The Illinois Department of Healthcare and Family Services' Medicaid Advisory Committee will review mental health/substance-use disorder parity rules at its next meeting 10 a.m. Friday at
the James R. Thompson Center, 100 W. Randolph St., second floor, in Chicago.
Below is the agenda for this meeting, as provided by the committee.
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.