chan asked members of the committee to send their agenda topic recommendations to veronica.archundia@illinois.gov DRAFT DRAFT DRAFT Illinois Department of Healthcare and Family Services Public Education Subcommittee Meeting October 13, 2016 8. Adjournment The meeting was adjourned at 12:00 p.m. The next meeting is scheduled for December 1st , 2016, between 10:00 a.m. and 12:00 p.m. Illinois Department of Healthcare and Family Services MAC/Public Education Subcommittee The Public Education Subcommittee meetings are open to the public. All meetings take place in the Illinois Department of Healthcare and Family Services’ videoconference rooms. Participants attend the meetings at either the Chicago or Springfield location, or by teleconference. 2017 Meeting Dates (Subject to Change) Time Location February 9th, 2017 April 13th, 2017 June 15th , 2017 August 10th, 2017 October 12th, 2017 December 7th, 2017 10:00 a.m. – Noon Chicago: 401 South Clinton, 1st Floor HFS Side Director’s Videoconference Room Chicago, Illinois 60607 Springfield: 201 South Grand Avenue, East Division of Medical Programs Videoconference Room Springfield, Illinois 62763 Children's Enrollment HFS December 2016 End of FY Enrolled Children FY2006-2016 #000s 2007 1,364 2008 1,455 2009 1,553 2010 1,630 2011 1,678 2012 1,697 2013 1,647 2014 1,572 2015 1,516 2016 1,491 End of Month 2013 Enrolled Children #000s End of Month 2014 Enrolled Children #000s End of Month 2015 Enrolled Children #000s End of Month 2016 Enrolled Children #000s Jan 1,666 Jan 1,582 Jan 1,540 Jan 1,505 Feb 1,665 Feb 1,582 Feb 1,540 Feb 1,502 Mar 1,667 Mar 1,591 Mar 1,532 Mar 1,501 Apr 1,665 Apr 1,595 Apr 1,527 Apr 1,497 May 1,656 May 1,587 May 1,522 May 1,495 June 1,647 June 1,572 June 1,516 June 1,491 July 1,638 July 1,564 July 1,515 July 1,488 Aug 1,635 Aug 1,567 Aug 1,514 Sept 1,626 Sept 1,561 Sept 1,513 Oct 1,610 Oct 1,554 Oct 1,510 Nov 1,600 Nov 1,547 Nov 1,508 Dec 1,587 Dec 1,541 Dec 1,503 1,364 1,455 1,553 1,630 1,678 1,697 1,6471,5721,5161,491 0 500 1,000 1,500 2,000 2006 2008 2010 2012 2014 2016 2018 Enrolled Children End of FY06-14 #000s Enrolled Children FY2006-2016 #000s Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec 2013 1,666 1,665 1,667 1,665 1,656 1,647 1,638 1,635 1,626 1,610 1,600 1,587 2014 1,582 1,582 1,591 1,595 1,587 1,572 1,564 1,567 1,561 1,554 1,547 1,541 2015 1,540 1,540 1,532 1,527 1,522 1,516 1,515 1,514 1,513 1,510 1,508 1,503 2016 1,505 1,502 1,501 1,497 1,495 1,491 1,488 1,350 1,400 1,450 1,500 1,550 1,600 1,650 1,700 Enrolled Children by Month #000s The ILLINOIS RxPortal is a powerful web-based collection of tools for prescribers and pharmacies created to support the new Pharmacy Benefits Management System (PBMS) which will be online in 2017. This new system will allow for faster and more efficient processing of pharmacy claims billed fee-for-service. The ILLINOIS RxPortal provides a secure, web-based interface for providers to: Coming in 2017… ILLINOIS Rx Portal Visit the ILLINOIS Rx Portal website to learn more about the new system including features, requirements for registration, frequently asked questions and training and webinar options. The Department will be updating this site frequently as the launch of the new PBMS gets closer. https://www.illinois.gov/hfs/MedicalProviders/Pharmacy/illinoisrx/ ? Submit Prior Authorization (PA) requests and upload any supplemental information needed. ? Check the status of PA requests ? Look up participant eligibility ? View participant drug history ? View the Preferred Drug List (PDL) ? Submit pharmacy claims and receive a real-time approval or denial notification. ILLINOIS RX PORTAL FAQ WHO CAN ACCESS THE ILLINOIS RX PORTAL? The ILLINOIS Rx Portal is limited to prescribers, pharmacists, and their staff who are enrolled and approved in the Illinois IMPACT system. For access to the Illinois Rx Portal, please refer to the Registering with the State of Illinois section of the Healthcare and Family Services (HFS) Web site. (http://www.illinois.gov/hfs/impact/Pages/default.aspx) HOW WILL I KNOW IF I AM APPROVED TO ACCESS THE ILLINOIS RX PORTAL? The ILLINOIS Rx Portal uses the Illinois IMPACT system to verify the identities of prescribers and pharmacies accessing participant data. You must be enrolled and approved in the IMPACT system to access the ILLINOIS Rx Portal. Once the ILLINOIS Rx Portal comes online, prescribers and pharmacies will receive an email providing them with details on how to access the ILLINOIS Rx Portal. I AM REGISTERED WITH MEDI. DO I NEED TO REGISTER AGAIN? Yes. The ILLINOIS Rx Portal is a new system. You must be enrolled and approved in the IMPACT system to access the ILLINOIS Rx Portal. WILL THE DATA I’VE ENTERED IN MEDI BE PRELOADED INTO THE NEW PORTAL? No. The data from your IMPACT enrollment will be the basis for access to the ILLINOIS Rx Portal. WHAT INFORMATION DO I NEED TO REGISTER FOR THE ILLINOIS RX PORTAL? You must be enrolled and approved in the IMPACT system to access the ILLINOIS Rx Portal. Once the ILLINOIS Rx Portal comes online, prescribers and pharmacies will receive an email providing them with details on how to access the ILLINOIS Rx Portal. CAN I HAVE SEVERAL PEOPLE IN OUR ORGANIZATION ACCESS THE ILLINOIS RX PORTAL? Yes. Once you are registered as a prescriber or pharmacy in the ILLINOIS Rx Portal, you can create additional user accounts and control the type of access for each of your staff in the Portal. CAN I CHECK THE STATUS OF MY PRIOR AUTHORIZATION (PA) REQUEST? The status of any PA entered can be checked in the ILLINOIS Rx Portal. CAN I SUBMIT A PHARMACY CLAIM? Pharmacies have the ability to submit claims through the Illinois Rx Portal and to review claim status and results immediately after adjudication.
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