MedicaidAdministrativeLow impact
Appeals Regarding Missing Payroll Based Journal (PBJ) Data
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Dec 19, 2025
We identified it
Jun 20, 2026
Summary
Illinois changed appeal rules for facilities with missing or suppressed Payroll Based Journal (PBJ) data. CNA incentive payments will be reduced by 10% per suppressed quarter, and nurse staffing add-on percentages will be reduced by 10 percentage points per suppressed quarter.
Action Required
No immediate action required for typical medical billing teams. This policy affects long-term care facilities' incentive payments and staffing calculations based on payroll reporting, not standard medical billing procedures.