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Local Education Agency Payment Error Rate Measurement (PERM) Audit Findings
Illinois Medicaid - HFS·IL · Pediatrics, Occupational Therapy, Physical Therapy +1 more·Provider Notice
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services identified documentation deficiencies and missing NPI requirements for Local Education Agency (LEA) school-based health services during a PERM audit. LEAs must maintain complete medical records including IEPs, progress notes, and transportation logs, and include ordering/referring provider NPIs on all claims.
Action Required
Immediately: LEAs billing Medicaid must ensure all claims include ordering/referring provider NPI numbers and maintain complete documentation including IEPs, daily progress notes, medication administration records, and transportation logs (U-210.13). Update billing processes to verify NPI requirements are met before claim submission. Missing documentation or NPIs will result in claim denials and potential overpayment recovery.