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HFS expects decision soon on new Medicaid behavioral health model

6 May 2024 1:31 PM | Deborah Hodges (Administrator)

A top Department of Healthcare and Family Services official said they hope to learn by next month whether the federal government will approve an application for a new behavioral health model for the state’s Medicaid program.[Health News Illinois]

Medicaid Administrator Kelly Cunningham told members of the Medicaid Advisory Committee Friday that they have “circled” June 17 on their calendar as the date when they’ll learn whether the state has approval for the certified community behavioral health clinics model.

The program aims to link behavioral health, case management and other services together in a single site.

“This can really give us the opportunity to really re-energize and reshape the behavioral health landscape," Cunningham said.

Along with being designed to be a more “holistic delivery system” that combines behavioral and physical health, the program will have a prospective payment system, where reimbursements are based on a predetermined, fixed amount, she said.

The state has provisionally certified 19 locations to participate in the program.

If approved, Cunningham hopes it can be operational by the fall. If denied, they will explore other options to move forward with the program, whether that be a state plan amendment or a waiver.

In other business, Cunningham said the agency plans to create a new position to oversee the implementation of the state’s 1115 waiver targeting the social determinants of health and behavioral health.

Cunningham said the current team has done great work to get them to this point, but “we're going to need more resources, particularly to drive this towards implementation.” 

She reiterated they hope to learn by June about federal approval for the waiver.


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