Provider Notice Issued 10/12/2018

Date:  October 12, 2018
 
To:     All Medical Assistance Providers
 
Re:     Better Care Illinois Behavioral Health Initiative: Residential/Inpatient Treatment for Individuals with Substance Use Disorder (SUD) Pilot
 
 
The purpose of this notice is to inform providers of the Better Care Illinois Behavioral Health Initiative: Residential/Inpatient Treatment for Individuals with Substance Use Disorder (SUD) 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 a pilot for Residential/Inpatient Treatment for Individuals with Substance Use Disorder (SUD) as a key component of the Better Care Illinois Behavioral Health Initiative. This pilot will allow Opioid Use Disorder (OUD)/SUD treatment services provided in residential and inpatient treatment settings currently licensed by SUPR that qualify as an Institution for Mental Disease (IMD), to receive Federal Medicaid match, as these services have not previously qualified to receive Medicaid matching funds under section 1903 of the Social Security Act.
 
This pilot is designed to deliver services to individuals who are primarily receiving short-term SUD treatment in an IMD setting using the American Society of Addiction Medicine (ASAM) criteria, as defined in 77 Ill. Adm. Code Sections 2060 and 2090. Providers of this service 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
Medicaid Director
 

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