Illinois joint CMS-State sponsored Medicare-Medicaid Alignment Initiative (MMAI)
Humana Gold Plus® Integrated Medicare-Medicaid plan prior authorization and notification lists
The document below lists services and medications for which preauthorization may be required for Humana Gold Plus Integrated (Medicare-Medicaid) members. Please review the detailed information atop each list regarding exclusions and other important information before submitting a preauthorization request.
You can also download , opens new window of the prior authorization and notification list.
Humana Gold Plus Integrated (Medicare-Medicaid) Pharmacy Materials
Stakeholder Advisory Committee
We invite community partners and stakeholders to join a quarterly virtual Stakeholder Advisory Committee. During our meetings, we encourage participants to:
- Provide feedback on how we’re doing as a health plan
- Share insights into how we can better serve our members
Medicaid Hospice Benefit Election
The Illinois Department of Healthcare and Family Services (HFS) requires the submission of the Medicaid Hospice Benefit Election Standardized Form to HFS for patients with Medicaid and dual Medicare-Medicaid coverage who elect hospice care. Hospice providers must complete the form for each hospice patient. , opens new window.
This form also must be submitted to HFS when a patient dies, ceases hospice care or transfers to another hospice. Use of this form is mandatory. Hospices are asked to allow two weeks after submittal of the HFS 1592 before submitting a claim.
Please visit Illinois government’s , opens new window for other Illinois Medicaid forms.
If a patient is covered under an HFS-contracted managed care entity (MCE), hospice providers also must submit a copy of the HFS 1592 form to the MCE.
For patients with Humana Gold Plus Integrated coverage via Humana, please submit a copy of the HFS 1592 form to Humana using one of the following methods:
Questions regarding this notice should be directed to the hospice’s billing consultant in the Bureau of Comprehensive Health Services at 877-782-5565.