MedicaidCoverageMedium impact
Post Kidney Transplant Preferred Drugs under the Emergency Medical Program
Illinois Medicaid - HFS·IL · Nephrology, Transplant Surgery, Pharmacy·Provider Notice
Effective date
Sep 30, 2022
We identified it
Jun 20, 2026
Summary
Illinois Medicaid Emergency Medical Program will cover specific post-kidney transplant drugs without prior authorization for qualifying patients who received transplants at least 12 months ago at Illinois Medicaid certified centers. Until system programming is complete, pharmacies must call HFS to manually add drug coverage segments before billing.
Action Required
Immediately: For post-kidney transplant patients covered under Illinois Medicaid Emergency Medical Program, pharmacies must contact HFS at 877-782-5565 to manually add drug coverage segments before billing each group of claims for the same date of service. Medical billing teams should identify these patients and coordinate with pharmacy partners to ensure proper coverage setup before prescription claims are submitted.