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PERM Audit Findings – Long Term Care

Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

Illinois Medicaid's PERM audit found that long-term care facilities are submitting claims with unenrolled ordering providers and missing NPIs for ICF services. A new claim edit will be implemented to automatically reject claims from unenrolled providers, and all ICF claims must include the ordering provider's NPI.

Action Required

Action needed
Immediately: Verify all ordering providers listed on long-term care claims are enrolled in Illinois Medicaid program before claim submission. For all Intermediate Care Facility (ICF) services, ensure ordering provider's NPI is included on every claim. Update billing system to validate provider enrollment status and NPI presence before submission. Contact Bureau of Long-Term Care at 1-844-528-8444 with questions. Failure to comply will result in automatic claim rejections.

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