Medicare AdvantageAdministrativeHigh impact
Medicare-Medicaid Alignment Initiative (MMAI) - Central Illinois Region Managed Care Updates
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 1, 2017
We identified it
Jun 20, 2026
Summary
Molina Healthcare is terminating its Medicare-Medicaid Alignment Initiative (MMAI) managed care plan in six Central Illinois counties effective May 1, 2017. Affected dual-eligible beneficiaries will transition to Original Medicare or Medicare Advantage plus Medicaid fee-for-service, requiring providers to verify enrollment status and bill accordingly.
Action Required
By May 1, 2017: Billing team must check MEDI system to verify each beneficiary's enrollment status (managed care vs fee-for-service) on date of service. Update billing workflows to bill Medicare-covered services per Medicare guidelines and Medicaid-covered services per HFS Medicaid fee-for-service guidelines. Front desk staff must verify correct insurance cards (Medicare card, Medicare Advantage card, or HFS medical card) and inform patients of potential new co-pays for visits and prescriptions.