Pritzker Announces Efforts to Expand
and Expedite Medicaid Coverage for Uninsured and Insured Illinois
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[September 23, 2020]
Chicago – As the state
continues to build on its robust response to the COVID-19 pandemic
and prepare for increased demand across the state’s health care
system, Governor JB Pritzker announced the “Care Comes First” action
plan, a series of efforts led by the Illinois Department of
Healthcare and Family Services to expand medical coverage for
residents across the state.
“My team is doing everything in our power to make
sure all of our residents can access the health care they need in
these trying times,” said Governor JB Pritzker. “That is why we’ve
applied for waivers with the federal government to expand Medicaid
availability during this period.”
The state has submitted two federal waivers requesting increased
flexibilities around Medicaid coverage. If approved, the
flexibilities will ensure that individuals, whether uninsured or
insured, can receive Medicaid coverage for treatment if they have
been diagnosed with COVID-19.
Illinois has also taken steps to request from the federal government
the authority to make Medicaid available to cover the costs to treat
COVID-19 for every uninsured resident, regardless of income. An
additional request seeks authority for Medicaid to help cover
out-of-pocket expenses for insured residents, as a secondary payer
for COVID-19 treatment costs.
In an effort to fast track Medicaid enrollment, the state has also
requested approval from the federal government to remove
time-consuming verification processes, such as numerous co-payments,
spend-downs, and asset verifications. The state is also streamlining
processes, such as more phone assistance to help residents obtain
information and complete applications as quickly as possible.
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The state is also working to simplify Medicaid
enrollment for providers to expand access, including a request to
allow any medical provider licensed in Illinois to bill Medicaid.
Site visits to join and revalidation to remain in the program are
suspended by the state, as well as minimum staffing levels for most
Quicker and expanded access to treatment and medications has
remained a priority for Illinois, as a result prior authorization
rules are suspended, and existing authorizations remain for most
services. The state is seeking authority from the federal government
to allow Illinois to expand telehealth and alternate settings for a
range of services, including allowing prescribers not enrolled in
Medicaid to write prescriptions.
Lastly, to promote social distancing and observance of stay-at-home
orders, the state is seeking authority to provide home-delivered
meals and temporary housing for those experiencing homelessness
through Medicaid coverage.
For more information for clients, provider notices, waiver or state
plan submissions, and corresponding fact sheets visit:
[OFFICE OF THE GOVERNOR JB PRITZKER]