December 19, 2024

On behalf of the IPHA Third-Party Billing Team, we wish you a cheerful and safe holiday season. May the new year bring you much joy and countless blessings.

State of Illinois Medical Debt Relief Pilot Program

The State of Illinois has committed $10 million to help alleviate the burden of medical debt for Illinois residents. This initiative has the potential to relieve up to $1 billion in medical debt for hundreds of thousands of Illinoisans.

The funding supports the Medical Debt Relief Pilot Program administered by the Illinois Department of Healthcare and Family Services. The program works by purchasing outstanding medical debt owed by low-income Illinois residents from health systems and other providers and forgiving those debts at no cost to the individuals.

The State of Illinois has contracted with Undue Medical Debt, a national 501(c)(3) nonprofit organization, to implement the program. Undue Medical Debt has extensive experience working with state and local governments across the country to relieve medical debt.

How does it work?

There is no individual application process for the program. Undue Medical Debt analyzes hospital debt portfolios to identify eligible accounts. If you have debt at a participating provider and your debt qualifies, your debt will be canceled, and you will be notified by mail – no action is required on your part. Eligibility requirements are listed here.

Please note, medical debt relief is source-based, meaning only qualifying medical debts sold from participating partners like hospitals are eligible for relief and consumers cannot request debt relief.

The program is currently seeking providers from whom to acquire qualifying medical debt. Undue purchases medical debts of those with a demonstrated financial need in bundled portfolios at an industry standard rate, which is often pennies or less on the dollar.

What impact has the program made so far?

As of November 2024, the Medical Debt Relief Pilot Program has relieved $72 million of medical debt for more than 50,000 Illinois residents. (Please see this Press Release for more details)

Individuals benefitting from medical debt relief will receive Undue Medical Debt-branded letters in the coming weeks notifying them that their debts have been eliminated. Future waves of relief letters will be announced by the state ahead of their release.

For more information, please contact HFS Medical Debt Relief Lead, Clare C. Fisher.

GetCoveredIllinois Open Enrollment Ends January 15

Open enrollment for plans through Illinois’ Health Insurance Marketplace, GetCoveredIllinois began November 1, 2024, and runs through January 15, 2025. For coverage to become effective on January 1, 2025, enrollment must have been completed by December 15, 2024. Coverage for enrollments completed between December 16, 2024, through January 15, 2025, will become effective on February 1, 2025.

For questions about open enrollment for Health Insurance Marketplace plans (also known as ACA plans), you may use the GetCoveredIllinois Open Enrollment Brochure or  the GetCoveredIllinois Open Enrollment website.

Clients who may be eligible for an Illinois Medicaid plan can use the Application for Benefits Eligibility (ABE) at ABE.Illinois.gov. This site allows applicants to determine their eligibility, enroll in a plan, and manage their benefits.

Every healthcare provider should be committed to help their clients stay informed about their healthcare coverage options and enrollment processes. This practice helps to minimize the number of clients that do not have coverage.

IPHA Third-Party Billing Webinar

On December 11, 2024, the IPHA Third-Party Billing Team hosted Telehealth Care Delivery and Payment Guidelines. Presented by Kem Tolliver, President and CEO of Medical Revenue Cycle Specialists (MRCS), participants in this session reviewed regulatory guidelines for providing telehealth services and best practices for establishing a sustainable hybrid telehealth model.

The recording and slide deck for this presentation will be archived on the IPHA Third-Party Billing Webpage.

This Month's MVR

To cap off the year, the December MVR award goes to Illinois ADVANCE. This team of 30 pharmacy professionals based out of the University of Illinois Chicago specializes in personalized education, known as academic detailing, for all healthcare professionals, from physicians to pharmacists to CHWs. Through tailored virtual or in-person meetings, this program provides targeted, unbiased, evidence-based recommendations and resources to support individual professionals, healthcare systems, and public health programs. They offer a wide variety of topics via this specialized approach and several others via web-based learning on their website https://illinoisadvance.uic.edu/welcome/

The education is state-funded and accredited for CME and CPE. The services and resources offered have been applied to the onboarding of new hires, resident training, refreshing team knowledge on a topic, and utilized as an educational component for grant-funded initiatives. This valuable resource ultimately optimizes care and outcomes for target populations. Illinois ADVANCE will work closely with you to support program and county goals, whether iPLAN or beyond.

Important Update for Tricare East Providers - Enroll in Electronic Funds Transfer (EFT) by January 1

All Tricare East providers must enroll in Electronic Funds Transfer (EFT) by January 1, 2025, even if you are already utilizing these services.

Please see the EFT and ERA enrollment package for the application, FAQs, and more. Once completed, please email your application to HMT5EFT@PGBA.com.

To learn about other changes for Tricare providers in the East Region, please click here.

HFS recently issued important Provider Notices:

• School Based Health Services Fee Schedule Effective 10/01/2024 Updated 12/11/2024
• Updated Community-Based Behavioral Health Fee Schedule and Billing Guidance
• Practitioner Fee Schedule Effective 10/01/2024 Updated 12/06/2024
• Telehealth Billing System Issue Resolutions and Billing Guidance
• Confirmation of Coverage for Continuous Glucose Monitors in Compliance with Public Act 103-0639
• Family Planning Program Fee Schedule Updated 11/25/2024
• Medicaid Provider Revalidation

If you have not already subscribed to receive email notifications from HFS when new Provider Notices are posted, you may subscribe here. To learn more about the many helpful resources available to healthcare providers, please visit the HFS Provider website.