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Illinois Medicaid - HFSMedicaid · Administrative · Provider Notice · ILHigh impact

Changes to Third-Party Liability Recovery Processes

Act
by May 1, 2026
Effective date
May 1, 2026
Identified
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.

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What to do

by May 1, 2026 · 5 steps
01Update billing workflows to handle new TED system notices.
02When receiving Medicare primary notices, billing team has 6 months from void date to bill Medicare as primary.
03For 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.
04Failure to respond in 60 days results in automatic voiding.
05Contact TPL Unit at (217) 524-2490 or hfs.tpl.1442@illinois.gov for coverage discrepancies.

Original notice

Changes to Third-Party Liability Recovery Processes
hfs.illinois.gov · Always check the source before changing claims.
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Illinois Medicaid - HFS policiesIL policy changes

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