How to Become Eligible for Medicaid Reimbursement
As you are aware, the ICS was successful last year in passing legislation that allows eligibility for full scope reimbursement for services rendered by chiropractic physicians. This transition is occurring in phases via Department of Healthcare and Family Services (HFS) rule changes.
At the current time, HFS rules make chiropractic spinal adjustments eligible for Medicaid reimbursement. This important first step to increase health care provider parity became effective in December 2021. ICS continues to push for more improvements through legislative or regulatory changes. You can review the legislation’s process by clicking here.
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So what does a doctor need to do to become eligible to receive Medicaid reimbursement in Illinois? The ICS has been in contact with the Illinois Department of Healthcare and Family Services (HFS) to find specific answers to that question, and we will be working with the department to help remove any obstacles that doctors of chiropractic may have in accessing Medicaid reimbursement.
Most importantly, in order to receive any reimbursement, a doctor must be enrolled in Illinois Medicaid. This is done through the IMPACT system at HFS. You can obtain access to the IMPACT system by creating an IMPACT user ID. Here are complete step-by-step directions to begin the process. Under “IMPACT sign-on,” click on “Account Activation Instructions for New External IMPACT users”.
Providers must have certified W-9 forms with the State of Illinois. The W-9s can be sent to IMPACT.HELP@Illinois.gov. Once the W-9s, which include your FEIN/EIN numbers, have been certified, you may begin the enrollment application with the IMPACT system.
ICS is also working with HFS to improve education and communication with Managed Care Organizations. There have been reports that some MCOs have denied Medicaid reimbursement for chiropractic services, specifically, spinal adjustments. The new law now authorizes Medicaid to cover expenses for limited chiropractic services for patients of all ages. Some of these denials may be due to legitimate billing errors, but the ICS is gathering information for a renewed awareness campaign targeted to MCOs to clear up any misunderstandings about the Illinois Medicaid eligibility laws.
We are currently looking for examples of cases where legitimate Medicaid claims have been denied. If you have any such examples, we would like to hear from you.
