REMINDER: June 30 Termination of HBIA Program
The Health Benefits for Immigrant Adults (HBIA) program operated by the Illinois Dept. of Healthcare and Family Services (HFS) will terminate after June 30, 2025. Individuals enrolled in the HBIA program will no longer have HBIA coverage through HFS after June 30, 2025. In an April 1, 2025
provider notice, HFS provided a list of resources available that may provide assistance to your patients who lose coverage under the program. Please see the provider notice for additional details. HFS also stated that providers should continue to check HFS eligibility after June 30, 2025, as former HBIA customers may have become eligible for another type of coverage and moved to another medical program. The Health Benefits for Immigrant Seniors (HBIS – ages 65+) program will continue and customer benefits will not change.
HHS Hosts Prior Authorization Roundtable with Payers
Yesterday, the U.S. Dept. of Health and Human Services (HHS)
hosted a roundtable with national health insurance payers to discuss their
pledge to streamline and improve the prior authorization process for Medicare Advantage, Medicaid Managed Care, Health Insurance Marketplace and commercial plans. The commitments payers pledged to uphold reinforce and build off of requirements outlined in the CMS Interoperability and Prior Authorization
rule finalized in January 2024.
Participating payers pledge to:
- Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces;
- Reduce the volume of medical services subject to prior authorization by Jan. 1, 2026;
- Honor existing authorizations during insurance transitions to ensure continuity of care;
- Enhance transparency and communication around authorization decisions and appeals;
- Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027; and
- Ensure medical professionals review all clinical denials.
Participating companies and applicable plan types cover approximately eight in 10 Americans. Changes are scheduled to be implemented over the next two plan years.
DEADLINE TOMORROW: Average Commercial Rate Data Due June 25
The Illinois Dept. of Healthcare and Family Services (HFS) and Milliman are currently collecting Average Commercial Rate (ACR) data from all Illinois hospitals to demonstrate that payments made to hospitals through the managed care program do not exceed the ACR—a requirement for continuing state directed payments under the Hospital Assessment Program (HAP).
Hospitals must submit their ACR survey data to HFS no later than tomorrow, June 25, to continue receiving HAP funding.
Click here for additional background and to view IHA memos on this topic, access webinar recordings, view the ACR data collection document, and open job aid upload instructions and an FAQ document. You must be registered on the IHA website to access these items.
DHS Issues Cybersecurity Advisory Due to Activity in Iran
The U.S. Dept. of Homeland Security (DHS) yesterday issued a
National Terrorism Advisory System bulletin about the potential for Iranian-related, low-level cyber attacks against the U.S. The bulletin called for increased vigilance against potential physical and cyber threats, either directed by the Iranian government or carried out by ideologically motivated individuals acting independently. The advisory also warned that poorly secured networks and internet-connected devices in the U.S. could be targeted. However, no specific or credible threats have been identified at this time.
You are encouraged to share the bulletin across your organization and monitor the
CISA Iran threat website for cyber threat analysis and threat mitigation recommendations.
The Illinois Dept. of Public Health (IDPH) has a weekly Infectious Respiratory Disease Surveillance Dashboard that is updated weekly on Friday. This report provides the public with the latest data on hospital visits, seasonal trends, lab test positivity and demographic data.
Click here to visit the IDPH COVID-19 resources webpage. IDPH will continue to report the weekly number of people with COVID-19 admitted to hospitals from emergency departments, deaths and vaccinations, with COVID-19, influenza and respiratory syncytial virus information also reported through the dashboard of the Illinois Wastewater Surveillance System.
Briefly Noted
According to the Food and Drug Administration (FDA), GE HealthCare has
issued a correction for certain Carestations due to the risk that they may not provide effective ventilation when used in Volume Control Ventilation (VCV) mode. The use of affected product may cause serious adverse health consequences, including failure of ventilation resulting in hypoxia (inadequate oxygen levels) and death. At this time, GE HealthCare has not reported any serious injuries or deaths related to this issue.
The FDA also
highlighted that Medline Industries LP is correcting certain lots of their medical procedure kits containing recalled Medtronic Aortic Root Cannulas due to potential excess material in the male luers. Using the affected products may cause serious adverse health consequences, including procedure delay, neurological deficits/stroke (reversable and irreversible), and death. At this time, there have been no serious injuries or deaths related to this issue.
Leading the News
Gov. JB Pritzker to announce campaign for third term Thursday: sources
Chicago Sun-Times
Gov. JB Pritzker will announce his campaign for a third term as Illinois governor on Thursday, sources told the Sun-Times. He’ll make his third consecutive statewide campaign official with reelection campaign kickoff events in Chicago and Springfield, as invitations were circulating to supporters early in the week.
Pritzker OKs changes to Prisoner Review Board following years of controversy
WSIU
Gov. JB Pritzker signed a new law Friday to make a series of changes to the Prisoner Review Board after it released a man who would go on to commit murder, leading to intense scrutiny in Springfield.
5 key patient safety priorities in 2025
Becker’s Hospital Review
Health systems are navigating a rapidly evolving healthcare environment where patient safety is shaped by both longstanding challenges and emerging risks. From the accelerated adoption of artificial intelligence to rising care complexity and capacity constraints, healthcare leaders are reexamining how safety and quality are defined, measured and sustained.
Monthly weight loss drug helps people lose 20% of body weight, trial finds
NBC News
A monthly weight loss drug from Amgen helped people lose about 20% of their body weight, according to the results of a phase 2 clinical trial. If approved, the drug, called MariTide, could make Amgen the first new entrant into a market that’s been dominated by Novo Nordisk, which makes Ozempic and Wegovy, and Eli Lilly, which makes Mounjaro and Zepbound.
