Traditional MedicareAdministrativeMedium impact
REMINDER – Statewide HealthChoice Illinois Managed Long Term Services and Supports (MLTSS) Implementation
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Illinois has implemented a mandatory Managed Long Term Services and Supports (MLTSS) program statewide effective July 1, 2019, for dual-eligible beneficiaries not in MMAI who reside in nursing facilities or specific HCBS waivers. Providers must contract with HealthChoice Illinois health plans and follow specific billing protocols for MLTSS enrollees, with Medicare remaining the primary payer.
Action Required
Immediately: Illinois providers serving dual-eligible beneficiaries in nursing facilities or HCBS waivers must contract with HealthChoice Illinois MLTSS health plans (Blue Cross Blue Shield of Illinois, CountyCare, IlliniCare Health Plan, Meridian Health, Molina Healthcare of Illinois, NextLevel Health) using contact information in Attachment A. Update billing procedures to bill appropriate payer (Medicare primary, then HealthChoice Illinois health plan or Medicaid FFS) based on service type. Review May 14, 2019 MEDI/MLTSS provider notice for identifying MLTSS enrollees and billing instructions.