MedicaidPrior AuthMedium impact
Confirmation of Coverage for Continuous Glucose Monitors in Compliance with Public Act 103-0639
Illinois Medicaid - HFS·IL · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now guarantees approval of continuous glucose monitor (CGM) prior authorization requests for at least 12 months for any type of diabetes, effective July 1, 2024. This applies to both Medicaid fee-for-service and managed care organizations in compliance with Public Act 103-0639.
Action Required
Immediately: Billing team should update prior authorization processes for continuous glucose monitors for Illinois Medicaid patients. When submitting CGM prior auth requests, ensure documentation includes diabetes type and request minimum 12-month approval period. Contact Illinois Medicaid at 877-782-5565 for fee-for-service claims or appropriate MCO for managed care questions.