Provider Notices

Provider notices and bulletins contain pertinent information for participating providers for medical services provided or for claims submitted for reimbursement.

 
Notices inform providers and billing agents of possible revisions or clarifications of medical services. Bulletins include information about general policy and procedural updates for the various provider handbooks issued by the department.
 

 

To filter Provider Notices by specific Provider Category, by Notice Year, or to apply both Filters simultaneously, please click the dropdown for the desired Filter(s), choose the desired value, and click Apply Filter. To apply both Filters simultaneously, you must click Apply Filter separately for each Filter. To remove all filters, click the Clear All Filters button.

Please note that when you filter by category, all Provider Notices tagged with your chosen Provider Category will be returned, including those that apply to multiple Provider Categories.

 
 

 

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Notices

 

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201710/17/2017prn171017aUtilization Review Update Effective December 1, 2017Hospitals
201710/5/2017prn171005bAnnual Rate Changes Effective October 1, 2017 Hospice
201710/4/2017prn171004aNew Third Party Liability (TPL) Code for MAP November 1, 2017Ambulatory Surgical Treatment Centers; Hospitals; Renal Dialysis Clinics
201710/3/2017prn171003aLTC Monthly Occupied Bed Provider Assessment Long Term Care
201710/3/2017prn171003bRenal Dialysis Add-On Payment Retroactive to Dates of Service Beginning July 1, 2015Hospitals; Renal Dialysis Clinics
20179/29/2017prn170929aDistribution of Fiscal Year 2018 Disproportionate Share Hospital (DSH) DeterminationHospitals
20179/29/2017prn170929bFederal Fiscal Year 2018 Safety Net DeterminationHospitals
20179/20/2017prn170920aInformation Regarding the Implementation of the Personal Needs Allowance (PNA) Increase Effective July 1, 2017Long Term Care
20179/8/2017prn170908aFiscal Year 2018 Provider Assessment ProgramLong Term Care
20179/8/2017prn170908bFiscal Year 2018 Long Term Care Provider AssessmentLong Term Care
20179/8/2017prn170908cDue Date for Payment of the Quarterly Licensed Bed AssessmentLong Term Care
20179/8/2017prn170908dChapter 100, Handbook for Providers of Medical Services, General Policy and Procedures - ReissueAll Medical Assistance Providers
20179/7/2017prn170907bReimbursement Rate Increase Effective July 01, 2017Supportive Living
20179/7/2017prn170907cReimbursement Rate Increase Effective July 1, 2017Long Term Care
20179/7/2017prn170907dWage Rate Increase Effective August 1, 2017 for Specified Personnel Serving Individuals with Developmental Disabilities in Institutional and Community-Based SettingsLong Term Care; Waiver
20178/29/2017prn170829aPersonal Needs Allowance (PNA) Increase Effective July 1, 2017Long Term Care
20178/23/2017prn170823aSelf-Disclosure ProtocolAll Medical Assistance Providers
20178/3/2017prn170803aMonthly Occupied Bed Provider Assessment Long Term Care
20178/1/2017prn170801bDental EncountersFederally Qualified Health Centers; Encounter Rate Clinics; Rural Health Clinics
20177/18/2017prn170718a Vaccines for Children (VFC) program - Private Stock Vaccines (Title XXI) Funding Extended Through June 30, 2018 for Title XXI and State-funded EnrolleesAll Medical Assistance Providers
20177/18/2017prn170718bTransition of Cigna-HealthSpring Integrated Care Program (ICP) EnrolleesAll Medical Assistance Providers
20177/17/2017prn170717aLocal Education Agencies (LEA) Payment Error Rate Measurement (PERM) Audit Findings and Claim ChangesLocal Education Agencies
20177/17/2017prn170717bPharmacy Influenza Vaccine Administration Fee - Billing Instructions Update Pharmacies
20177/14/2017prn170714aOfficial FY 18 Hospital Access Improvement Payments ScheduleHospitals
