MedicaidAdministrativeHigh impact
Recovery Audit Contractor (RAC) Audits
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Apr 19, 2024
We identified it
Jun 20, 2026
Summary
Illinois has launched Recovery Audit Contractor (RAC) audits for Medicaid fee-for-service claims through HMS/Gainwell Technologies. Hospitals must respond to audit requests for medical records or face automatic overpayment determinations and potential sanctions.
Action Required
Immediately: Register for HMS Provider Portal at HMS - Portal / Login or call 855-699-6292. Verify contact address in IMPACT system is current or set up alternative address through HMS portal. Respond promptly to all HMS audit requests for medical records to avoid automatic overpayment findings and 60-day collection demands. Billing team and HIM directors must establish workflow for tracking audits through HMS portal.