Provider Frequently Asked Questions (FAQ)

 

  1. What is MMAI?

    MMAI is the Medicare-Medicaid Alignment Initiative. This program is a contract between the Centers for Medicare and Medicaid Services (CMS), the participating state and the selected health plan. The program was put into place to better serve the needs of dual beneficiaries of both Medicare and Medicaid. Cigna-HealthSpring brings over 10 years of experience focused on increasing the quality of care for the dual eligible population.


  2. Why was it created?

    The MMAI is part of the Affordable Care Act. It was created to better align health benefits and community and social services provided to people with both Medicare and Medicaid. Participating states are changing their Medicaid systems from a program that simply pays medical bills, to a wellness system. Plans available through the MMAI are called Medicare-Medicaid Plans (MMPs).


  3. What is the name of our MMAI plan?

    Cigna-HealthSpring CarePlan of Illinois (Medicare-Medicaid Plan)


  4. How will members benefit from CarePlan of Illinois?

    Cigna-HealthSpring CarePlan of Illinois makes it easier for people with both Medicare and Medicaid to receive medical and community-based services through one health plan. This plan will make it easier to manage one’s own health care needs through better care coordination. Under Cigna-HealthSpring CarePlan of Illinois, members will not lose any of their current Medicare or Medicaid benefits, but will receive additional benefits, including: transportation, gym membership, 24-hour nurse line, over-the-counter monthly allowance, and a care coordinator.


  5. How will CMS and Illinois ensure Medicare-Medicaid enrollees receive quality care under this initiative?

    A primary goal of the Illinois Medicare-Medicaid Alignment Initiative is to improve quality of care. In this demonstration, improving quality includes an emphasis on not only medical care, but also on long term support services and the overall Medicare-Medicaid enrollee experience. CMS and the State will conduct a joint performance and quality monitoring process that will ensure beneficiaries are receiving quality care.



  6. How will this affect how I submit Medicare and Medicaid claims and billing processes? How does it affect reimbursement rates?

    If you are already a Cigna-HealthSpring provider, you will continue to submit claims via your standard process with Cigna-HealthSpring. 90% of clean electronic claims are generally paid within 14 days of submission. This reduces the Medicaid turnaround times for payment and you will begin to receive payments directly from Cigna-HealthSpring.


  7. Who are the other selected health plans for the MMAI?

    The participating health plans include: Aetna Better Health, Blue Cross/Blue Shield of Illinois, Cigna-HealthSpring, Humana Health Plan, IlliniCare Health Plan (Centene) and Meridian Health Plan of Illinois.


  8. What is the service area?

    The service area for the Cigna-HealthSpring CarePlan of Illinois is Cook, DuPage, Kane, Lake and Will counties.


  9. Questions?

    Please email us at WeCanHelp@HealthSpring.com