20177/14/2017prn170714b​Updates to Critical Access Hospital EAPG Standardized Amount
20177/7/2017prn170707aChanges to the Face-to-Face Encounter Requirements for the Initial Ordering of Home Health Services; New Face-to-Face Encounter Requirements for the Initial Ordering of Durable Medical Equipment (DME) under the Home Health BenefitHome Health Agencies; Durable Medical Equipment Suppliers; Physicians; Nurses
20177/6/2017prn170706aStimulants/ADHD Agents Update to Preferred Drug List (PDL)Pharmacies
20177/6/2017prn170706bMoney Follows the Person Demonstration:  Illinios Pathways to Community Living ProgramAll Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
20176/29/2017prn170628aFiscal Year 2018 Hospital Inpatient and Outpatient Assessment ProgramsHospitals
20176/29/2017prn170628bMonthly Occupied Bed Provider Assessment Long Term Care
20176/26/2017prn170620aPsychiatric Services Provided Within Community Mental Health Centers (CMHCs) Extended Through December 31, 2017Community Mental Health Providers; Physicians
20176/23/2017prn170623a2017 Long Term Care (LTC) Cost Report Forms and InstructionsLong Term Care; Nurses
20176/19/2017prn170619aAnnual Provider Blood Lead Screening ReportAll Medical Assistance Providers
20176/8/2017prn170608aDue Date for Payment of the Quarterly Licensed Bed AssessmentLong Term Care
20175/18/2017prn170518aProvider Enrollment Changes for Nursing Facilities Billing for OxygenLong Term Care
20175/18/2017prn170518bDurable Medical Equipment (DME) Prior Approval Process with Transition from Managed Care Organization (MCO) to Healthcare and Family Services (HFS)All Medical Assistance Providers
20175/10/2017prn170510aDepartment of Human Services Medical Field Operations ChangesLong Term Care; Supportive Living
20175/5/2017prn170505aExtension in Due Date for Payment of the Monthly Occupied Bed Provider AssessmentLong Term Care
20174/11/2017prn170411aExtension in Due Date for Payment of the Monthly Occupied Bed Provider AssessmentLong Term Care
20174/7/2017prn170407aMedicaid Managed Care TransformationAll Medical Assistance Providers
20174/7/2017prn170407bFamily Health Population (FHP) Program - Central Illinois Region Suspension of Mandatory Managed Care UpdatesAll Medical Assistance Providers
20174/7/2017prn170407cMedicare-Medicaid Alignment Initiative (MMAI) - Central Illinois Region Managed Care UpdatesAll Medical Assistance Providers
20174/7/2017prn170407dIntegrated Care Program (ICP) - Central Illinois Region Suspension of Mandatory Managed Care UpdatesAll Medical Assistance Providers
20174/6/2017prn170406aRate Year 2018 Determination for Disproportionate Share, Medicaid Percentage Adjustment, and County Trauma Center Adjustment PaymentsHospitals
20174/4/2017prn170404aPre-Admission Screening Process for Long Term Care AdmissionsLong Term Care
20174/3/2017prn170403aCurrent Procedural Terminology (CPT) Codes and Reimbursement Rates for Physical and Occupational Therapy Evaluations Effective January 1, 2017Hospitals; Physicians; Local Health Departments; Rural Health Clinics; Encounter Rate Clinics; Federally Qualified Health Centers; Community Mental Health Providers; Therapists
20173/30/2017prn170330aChapter HK-200, Handbook for Providers of Healthy Kids Services – Re-issue All Medical Assistance Providers; All Kids Application Agents Instructions & Alerts; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Optometrists; Nurses; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; Supportive Living; School Based/Linked Health Center Services; Therapists; Transportation Providers; Waiver
20173/24/2017prn170324bProvider Drug Prior Approval Hotline - Extended HoursDentists; Hospitals; Nurses; Optometrists; Pharmacies; Physicians; Podiatrists
20173/22/2017prn170322aREMINDER - Point of Sale (POS) System Outage & New POS Payor Sheet Dentists; Hospitals; Nurses; Optometrists; Podiatrists; Pharmacies; Physicians
