Provider Notice Issued 12/06/2019

Date:    December 6, 2019
 
 
To:       All Medical Assistance Program Providers
 
Re:      Illinois Medicare-Medicaid Alignment Initiative Statewide Expansion Effective January 1, 2021
 
 
Effective January 1, 2021, the Medicare-Medicaid Alignment Initiative (MMAI) program will be expanding statewide. Expanding the MMAI demonstration statewide will provide all full dual eligible beneficiaries in every Illinois county with the opportunity to receive their Medicare Parts A and B benefits, Medicare Part D benefits, and Medicaid benefits from a single Medicare-Medicaid Plan, also known as MMAI plan.
 
MMAI Program
The MMAI program brings together Medicare, Medicaid and prescription drug benefits into one health plan. Most MMAI health plans also offer extra benefits such as more dental care and lower prescription co-pays. All MMAI health plans have care coordination to manage all the healthcare and long-term services and supports of enrollees.
 
Contracting with Participating MMAI Illinois Plans
Providers of all specialties and localities are strongly encouraged to join the multiple MMAI plan networks as soon as possible in order to participate in the statewide MMAI program. The 2021 MMAI Provider Network evaluations begin in February 2020. Contracting is also important for timely payment and continuity of care. As a network provider, you will be able to provide care to new and existing Medicare-Medicaid dually eligible patients while benefitting from simpler reimbursement systems and a team-based approach to care.
 
Why should I participate in MMAI as a contracted provider?
MMAI aligns with Illinois’ overall efforts to provide higher quality and more coordinated care, including:
       Better care through a clinically integrated, person-centered care model;
       Better value by supporting reimbursement models that focus on quality, not quantity, through financial incentives; and
       Better health for the individual through flexible benefits aimed at providing the right care, at the right time, in the right place.
 
Questions regarding this notice may be directed to the Department’s Bureau of Managed Care at
217-524-7478 or HFS.MMAI@Illinois.gov
 
 
Doug Elwell
Medicaid Director

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