MedicaidAdministrativeMedium impact
Reconsideration of Previously Denied Ground Ambulance Claims per Public Act 102-0650
Illinois Medicaid - HFS·IL · Emergency Medicine·Provider Notice
Effective date
Nov 23, 2021
We identified it
Jun 20, 2026
Summary
Illinois is allowing reconsideration of previously denied non-emergency ground ambulance claims from December 15, 2012 to January 1, 2021 that were denied for missing MCA or PCS forms. A $2 million pool is available for reimbursement if providers can demonstrate medical necessity through alternative documentation.
Action Required
By December 31, 2021: Transportation providers must submit each denied non-emergency ground ambulance trip via secured email to HFS.Transportation@Illinois.gov with subject line 'Reconsideration of Ambulance Appeal –[Provider Name] and RTN Number'. Include cover sheet, MCA/PCS form if available, denial documentation, medical necessity documentation, completed NETSPAP trip form, run report, and other pertinent information. Partial requests with insufficient information will not be reviewed.