MedicaidPrior AuthHigh impact
Resuming Pharmacy Prior Authorization System April 29, 2025
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Apr 29, 2025
We identified it
Jun 20, 2026
Summary
Illinois Medicaid's pharmacy prior authorization system will resume normal operations on April 29, 2025, after being offline since February 21, 2024 due to the Change Healthcare outage. All prior authorization requests submitted during the outage period must be resubmitted if patients continue to need those medications.
Action Required
By April 29, 2025: Billing team must prepare for resumption of Illinois Medicaid pharmacy prior authorization requirements. Resubmit any prior authorization requests originally submitted between February 21, 2024 and April 28, 2025 for patients who continue to need those medications. Update workflow to use phone (800-252-8942 or 877-782-5565) or fax (217-524-7264) for PA submissions. Verify extended PA expiration dates per the policy schedule. Claims for non-preferred medications and preferred medications requiring PA will be denied without proper authorization.