HFS Notices and Policies
The Illinois Department of Healthcare and Family Services (HFS) is a key resource for important provider notices and policies. Updates from IHA policy experts will also be posted here.
New Medicaid Add-on Payment: Emergency Dept. Opioid Treatment
HFS has issued a Provider Notice updating guidance on coverage and reimbursement for the initiation of medication for the treatment of MOUD in a hospital ED setting.
HFS-IHA Webinar on Recovery Audits
IHA hosted a joint webinar with the Dept. of Healthcare and Family Services, the Department’s Office of the Inspector General, and the OIG’s Recovery Audit Contractor, HMS Gainwell, on Nov. 1, 2023.
HFS Rate Year 2022 Safety Net Hospital Determination
The Illinois Department of Healthcare and Family Services has posted the annual Safety Net Hospital determinations effective Oct. 1, 2021.
HFS Directed Payment and Passthrough Calculations Posted on HFS Website
The Illinois Department of Healthcare and Family Services has issued a notice announcing that the Oct. – Dec. MCO Hospital Access Program Payments have been posted to its website.
HFS Updated Inpatient and Outpatient Pricing Calculations
The Illinois Department of Healthcare and Family Services (HFS) has posted updated inpatient and outpatient pricing calculators effective July 1, 2021.
HFS COVID-19 Vaccine Administration Performed in Hospital-Based Outpatient Settings
HFS posted a Provider Notice informing hospitals that it will cover vaccine administration costs, specifically in hospital-based outpatient settings.
Hospital and Healthcare Transformation Update No. 5 Transformation Program App.
HFS has released a Provider Notice announcing the Healthcare Transformation Collaboratives Program that includes the Application for Funding Healthcare Transformation Collaboratives.
Health Benefits for Immigrant Seniors
HFS issued a Provider Notice (Dec. 11, 2020) to implement a new, state-only funded Medicaid eligibility category—Health Benefits for Immigrant Seniors.
HFS CARES Portal is Open
HFS has posted a Provider Notice announcing that the HFS CARES Portal is now open for CURE Fund applications.
HFS Billing Guidance: Lab Testing and Claims Submittal Related to COVID-19
HFS posted a Provider Notice updating information regarding its upcoming deployment of an online portal that will allow providers to bill for COVID-19 testing services for patients.
FY2021 Disproportionate Share Hospital (DSH) Determination
HFS posted a Provider Notice on the completion of the annual Disproportionate Share Hospital determination, as well as the annual Medicaid Percentage and Medicaid High Volume Adjustments.
Hospital Assessment – UPDATED Tax Due Date & July Payment Updates
HFS issued a provider notice, stating that the updated due date for the July 2020 hospital assessment tax is now August 14, 2020.
Hospital Assessment Payment Banking Information
This is a list of hospitals which need to provided banking information to MCOs to facilitate assessment payments.
HFS Notices Issued in May 2020 through June 2020
In May through June 2020, the Department of Healthcare and Family Services issued several notices that may or will impact hospitals.
HFS Proposed Rules on Reimbursement for Days beyond Medical Necessity
This memo summarizes an HFS proposed rule on reimbursement to hospitals for stays beyond medical necessity and IHA’s concerns.
Correction 2Q 2020 MCO-HAP Payments
HFS released a notice that identifies a correction process for the Quarter 2 2020 managed care organization hospital access program payments (MCO-HAP).
FAQs on Hospital Professional Billing Transition to the Outpatient Institutional Billing
The Illinois Department of Healthcare and Family Services (HFS) has posted a new document, FAQs for Hospital Professional Billing Transition to the Institutional Claim Format.
Hospital Professional Billing Transition to the Outpatient Institutional Billing
HFS: all hospital OP services billed on a professional claim and paid under the Practitioner Fee Schedule will be billed on an institutional claim and reimbursed at EAPG, effective July 1, 2020.
