MedicaidReimbursementLow impact
Outpatient Adjustments Related to EAPG Software Issue
Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
We identified it
Jun 20, 2026
Summary
Illinois Medicaid had a software issue that incorrectly discounted some procedure revenue lines on multi-day emergency room and observation claims from August 1, 2023 onwards. The state will automatically identify and adjust all impacted claims with no action required from providers.
Action Required
No action required. Illinois Department of Healthcare and Family Services will automatically identify and adjust all impacted claims. Monitor future remittance advice for adjustment payments on previously submitted outpatient emergency room and observation claims.