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HFS: Prior Approval Now Needed for Non-Emergency Ambulance Services
Posted on: 7/12/2013

Effective July 1, 2013

The Illinois Department of Healthcare and Family Services (HFS) has implemented new requirements for prior approval of non-emergency ambulance services. 

Essentially, due to the Save Medicaid Access and Resources Together (SMART) Act, HFS now requires completion of a Medical Certification for Non-Emergency Ambulance (MCA) form for patients covered under Illinois' medical assistance program, who upon discharge require medically supervised ground ambulance services. The form must specify the level of ground ambulance services needed, and establish that the patient's condition meets the department's criteria for approval of non-emergency ambulance service.

Full details are available on the HFS website. Direct questions regarding this requirement to the Bureau of Comprehensive Health Services at 877-782-5565, option 3, and then option 3.

ISMS members may request further assistance by contacting the Advocacy team via email or calling 800-782-4767.

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