Provider Notice Issued 07/25/2019

Facility Compliance in Completing the HFS 2270, Physician Certification Statement for Non-Emergency Transportation

​To: Enrolled Transportation Providers; Hospitals; and Long Term Care Facilities
​Date: ​July 25, 2019
​Re: Facility Compliance in Completing the HFS 2270, Physician Certification Statement for Non-Emergency Transportation

Pursuant to Public Act 100-0646, the Hospital Licensing Act, the Nursing Home Care Act and the Illinois Public Aid Code were amended to require completion of the standardized medical necessity form, HFS 2270 Physician Certification Statement (PCS). 

This notice serves to remind providers that this form is mandatory every time non-emergency transportation originates from a hospital or long term care facility via ground ambulance, medicar/wheelchair van or service car transport. Transportation providers should notify the Department in writing if they are not receiving accurately completed and signed PCS forms from these facilities. Please submit notification via email to hfs.transportation@illinois.gov.

The most recent version (07-19) of the HFS 2270 is on the Department’s website. An updated PowerPoint presentation on the completion of this form has been posted as well.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, or to the applicable HealthChoice Illinois managed care plan.

 

 

Doug Elwell
Medicaid Director


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