MedicaidAdministrativeHigh impact
Changes to Third-Party Liability Recovery Processes
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 1, 2026
We identified it
Jun 16, 2026
Summary
Illinois Medicaid is implementing a new Third-Party Liability Electronic Database System (TED) effective May 1, 2026, changing how providers handle Medicare primary billing and third-party insurance recovery. When Medicaid identifies Medicare as primary or retroactive third-party coverage, providers will receive notices requiring them to rebill the primary carrier within specific timeframes.
Action Required
By May 1, 2026: Update billing workflows to handle new TED system notices. When receiving Medicare primary notices, billing team has 6 months from void date to bill Medicare as primary. For retroactive third-party coverage notices, providers must adjust original Medicaid claims and rebill primary coverage within 60 days for medical claims identified within 5 months of DOS and pharmacy claims within 2 months of DOS. Failure to respond in 60 days results in automatic voiding. Contact TPL Unit at (217) 524-2490 or hfs.tpl.1442@illinois.gov for coverage discrepancies.