Illinois Continuity of Care and Administrative Simplification Extension

On June 30, 2025, Illinois submitted a 5-year extension request of its "Illinois Continuity of Care and Administrative Simplification" demonstration.  The state proposes to continue the following authorities: 1) the waiver of hospital presumptive eligibility for 18 months and 2) allowing the state to re-enroll Medicaid beneficiaries into their prior managed care organization (MCO) when the Medicaid beneficiary submits late redetermination paperwork and is reinstated within 90 days of disenrollment. The state requests authority to allow the state to treat out-of-state address changes as reliable based on information from the United States Postal Service (USPS) National Change of Address (NCOA) database and MCOs if the MCO has received information directly from or verified the information with the beneficiary.  This would allow the state to send a termination notice to the updated out-of-state address as the beneficiary would no longer meet the state residency requirement.  The beneficiary would retain appeal rights and would be reinstated into coverage if there was an error.  The federal public comment period will be open from July 16, 2025 through August 15, 2025.

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