December 2017
Introducing the Blue Cross Community Health PlansSM
The Illinois Department of Healthcare and Family Services (HFS) has entered into a contract with Blue Cross and Blue Shield of Illinois (BCBSIL) to offer Blue Cross Community Health Plans (BCCHPSM) beginning Jan. 1, 2018. BCCHP will be offered to eligible participants in every county of Illinois.
Blue Cross Community Health Plans replaces three previous Medicaid programs:
- Blue Cross Community Family Health PlanSM (FHP)
- Blue Cross Community Integrated Care Plan (ICP)SM
- Blue Cross Community Managed Long Term Supports and ServicesSM (MLTSS)
Enrollment in a managed care organization (MCO) is mandatory for those individuals who are eligible for Medicaid Managed Care. Eligible individuals may enroll in the plan of their choice, or the State of Illinois will automatically enroll them. Illinois Client Enrollment Services (ICES) provides individuals with access to unbiased education and information on available health plan options and assists members in the enrollment processes.
BCBSIL has a network of independently contracted providers including physicians, hospitals, skilled nursing facilities, ancillary providers, Long Term Supports and Services (LTSS) and other health care providers through which members may obtain covered services.
Required Training for Providers
The State of Illinois contract with BCBSIL requires providers servicing BCCHP members to participate in mandatory training. This training is also required for providers serving members in the Blue Cross Community MMAI (Medicare-Medicaid Plan)SM. MMAI is offered to eligible participants in six Illinois counties: Cook, DuPage, Kane, Kankakee, Lake and Will. BCBSIL is required by the State of Illinois to offer training to providers on the following topics:
- Model of Care/Medical Home (Person Centered Practice)
- Combating Medicare Parts C and D Fraud, Waste, and Abuse
- Abuse, Neglect, Exploitation/Critical Incidents
- Cultural Competency
- Americans with Disabilities Act (ADA)/Independent Living
- Medicare Parts C and D General Compliance Training
For links to our online training modules please refer to the Medicare/Medicaid page in the Network Participation section of our website at bcbsil.com/provider.
For More Information
The Blue Cross Community Health Plans Provider Manual includes additional details about the network. The manual can be viewed in the Standards and Requirements/BCBSIL Provider Manual section of our Provider website. Information contained in the BCBSIL Provider Manual section is password protected. You will need to follow the instructions given on our Provider website to gain access to this secure information.