News & Perspectives

Illinois Wins CMS Approval for Medicaid Behavioral Health Services Innovation

10. May 2018 Tom Entrikin Health

On May 7, 2018, Illinois Governor Bruce Rauner announced that Illinois has won federal approval to launch a 5 year, $2 billion Medicaid behavioral health services initiative.  The initiative will be implemented by the Illinois Department of Healthcare and Family Services in collaboration with the Governor’s office and eleven other Illinois state health and human services agencies.  Objectives of Illinois’ initiative include:

  • Reduction in over-reliance on high-cost institutional care.
  • Better integration of behavioral health care and physical health care.
  • Improvements in support services such as housing and employment services for individuals with behavioral health needs.
  • Transitioning behavioral health providers toward value-based and outcomes-based reimbursement systems.

The Illinois initiative encompasses ten innovative pilot projects designed to achieve Illinois’ objectives:

  • Residential and inpatient treatment for individuals with substance use disorders in settings such as institutions for mental diseases (IMDs).
  • Clinically directed drug withdrawal management services.
  • Substance use disorder case management services.
  • Peer recovery support services.
  • Crisis intervention services.
  • Evidence-based home visiting services.
  • Community integration services.
  • Supported employment services.
  • Intensive in-home services.
  • Respite services.

Illinois’ Medicaid managed care organizations (MCOs) will be instrumental in facilitating implementation of the pilot projects.

The Illinois initiative was approved effective July 1, 2018 by the Centers for Medicare and Medicaid Services (CMS) under research and demonstration waiver authority in section 1115 of the Social Security Act.  Additional information on Illinois’ initiative is available here.