Volume XIII, Issue XXXIX - June 2020

FY2021 Rate Increases, Contractual Policy Manual and DARTS Changes for FY2021

Cost of Living Adjustment:

We are pleased to announce that Governor JB Pritzker has approved a budget for FY2021 that includes a 2% cost of living adjustment (CoLA) for organizations funded by the Illinois Department of Human Services/ Division of Substance Use Prevention and Recovery (IDHS/SUPR). We are currently working on contract amendments and rate adjustments to reflect the CoLA and additional information will be forthcoming. Additionally, the SUPR Contractual Policy Manual will be updated to reflect the CoLA increase and organizations will be notified when this is available. The 2% CoLA will be effective 7/1/2020.

Residential Rate Study:

The residential rate study (including ASAM Levels 3.1, 3.2, 3.5 and 3.7) seeks to eliminate individualized rates for a streamlined cost-based rate structure. The study is being finalized over the next few weeks with an anticipated implementation date of 9/1/2020. Organizations providing these levels of care will be notified for a meeting to present the results of the study in the next few weeks.

DARTS Changes:

DARTS changes for FY2021 were previously sent to organizations in preparation for the new fiscal year. The document specifying these changes is attached. The DARTS Manual will be posted in July and communication will be sent to organizations when it is available.

Contractual Policy Manual Changes:

IDHS/SUPR has posted the Contractual Policy Manual for FY2021 at https://www.dhs.state.il.us/page.aspx?item=29747.

This manual applies to all IDHS/SUPR funded SUD treatment organizations and contains several important revisions and new policies for FY2021. The identification and location of these changes is as follows:

Introduction:

A section on Capacity Management (CapMan) requirements has been added.

Eligibility- Organization and Patient:

Family Income Eligibility Requirements have been removed. It is now required that organizations establish their own policies and procedures for eligibility requirements that will allow the use of contract funds for reimbursement.

Income Eligibility Waiver Criteria has been removed. Organizations should establish their own waiver criteria as part of their Income Eligibility Requirements policy and procedure.

Reimbursement Policy:

Emphasis has been added to encourage all organizations to execute contracts with all Medicaid Managed Care Organizations (MCO) or, if not, to have policy for referral or a patient to an organization with a contract for that patient's MCO.

Beginning July 1, 2020, organizations should bill Medicare directly for methadone service packages for eligible patients.

The list of covered services has been combined with the rate structure table.

Reimbursement/Disbursement Specifications:

Language related to reimbursement for the day of discharge for Level 3 services has been removed. Effective September 1, 2020, the day of discharge will no longer be eligible for reimbursement.

Early Intervention service language has been changed from identification of risk factors that may be related to problems associate with substance use disorders to identification of risk factors that are related to problems associated with substance use disorders. Current examples were clarified, and new examples were included.

Information related to Recovery Support Services added.

The case management, early intervention and community intervention billing allowance section was removed.

Telehealth billing instructions were updated.

Service Requirements:

Section 3- Service Requirements for Substance Use Disorder Treatment/Ancillary Services/Recovery Services for DCFS Recipients:

  • Criteria for target population was updated.
  • Purchase of Service (POS) workers have been included in reporting.
  • Language requiring CANTS checks has been added.
  • A section on Investigations has been added.
  • Language has been updated and added under Target Population Specific Service Requirements.

Section 7- Service Requirements for Gambling Disorder Services:

  • Language was added regarding the ASAM assessment.
  • Replaced the number of hours required to establish a dedicated gambling program with a dollar amount.
  • Language was added to the outreach activities that includes marketing.

Section 8- Renamed to Service Requirements for Substance Use Disorder Treatment Organizations that Provider Daytime Childcare and Child Domiciliary Services

  • Parent and Guardian language added.

Please ensure that all management and professional staff in each IDHS/SUPR funded SUD treatment organization has access to and reviews the content of FY2021 Contractual Policy Manual to ensure compliance during FY2021.

Thank you for your attention to these matters and for your continued commitment to the provision of SUD services. Please direct any questions to DoIt.SUPRHelp@illinois.gov.