Managed Care Presentations

HFS-Managed Care Forums - August 2015
HFS and MCOs hosted forums in August 2015 to address long-term care providers questions/concerns about managed care. HFS and the Illinois Association of Medicaid Health Plans (IAMHP) gave presentations outlining some common issues from providers. View the HFS presentation  and IAMHP presentation

Supportive Living Managed Care Update with Polsinelli
This is a PowerPoint presentation by Polsinelli, the law firm that reviewed and revised the MCO’s Supportive Living contracts on behalf of AALC. The Presentation is a comprehensive update for SL providers on the current state of the ICP and MMAI program rollouts. It also covers major issues being faces what it means for SL providers.

May/June 2015 - Surviving Managed Care: SL One Day ICP MMAI Challenge
This is a PowerPoint presentation by Polsinelli from May/June 2015. It provides an update for SL providers on the new challenges the SLs face with the implementation of managed care and the implications for providers. It covers the major issues being faced by providers and the issues that have hampered the MCO's efforts.

July 2014 Molina Healthcare Presentation

Sept 2012 Managed Care Powerpoint Presentation
This is the Powerpoint presentation by CliftonLarsonAllen, the national consulting firm with expertise in managed care hired by AALC, that was reviewed during our September 2012 meetings about managed care. It has some excellent information about how to negotiate managed care contracts for SLFs.

 

Managed Care Contracts

Health Alliance
Health Alliance Final Contract


CCAI
CCAI Agreement
 

Aetna
This contract isn't available online.
 

Meridian
Meridian Illinois Ancillary Provider Agreement


Molina
Molina AALC Approved Final Contract (MS Word)
Molina AALC Approved Final Contract (pdf)
 

Humana ILS
ILS Standard Provider Agreement Supportive Living Facility

Blue Cross Blue Shield
BCBS Dual Eligible Contract SLF 2013 (pdf)
BCBS Dual Eligible Contract SLF 2013 (MS Word)
BCBS Provider Application SLF 2013 (MS Word)


HealthSpring
HealthSpring SLF Contract Final (MS Word)
HealthSpring IL LTSS Provider App (MS Word)
If you have any questions about these items, please contact Andrew Galbierz of HealthSpring, (847)-993-1966, or andrew.galbierz@healthspring.com


IlliniCare
IlliniCare Final Approved Contract (pdf)
To obtain your own individualized copy of this contract, or if you have any questions, please email Preston Medrano, Director, Network Development, at PMEDRANO@centene.com or call (866) 329-4701 ext. 47824. Preston will need the facility’s name, tax id, mailing address and the email address of a contact at the facility. He will then send a customized approved agreement for execution.
Important Implementation Documents

 

MMAI QA - questions and answers from the Stakeholders Meeting on April 18, 2013
MMAI Map & Chart  
Managed Care Directory
Medicare Readmissions Penalties 2013
AALC Questions to HFS.2 - AALC submitted questions to HFS on behalf of members, and this document provides the answers.
If you have any questions, please contact Wayne Smallwood at wsmallwood@aalconline.org or (217) 525-0700 ext-124 or (217) 622-0373 (cell).

 

AALC Legal Review - Response Letters Sent to Providers:

Aetna
Health-Alliance
HealthSpring
IlliniCare
Meridian
Molina