IHA Daily Briefing: May 15

REMINDER: Upcoming Medicaid Eligibility Changes and Available Resources

Illinois hospitals and healthcare providers are encouraged to continue outreach efforts to help Medicaid enrollees prepare for upcoming federal eligibility and reporting changes tied to H.R. 1.

Under the new federal requirements, certain adults enrolled in Medicaid may eventually need to report work, education, or training activities to maintain coverage. While many individuals are expected to qualify for exemptions, ensuring patients receive clear, timely information will be essential to helping eligible individuals avoid unnecessary coverage disruptions.

To support stakeholder education and planning efforts, the Illinois Dept. of Healthcare and Family Services (HFS) continues to host a webinar series focused on the anticipated Medicaid changes under H.R. 1. The first webinar, "A Medicaid Overview and HR 1 Changes, Impact, and Timeline," will take place Thursday, May 21 from 1-2 p.m. CT. Additional webinars are also planned in the coming months. To register for this webinar, and view other upcoming webinars, click here.

HFS has also developed a communication toolkit to help providers educate Medicaid enrollees about the importance of maintaining current contact information with the state. These resources are intended to reduce avoidable coverage losses as eligibility-related changes begin to roll out in late 2026 and 2027. The toolkit includes flyers, presentation materials, and multilingual resources available in English, Spanish, and several additional languages. Click here to access the HFS toolkit.

In addition, through IHA's participation in Cook County Health's Medicaid Impact Workgroup, IHA is helping amplify public awareness efforts and distribute additional educational resources. This includes the "Get Medicaid Facts" website and accompanying multilingual communications materials designed to support hospitals, providers, and community organizations in educating patients and preparing for the upcoming changes.

AMA Survey: Physicians, Patients Heavily Burdened by Prior Authorization

The prior authorization process continues to negatively impact patient outcomes and employee productivity, according to a survey of physicians released this week by the American Medical Association (AMA). More than nine in 10 physicians (95%) said prior authorization negatively affects clinical outcomes, and one in four physicians (26%) said that prior authorization led to a serious adverse event. Additionally, 95% of surveyed physicians said that prior authorization delays access to necessary care and 79% reported that patients abandoned treatment due to authorization challenges.

Physicians continue to report that prior authorization places significant strain on physician practices, driving high volumes of requests and denials, consuming clinical and administrative time, and contributing to widespread burnout. Nearly one in three physicians (32%) reported that prior authorization requests are often or always denied, and more than four in five (88%) reported that prior authorization requirements lead to higher overall use of resources, resulting in unnecessary waste. More than nine in 10 physicians (94%) said prior authorization contributes to burnout.

Two New Rural Community Opioid Response Program Funding Opportunities

While national overdose death rates have declined, rural rates remain higher than pre-2020 levels and are decreasing more slowly than in urban areas, reflecting ongoing challenges with access to prevention, treatment, and coordinated transportation to care. The Health Resources and Services Administration (HRSA) has announced the release of two new funding opportunities that will fund $64 million to help rural communities address the overdose crisis.

The Rural Communities Opioid Response Program (RCORP) is the only federal program dedicated exclusively to addressing opioid and substance use disorders (SUDs) in rural communities. RCORP supports the development of coordinated behavioral health systems in rural areas across the prevention, treatment, and recovery spectrum, with the aim of reducing the risks associated with substance misuse and SUD. All services must be provided in HRSA-designated rural areas.     

For questions, email [email protected].

Save the Date: 2026 Illinois Vectorborne Disease Conference

The Illinois Dept. of Public Health (IDPH) is hosting the 2026 Illinois Vectorborne Disease Conference on Sept. 9 at the I Hotel and Illinois Conference Center in Champaign. This free event will bring together clinicians and professionals from local health departments, communicable disease programs, government agencies, academic institutions, and healthcare systems to address vectorborne disease threats in Illinois. The conference will focus on strengthening community outreach, enhancing public awareness, and building cross-sector partnerships to improve prevention and response efforts throughout Illinois. Complimentary continuing education credit opportunities will be available.