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Date: Friday, July 12, 1996 FOR IMMEDIATE RELEASE Contact: HCFA Press Office(202)690-6145
HHS Secretary Donna E. Shalala today announced approval of Illinois' statewide health care reform proposal, MediPlan Plus. MediPlan Plus will increase access and quality of health care for the state's 1.1 million Medicaid beneficiaries through increased use of managed care.
"This project demonstrates the Administration's commitment to working with states to develop innovative programs that ensure that our neediest citizens have access to quality health care," said Secretary Shalala.
Under MediPlan Plus, managed care will be provided through a mix of health maintenance organizations, provider-run managed care community networks (MCCNs), pre-paid health plans (for a limited period), and enrolled managed care providers who agree to provide case management services. These providers will include Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and physicians.
All Medicaid eligibles will receive the same services offered under the existing Medicaid program through either this delivery network or, in limited circumstances, the existing fee-for-service system. MediPlan Plus will be implemented statewide. The state anticipates that it will take a minimum of 13 months to implement the program.
In order to protect against improper enrollment practices, marketing materials will be pre-approved, and beneficiary education and enrollment activities will be conducted by the state or its agents. Direct marketing to Medicaid recipients by managed care organizations is not allowed under the plan.
Bruce C. Vladeck, administrator of the Health Care Financing Administration, said, "By fostering the creation of an innovative managed care infrastructure, Illinois will increase access to quality health care for its Medicaid beneficiaries."
Illinois is the 13th comprehensive health care reform demonstration project approved since January 1993.