From:  Maria Bruni, Acting Director
Division of Alcoholism and Substance Abuse

MEDICAID BILLING AND DASA CONTRACT FUNDS

Past practice did not prohibit the use of fixed-rate grant funds contained in a DASA contract to pay for Medicaid covered services to eligible patients. Additionally, Medicaid certification and site enrollment was an option for organizations with DASA contracts. However, as the availability of contract funding continues to decrease, these policies will be amended in order to ensure that contract funding remains available for non-Medicaid covered services.

Therefore, as of September 1, 2016, an edit will be placed on the DASA mainframe that will no longer allow Medicaid covered services that are delivered to eligible patients to be reimbursed with DASA fixed-rate grant funds. As a result, any billing for a Medicaid patient for a Medicaid covered service using funding code DC will reject at the DASA mainframe. This edit will also apply to any patient in a Medicaid Managed Care Organization (MCO). Additionally, DASA will require all organizations with DASA contracts to obtain Medicaid certification and to enroll all licensed sites for applicable services.

If your organization has a DASA contract and is not Medicaid certified and enrolled to provide and bill for Medicaid covered services, please contact Charles.Goldman@illinois.gov to obtain a Medicaid certification application. Upon receipt of certification, each site should be enrolled in the Department of Health and Family Services IMPACT system at: http://www.illinois.gov/hfs/impact/Pages/default.aspx.

If you are not currently contracted to provide services through the MCOs in your network, please go to http://www.illinois.gov/hfs/MedicalProviders/cc/Pages/default.aspx for information.

Please contact DHS.DASAHelp@Illinois.gov with any questions you may have regarding this communication.