IHA Daily Briefing: August 14

Illinois Chief Behavioral Health Office Releases Report to Strengthen State's Behavioral Health System
The Illinois Dept. of Human Services and the Chief Behavioral Health Office (CBHO) for the State of Illinois, led by Dr. Inger Burnett-Zeigler, recently announced the release of "The Care Compass: A Strategic Framework for Behavioral Health Access and Integration." The report is a comprehensive, data-driven roadmap designed to strengthen the state's behavioral health system.

IHA's Behavioral Health Advisory Forum met with Chief Burnett-Ziegler last year to provide feedback on the plan, and IHA staff have continued working with the Chief and state behavioral health leaders. A key report objective is to implement intensive treatment options to address inpatient bed capacity needs for youth and adults. To achieve these goals, the plan seeks to:

• Assess inpatient psychiatric bed capacity for adults, creating a gap analysis by region;
• Explore a longer-term goal of expanding the Behavioral Health Care and Ongoing Navigation (BEACON) resource for adults, which currently helps youth and families find behavioral health services;
• Enhance care coordination to support care transitions; and
• Stand up Psychiatric Residential Treatment Facilities (PRTFs) and home and community-based services for youth.

The report is organized around core priorities of increasing access to high-quality healthcare, strengthening the workforce, and integrating data, reporting, and monitoring systems. The report also provides a comprehensive overview of Illinois' behavioral health landscape, combining qualitative insights from community engagement with quantitative analysis of statewide data.

The framework was developed through a year-long process of public engagement and cross-agency collaboration, including listening sessions with providers, advocates, community members, and individuals with lived experience. See the related news release. IHA will continue to work with Chief Burnett-Ziegler on plan implementation and provide updates periodically.

Staff contact: Lia Daniels

Upcoming NonCitzen Medicaid Eligibility Changes - Oct. 1

H.R. 1 narrows Medicaid eligibility for certain noncitizens, causing these individuals to lose coverage on Oct. 1, 2026. This includes refugees, asylees, humanitarian parolees and numerous others. The Illinois Dept. of Healthcare and Family Services (HFS) has sent notices to these individuals informing them of their upcoming coverage loss. Those who are losing coverage may still receive Emergency Medicaid, which provides time-limited coverage for emergency medical services for individuals who are not eligible for full-scope Medicaid benefits solely due to their immigration status.

HFS has developed an H.R. 1 NonCitizen Toolkit to inform providers of these upcoming changes. The toolkit, and accompanying materials, are available in multiple languages on the HFS Federal Resource Center webpage. This webpage also includes a webinar recording with more details on this upcoming coverage loss for noncitizens.

CMS Requests Updated Billing Information from Qualifying Alternative Payment Model Participants
The Centers for Medicare & Medicaid Services (CMS) has released an advisory for certain clinicians who are Qualifying Alternative Payment Model (APM) participants and eligible to receive APM incentive payments. CMS said it issued this alert to notify these clinicians that their current billing information must be updated to receive funds for the 2026 payment year. CMS said that when it processed the 2026 APM incentive payments, CMS was unable to identify a taxpayer identification number (TIN) or TINs associated with some of the participants and was therefore unable to disburse the payment. To successfully issue the APM incentive payment for the 2026 payment year, CMS is requesting assistance identifying current Medicare billing information for these participants. The agency said that all information must be received by Oct. 13. Following that date, CMS said any claim to an APM incentive payment for the 2026 payment period based on an eligible clinician's qualifying APM participant status for the 2024 performance period will be forfeited.

International Agencies Issue Advisory on Attacks by Gunra Ransomware
U.S. and international agencies recently released a joint cybersecurity advisory alerting the healthcare sector and other organizations about recent actions by Gunra ransomware. First identified in 2025, Gunra is a ransomware-as-a-service program that has been observed targeting critical infrastructure, including healthcare, in the U.S. and internationally. Gunra actors leverage a double-extortion model, both encrypting data and threatening to publish stolen data to a dedicated leak site if a ransom is not paid. The advisory provides details on Gunra activity and includes recommended actions organizations can take to protect themselves from Gunra, including detection and mitigation guidance.

Report: Prior Authorization Metrics Provide New Insights Into Insurer Practices
A KFF report published this week on publicly reported prior authorization metrics from health insurers found that in 2025, Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14%, and Health Insurance Marketplace insurers denied 18%. KFF said that prior authorization denials are rarely appealed, but when they are, a substantial number are overturned. Upon appeal in Medicare Advantage, 67% of prior authorization denials were overturned, 47% were overturned upon appeal in Medicaid managed care, and 43% were overturned in the Affordable Care Act federally facilitated Marketplace.

Illinois Respiratory Disease Surveillance Data