Date: October 11, 2018
To: All Medical Assistance Providers
Re: Better Care Illinois Behavioral Health Initiatives: Case Management Pilot, Peer Recovery Support Services Pilot, Clinically Managed Residential Withdrawal Management Pilot
The purpose of this notice is to inform providers of the following Better Care Illinois Behavioral Health Initiatives: Case Management Pilot, Peer Recovery Support Services Pilot and Clinically Managed Residential Withdrawal Management Pilot implementation.
In May 2018, the Illinois Department of Healthcare and Family Services (HFS) received approval of its 1115 Waiver request. This waiver includes pilots designed to better serve Medicaid beneficiaries in need of behavioral health services.
The approved waiver authorizes the state to receive Federal Financial Participation (FFP) for a continuum of services to treat opioid and other substance use disorders as well as other behavioral health conditions. The programs and related innovations are known as the Better Care Illinois Behavioral Health Initiative.
HFS, in partnership with the Department of Human Services/Substance Use Prevention and Recovery (DHS/SUPR), is preparing to implement pilots for Case Management to individuals that qualify for diversion into treatment from the criminal justice system, Peer Recovery Support Services, and Clinically Managed Residential Withdrawal Management for individuals with Substance Use Disorder (SUD) as a key component of the Better Care Illinois Behavioral Health Initiative. These pilots will include Opioid Use Disorder (OUD)/SUD services delivered by providers currently licensed by SUPR, which are not otherwise matchable expenditures under section 1903 of the Social Security Act.
These pilots are designed to support individuals who are receiving other OUD/SUD treatment services using the American Society of Addiction Medicine (ASAM) criteria, as defined in 77 Ill. Adm. Code Sections 2060 and 2090. Providers of Clinically Managed Residential Withdrawal Management must have the ability to coordinate or provide Medication Assisted Treatment (MAT) for those patients who need this regimen of care.
Information regarding enrollment and billing will be scheduled once all programming is complete. Currently licensed, eligible providers will be notified of this date by email.
Teresa T. Hursey