MedicaidAdministrativeHigh impact
Temporary System Outage for Fee-For-Service (FFS) Pharmacy Billing
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Feb 22, 2024
We identified it
Jun 20, 2026
Summary
Change Healthcare (Optum) is experiencing a nationwide outage affecting Illinois Medicaid pharmacy billing systems. All prior authorization requirements are temporarily suspended, and pharmacies should continue filling prescriptions up to 30-day supplies in good faith until the system is restored.
Action Required
Immediately: Pharmacy billing staff should continue processing Illinois Medicaid prescriptions without prior authorization checks, limiting fills to 30-day supplies maximum. Do not bill patients directly for covered services. Monitor system restoration announcements and prepare to resubmit claims once PBMS is operational. For eligibility verification, use MEDI system or call 800-252-8942.