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If You Treat Medicaid Patients, Take Notice

This summer, Illinois' Department of Healthcare and Family Services (HFS) will begin moving approximately 1.5 million Illinois Medicaid patients into managed care, based on the geographic location of the patient.


Illinois' Medicaid reform law, enacted in 2011, directs that 50 percent of the state's Medicaid recipients are to be enrolled in coordinated care by 2015. Children, their family members and the newly eligible Affordable Care Act (ACA) adults who reside in one of five mandatory managed care regions will be affected - and, if you treat Medicaid patients in one of those regions, so will your practice.

See map showing the five regions and the care coordination entities within those regions.

Patients residing in these regions must either choose a care coordination entity or one will be assigned to them. Over the summer, these plans will begin to market to patients.

ISMS advises physicians to inform their affected Medicaid patients to choose a plan that will allow them to continue seeing their current physician.

For areas outside the five mandatory regions, Illinois Health Connect will continue to operate.

Read the Care Coordination Roll-Out Plan Summary.

HFS' May 23 Informational Notice identifies the regions and provides a list of the counties affected and the plans operating in those counties, along with their contact information.

Read Illinois Health Connect's Provider Newsletter.

If you have questions, please contact the ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email.

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