20173/20/2017prn170320bREMINDER - Point of Sale (POS) System Outage & New POS Payor SheetDentists; Hospitals; Optometrists; Nurses; Pharmacies; Physicians; Podiatrists
20173/20/2017prn170320cChapter O-200, Handbook for Providers of Optometric Services - ReissueOptometrists; Physicians
20173/16/2017prn170316aPoint of Sale System Outage and New POS Payor SheetPharmacies; Physicians; Dentists; Optometrists; Podiatrists; Hospitals; Nurses
20173/10/2017prn170310bInstitutional Paper Claims Technical Guidelines Hospitals; Ambulatory Surgical Treatment Centers; Renal Dialysis Clinics; Hospice
20173/8/2017prn170308aDue Date for Payment of the Quarterly Licensed Bed AssessmentLong Term Care
20173/2/2017prn170302aElectronic Health Records (EHR) Incentive Program Attestation Extension Physicians; Nurses; Optometrists; Dentists
20172/15/2017prn170215a Managed Care Organization (MCO) Provider PortalAll Medical Assistance Providers
20172/14/2017prn170214aHospital Cost Report Forms and InstructionsHospitals
20172/9/2017prn170209cNew Web-Based Medical Record Submission Process for Retrospective Pre-Payment and Post-Payment Utilization Review Effective with Dates of Notice Beginning April 11, 2017Hospitals
20172/8/2017prn170208aPharmacy Benefits Management System (PBMS) Registration for Pharmacy Pilot Testing Pharmacies
20172/8/2017prn170208bMonthly Occupied Bed Provider Assessment Extension in Due Date for PaymentLong Term Care
20172/7/2017prn170207aPharmacy Pilot Testing of Pharmacy Benefits Management System (PBMS)Pharmacies
20171/23/2017prn170123aChanges to Current Procedural Terminology (CPT Codes)Therapists; Physicians; Nurses; Local Health Departments; Home Health Agencies; Hospitals
20171/17/2017prn170117aVaccines for Children (VFC) program - Private Stock Vaccines (Title XXI)All Medical Assistance Providers
20171/17/2017prn170117bNew Orthodontia Scoring ToolDentists
20171/13/2017prn170113aMonthly Occupied Bed Provider Assessment Due Date ExtensionsLong Term Care
20171/13/2017prn170113bUpdated Hospital Rate Sheets and Payment CalculatorsHospitals
20171/10/2017prn170110aImplementation of the Requirement for Long Term Care providers to Submit Monthly Billing for Reimbursement PurposesLong Term Care
201612/29/2016prn161229aNew Outpatient EAPG Grouper Version and Updates to Hospital Reimbursement Components Effective January 1, 2017Hospitals
201612/28/2016prn161228bPharmacy Claim Submissions with Incorrect Prescribing Provider Information Pharmacies
201612/28/2016prn161228aFee-For-Service Reimbursement for Licensed Clinical Psychologist (LCP) or a Licensed Clinical Social Worker (LCSW)All Medical Assistance Providers; All Kids Application Agents Instructions & Alerts; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201612/21/2016prn161221aPharmacy Benefit Management System (PBMS) Updates – New Payor Sheet and Prescriber Enrollment Requirement Pharmacies; Physicians; Dentists; Podiatrists; Optometrists; Hospitals; Nurses
201612/16/2016prn161216aPrevention of Spousal Impoverishment Standards for 2017 Long Term Care; Supportive Living
201612/13/2016prn161213aExtension in Due Date for Payment of the Monthly Occupied Bed Provider AssessmentLong Term Care
201612/9/2016prn161209bBilling Instruction Changes for Observation ServicesHospitals; Ambulatory Surgical Treatment Centers
201612/8/2016prn161208aIMPACT Provider Revalidation Termination ActionsAll Medical Assistance Providers; All Kids Application Agents Instructions & Alerts; Ambulatory Surgical Treatment Centers; Waiver; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers
201612/7/2016prn161207aIntegrated Care Program (ICP) - Central Illinois Region Temporary Suspension of Mandatory Managed Care All Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201612/7/2016prn161207bFamily Health Plan (FHP) Program - Central Illinois Region Temporary Suspension of Mandatory Managed Care All Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201612/7/2016prn161207cUtilization Review UpdateHospitals
