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Illinois Medicaid - HFSMedicaid · Administrative · Provider Notice · IL · GeriatricsHigh impact

PERM Audit Findings – Long Term Care

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026

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.

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What to do

immediately · 4 steps
01Verify all ordering providers listed on long-term care claims are enrolled in Illinois Medicaid program before claim submission.
02For all Intermediate Care Facility (ICF) services, ensure ordering provider's NPI is included on every claim.
03Update billing system to validate provider enrollment status and NPI presence before submission.
04Contact Bureau of Long-Term Care at 1-844-528-8444 with questions.
If missed: Failure to comply will result in automatic claim rejections.

Original notice

PERM Audit Findings – Long Term Care
hfs.illinois.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

Illinois Medicaid - HFS policiesIL policy changesGeriatrics

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