HFS Notices Issued in March 2020 through April 2020
The Department of Healthcare and Family Services (HFS) has issued several notices that may impact hospitals.
CMS Issues Partial Approval of Medicaid COVID-19 Section 1135 Waiver Request
CMS issued partial approval of the Section 1135 request to waive certain federal Medicaid, CHIP, and HIPAA regulations during the COVID-19 public health emergency.
COVID-19 Proposed Medicaid Eligibility & Enrollment Changes
To expand access to coverage during COVID-19, HFS submitted formal requests to CMS to modify the CHIP eligibility and enrollment processes.
COVID-19 Behavioral Health Update
See several new updates concerning COVID-19 and hospital and health system behavioral healthcare.
HFS Notices Issued in December 2019 through February 2020
The Department of Healthcare and Family Services (HFS) has issued several notices that may impact hospitals. IHA also sent memos to members concerning some of these notices.
HFS Notices Issued in September through Mid-November 2019
Between September and mid-November 2019, HFS issued several notices that may impact hospitals. IHA sent memos to members concerning some of these notices.
Federal Fiscal Year 2020 Safety Net Determination
HFS posted a new provider notice regarding Federal Fiscal Year 2020 Safety Net Determination.
Attending Provider NPI Requirements Delay to November 1, 2019
On Sept. 23, 2019, HFS released two notices: 1) Attending Provider NPI Requirements Delay to November 1, 2019; and 2) Ordering/Referring/Prescribing Provider Enrollment and Provider Directory.
HFS Distribution of Rate Year 2020 DSH, MPA and MHVA Determination & Rates
HFS posted the Rate Year 2020 DSH, MPA and MHVA determination and rates on its website. HFS will not mail these notification letters. Please review your calculations in detail.
ABE Partner Portal Report of Birth is Live
The Report of Birth functionality in the Application for Benefits Eligibility Partner Portal is now live. The HFS notice includes frequently asked questions.
HFS Notices Issued in July and August 2019
HFS has issued several notices that may impact hospitals. IHA has sent memos to members concerning some of these notices.
HFS FY2020 Hospital Inpatient & Outpatient Assessment Program Notice
HFS has posted a notice indicating that it has mailed each hospital the facility’s inpatient and outpatient assessment remittance notices for FY2020.
Payments Linked to or Requiring the Provision of OB Services
This document outlines specific Medicaid payments that are contingent on providing inpatient obstetrical services.
HFS Notices Issued May-June 2019
The Illinois Dept. of Healthcare and Family Services released notices on numerous issues, including ABE, NPI requirements, APR-DRG and EAPG, and MMAI.
HFS Delays Medicaid Ordering/Referring/Prescribing NPI Requirement
The Illinois Dept. of Healthcare and Family Services (HFS) has informed IHA that it will delay until October 1, 2019 implementation of the ordering, referring, prescribing (ORP) requirement.
HFS Update: New Inpatient APR-DRG and Outpatient EAPG Grouper Version
The Illinois Dept. of Healthcare and Family Services announced it will use Grouper Version 3.13 of the Enhanced Ambulatory Patient Groups (EAPG) payment system.
HFS Notices and Notifications Issued Nov.-Dec. 2018
The Illinois Dept. of Healthcare and Family Services released notices on numerous issues, including Integrated Health Homes, NPI requirements and non-emergency ambulance transfers.
HFS Notices and Notifications Issued Late August through October
The Illinois Dept. of Healthcare and Family Services released notices on a Hospital Assessment payment extension, FFY2019 DSH and Safety Net determinations and other issues from Aug-Oct.
Fee-for-Service ACA Hospital Access Payments and ACA Assessment Reconciliation Adjustment
HFS has informed IHA that the state has also received approval from CMS to pay the Fee-for-Service ACA payments.
HFS Notice: Changes to Hospital Inpatient and Outpatient Reimbursement Systems
HFS notice regarding changes applicable to fee-for-service payments effective with dates of service on and after July 1, 2018.