MedicaidPrior AuthMedium impact
Health Benefits for Immigrant Adults (HBIA) and Seniors (HBIS) 90-Day Nursing Facility Rehabilitation Stay Coverage by Managed Care Organizations (MCOs)
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Starting January 1, 2024, HBIA and HBIS patients transitioning to managed care will have 90-day nursing facility rehabilitation stays covered by MCOs, requiring initial 30-day prior authorization. Nursing facilities must use specific rehabilitation revenue codes (0118, 0128, 0138, 0148, or 0158) and cannot enter these patients in MEDI system.
Action Required
Immediately: Nursing facilities must obtain 30-day prior authorization for HBIA/HBIS rehabilitation stays and bill using revenue codes 0118, 0128, 0138, 0148, or 0158. Do not enter these patients in MEDI system or patient credit file. Coordinate with MCOs to ensure discharge within 90 days as no payments will be made after 90 days.