201612/5/2016prn161205aAnnual Rate Changes Effective October 1, 2016Hospice
201611/15/2016prn161115aEpinephrine Auto Injector Update to Preferred Drug List (PDL)Pharmacies; Physicians; Dentists; Podiatrists; Optometrists; Hospitals
201611/10/2016prn161110aMonthly Occupied Bed Provider Assessment Long Term Care
201611/9/2016prn161109aChapter D-200, Handbook for Providers of Encounter Clinic Services - Vaccination Billing InstructionsFederally Qualified Health Centers; Encounter Rate Clinics; Rural Health Clinics
201611/9/2016prn161109bRevised Statewide Transition Plan for Home and Community-Based Settings All Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201611/7/2016prn161107aChapter K-200, Handbook for Hospice Agencies - ReissueHospice
201611/4/2016prn161104aHOSPITAL PROVIDER ASSESSMENT NOTICEHospitals
201610/27/2016prn161027aDis-Enrollment of Health Alliance Connect Family Health Plan (FHP) Program EnrolleesAll Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201610/27/2016prn161027bDis-Enrollment of Health Alliance Connect Integrated Care Program (ICP) EnrolleesAll Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201610/24/2016prn161024aRequirement for Long Term Care Providers to Submit Monthly Billing for Reimbursement Purposes – Delayed ImplementationLong Term Care; Supportive Living
201610/19/2016prn161019aPsychiatric Services Provided Within Community Mental Health Centers (CMHCs) -CLARIFICATIONPhysicians; Nurses; Community Mental Health Providers
201610/18/2016prn161018aHandbook for Providers of Practitioners Rendering Medical Services - Reissue All Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
201610/18/2016prn161018bClarification Regarding Record Requirements for Therapy Services in Individualized Education Programs (IEPs)School Based Health Services
201610/18/2016prn161018cChapter F-200, Handbook for Providers of Podiatric Services - ReissuePodiatrists
201610/18/2016prn161018dChapter B-200, Handbook for Providers of Chiropractic Services - ReissueChiropractors
201610/14/2016prn161014aMonthly Occupied Bed Provider Assessment Due Date ExtensionLong Term Care
201610/14/2016prn161014bVaccines for Children (VFC) Program Transition – Billing 317-Funded Vaccines Federally Qualified Health Centers; Rural Health Clinics; Encounter Rate Clinics
201610/14/2016prn161014cVaccines for Children (VFC) Program Transition – Billing 317-Funded VaccinesPhysicians; Nurses; Local Health Departments; School Based/Linked Health Center Services; Local Education Agencies
201610/13/2016prn161013aPsychiatric Services Provided Within Community Mental Health Centers (CMHCs)  Physicians; Community Mental Health Providers
201610/13/2016prn161013bEnhanced Payment for Psychiatric Services Provided Within Community Mental Health Centers (CMHCs) Community Mental Health Providers
201610/12/2016prn161012aService Definition and Reimbursement Guide (SDRG), ReissueAll Kids Application Agents Instructions & Alerts; All Medical Assistance Providers; Ambulatory Surgical Treatment Centers; Audiologists; Chiropractors; Community Mental Health Providers; Dentists; Department of Alcohol and Substance Abuse Provider; Durable Medical Equipment Suppliers; Early Intervention Services; Encounter Rate Clinics; Federally Qualified Health Centers; Home Health Agencies; Hospice; Hospitals; Imaging Centers; Laboratory; Local Education Agencies; Local Health Departments; Long Term Care; Nurses; Optometrists; Other Governmental Payors; Pharmacies; Physicians; Podiatrists; Renal Dialysis Clinics; Rural Health Clinics; School Based Health Services; School Based/Linked Health Center Services; Supportive Living; Therapists; Transportation Providers; Waiver
20169/30/2016prn160930aFFY17 Safety Net DeterminationHospitals
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