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Illinois Medicaid Proposes Changes to Certain Psychiatric & Behavioral Health Payments

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June 13, 2018

By: Stacy Walton Long

In a May 25, 2018 notice, the Department of Healthcare and Family Services (the “Department”) announced a proposed change in the methods and standards by which the Department will reimburse providers for psychiatric and behavioral health services.[1] The proposed changes, effective for dates of service on or after July 1, 2018, through June 30, 2019, apply to psychiatric and behavioral health services rendered by a physician, advanced practice nurse or a licensed community mental health center.

In essence, the proposed change extends enhanced payments that already were extended on three separate occasions (June 30, 2017; December 31, 2017; and June 30, 2018). Note the payments apply to mental health rehabilitative services provided in or by a community mental health center as well as to the physician benefit categories. The extension will increase expenditures by approximately $13,750,000 based on current utilization patterns. Of that amount, $12,825,000 applies to the mental health rehabilitative services benefit category and $675,000 applies to the physician benefit category.

The proposed change to Illinois’ Medicaid program is subject to approval by CMS and may be modified or revised during the approval process. Krieg DeVault will provide updated information regarding the proposed changes when first available.

For questions on Medicaid reimbursement and state program updates, please contact Stacy Walton Long at slong@kdlegal.com or your regular Krieg DeVault attorney.

 

[1] https://www.illinois.gov/hfs/SiteCollectionDocuments/51518BHaddonextensionPublicNotice.pdf.