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Medicaid Redetermination Now in Progress

 

Each year, everyone who is enrolled in Medicaid must undergo a redetermination (sometimes called “rede”) to check and see if they are still eligible.
 
Illinois has had a backlog of individual “cases” waiting for redetermination for some time and has not been able to catch up.
 
The IMRP, which is also called Enhanced Eligibility Verification (EEV), is being run under contracts that the Illinois Department of Healthcare and Family Services (HFS) has with two private companies:

1.  MAXIMUS Health Service,Inc: http://www.maximus.com/services/health/eligibility-enrollment-modernization
 
MAXIMUS will review “cases” for people who get medical benefits only during January 2013. Starting on February 1st, they will also review cases of people who get SNAP and/or cash benefits. First, they will verify all possible data electronically, and contact clients to complete the redetermination process. They will identify themselves to Medicaid enrollees as working for the Medicaid Redetermination Project, not as MAXIMUS employees.
 
People contacted by MAXIMUS will have only 10 business days to respond.
People who do not provide information within this deadline will then need to work with their local DHS Family and Community Resource Center to complete their redetermination.
 
Medicaid enrollees can mail or fax their information to MAXIMUS IMRP. They can also bring it to their local DHS office.Future plans include the option to scan and email documents to MAXIMUS.  No start date has been given for this electronic submission.
 
MAXIMUS will also operate a toll-free program hotline for consumers: 1-855-458-4945.  The hotline will begin operation on January 21, 2013.
 
People who receive SNAP (Food Stamps) benefits and/or cash benefits will be contacted by caseworkers from their local DHS Family and Community Resource Center, not by MAXIMUS, through the end of January 2013. Starting on February 1, 2013, these people will also be contacted by MAXIMUS.

2.  HMS: http://hmspermedion.com/our-services/healthcare-data-mining

HMS will provide MAXIMUS with a data mining computer system that will review records electronically and select those people who are most likely to be eligible as well as those who are most likely to no longer be eligible. They will do this by matching data across agencies and programs.
 
Here is contact information for the IMRP:
 
Illinois Medicaid Redetermination Program Hotline Information
 
Hours of Operation: Monday – Friday, 7:00 am – 9:00 pm, Central Time Saturday, 8:00 am – 1:00 pm, Central Time
 
Holidays:   The IMRP Hotline will be closed on the following holidays:
–           New Year’s Day
–           Memorial Day
–           Fourth of July
–           Labor Day
–           Thanksgiving Day
–           Christmas Day
 
Phone Number:  1-855-HLTHYIL (1-855-458-4945
 
FAX: 1-855-394-8066)
 
TTY: 1-855-694-5458
 
Mailing Address:
 
 Illinois Medicaid Redetermination,
 PO Box 1242,
 Chicago, IL 60690-9992
 
For more information:

  1. HFS fact sheet on Enhanced Eligibility Verification: http://www2.illinois.gov/hfs/sitecollectiondocuments/111912_maceev.pdf
  2.  Press Release on the Medicaid Redetermination Project: http://www3.illinois.gov/PressReleases/ShowPressRelease.cfm?SubjectID=2&RecNum=10838

If you have any questions or need more information, you can call The Arc of Illinois Family to Family Health Information Center at 866-931-1110.


Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
708-828-0188 (CELL)
Tony@thearcofil.org

 

 

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The Arc of Illinois | 20901 LaGrange Rd. Suite #209 | Frankfort, IL 60423
Phone: 815-464-1832 | Fax: 815-464-5292
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