MedicaidAdministrativeMedium impact
Provisional Eligibility for Long Term Care Services
Illinois Medicaid - HFS·IL · Geriatrics, Internal Medicine·Provider Notice
Effective date
Oct 18, 2023
We identified it
Jun 20, 2026
Summary
Illinois has reimplemented the Provisional Eligibility process for Long Term Care (LTC) Medicaid applications that exceed 45-day processing timeframes. This allows LTC providers to submit claims for reimbursement more quickly while applications are still pending, with monthly processing to identify and approve eligible individuals.
Action Required
Billing teams at LTC facilities in Illinois should monitor for Provisional Eligibility determinations processed monthly by HFS. Direct questions about the process to hfs.ltc.mediadmissions@illinois.gov. Review the HFS Long Term Services and Supports webpage for detailed process information and ensure claims submission procedures accommodate provisionally eligible patients.