The Illinois Department of Health and Family Services said that copay requirement are paused for noncitizens on state health plan.
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The Illinois Department of Health and Family Services says it is not yet ready to implement cost-saving measures implemented by the Pritzker administration.
Interim chief of administrative rules at the Illinois Department of Health and Family Services, Omar Shaker, told a legislative oversight committee onTuesday that the department ultimately plans to reinstate the copay police but they still do not have the systems to properly administer it.
The Illinois Department of Health and Family Services originally oublished a notice in June that customers enrolled in Health Benefiits for Immigrant Adults program and the Health Benefits for Immigrant Seniors Program would be required to pay copays for certain services, effective July 1st. The programs offer coverage similar to Medicaid. But unlike the regular Medicaid, the immigrant health care programs are funded almost entirely with state dollars due to federal reimbursement limitations for that population.
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The state’s Illinois Department of Health and Family Services began first covering immigrant senior aged 65 and over last 2021. The program was then expanded to include adults aged 42-64.
The rules went into effect on July 1st requiring enrollees to make a $250 copay for inpatient hospital stays, and $100 for emergency room visits and 10% of the Medicaid reimbursement rate for outpatient ambulatory surgery.
However, on September 5, the Illinois Department of Health and Family Services published another notice advising providers to stop charging copays and to refund any money that was collected thus far. Illinois Department of Health and Family Services interim chief of director, Omar Shaker, told JCAR on Wednesday that there was a problem with charging copays for emergency room services as that is one service for which the federal government does not offer reimbursements, even for immigrants not lawfully present in the US.
Jamie Munks, the Illinois Department of Health and Family Services spokesperson said in a separate email that the Illinois Department of Health and Family Services also need to reprogram their computer systems that manage the reimbursements to account for the new copayment requirements. Shaker said that he could not estimate a timeline when to reestablish the copays. However, the Illinois Department of Health and Family Services are anticipating a provider notice with sufficient time notifying them on a specific date the copays would reinitiate as well as notifying the actual recipients and advising what their responsibilities would be.
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