MedicaidCoverageMedium impact
End of Synagis Season Effective February 28, 2023
Illinois Medicaid - HFS·IL · Pediatrics, Pharmacy·Provider Notice
Effective date
Feb 28, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is ending Synagis (RSV prevention medication) coverage season effective February 28, 2023, due to decreased RSV incidence. This applies to both fee-for-service and managed care Medicaid plans in Illinois.
Action Required
By February 28, 2023: Stop submitting Synagis claims to Illinois Medicaid (both FFS and MCO plans). Billing team must update system to block Synagis authorization requests after this date. Contact pharmacy consultant at 877-782-5565 for FFS claims or appropriate MCO with questions.