Enrollment Requirements Resume August 1 for Health Professionals Who Order, Refer or Prescribe to Medicaid Beneficiaries

medicaidAs a result of the COVID-19 public health emergency, the Illinois Department of Healthcare and Family Services (HFS) waived the requirement that health professionals who order, refer or prescribe to Medicaid beneficiaries be enrolled with Illinois Medicaid.

HFS also requested a waiver through the Centers for Medicare and Medicaid Services (CMS) to temporarily cease this requirement. However, this waiver request was not approved by CMS.

Therefore, effective with claims received starting Aug. 1, 2020, HFS will resume this requirement, which applies to claims for both managed care and traditional fee-for-service participants.

Please note: If you were not enrolled with Illinois Medicaid at the start of the public health emergency and would like to continue providing these services, you must enroll in the Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system.

If you have questions, please contact HFS by calling 877-782-5565.

  You may also contact the ISMS Health Policy Research and Advocacy team with questions at 800-782-4767 ext. 1470, or by email.

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