IL Dept. of Healthcare and Family Services Reminds Primary Care Physicians to Sign Up for Enhanced Medicaid Rates By June 30

CHICAGO – The Illinois Department of Healthcare and Family Services (HFS) is reminding qualified primary care providers in the state’s Medicaid program to sign up online for enhanced Medicaid rates by June 30, 2013. As part of the Affordable Care Act (ACA), certain qualified primary care providers will receive enhanced payments from the federal government for certain Medicaid primary care services provided through the end of 2014.

“This temporarily increased federal funding should help boost participation in the Medicaid program, which will help increase access to care and result in better outcomes for our most vulnerable populations,” HFS Director Julie Hamos said.

In order to receive the enhanced payments, qualified providers must first file an attestation form that is available on the HFS website. HFS is encouraging providers to sign up online at http://www2.illinois.gov/hfs/MedicalProvider/PCPAttest/Pages/default.aspx instead of using the paper format.

The effective date for the enhanced Medicaid payments for physicians who submit their attestation forms no later than June 30, 2013, will be retroactive to January 1, 2013. If submitted after June 30, 2013, the effective date for the enhanced payments will be the date the attestation form is received by HFS, not retroactive. The enhanced rates will be paid for services with dates of service on and after the effective date through Dec. 31, 2014.

To be eligible for enhanced Medicaid payments, physicians must first attest that they meet at least one of the following criteria:

• Hold board certification from the American Board of Medical Specialties, the American Board of Physician Specialties or the American Osteopathic Association in pediatric medicine, internal medicine or family medicine, or

• 60 percent of the Medicaid codes paid during the most recently completed calendar year or for newly eligible providers, the prior month, were for eligible procedure codes specified in the regulation.

More information about the enhanced Medicaid payments and eligibility requirements is available at the HFS website at http://www.hfs.illinois.gov/assets/061013n1.pdf.