MedicaidReimbursementMedium impact
Change to Managed Care Organization (MCO) Hospital Access Program
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Feb 1, 2020
We identified it
Jun 20, 2026
Summary
Illinois is changing how Medicaid MCO Hospital Access Program payments are distributed to comply with federal CMS rules. Starting February 2020, hospitals will receive a combination of directed payments and pass-through payments directly from MCOs instead of the previous payment structure, with methodology updates planned for July 1, 2020.
Action Required
By February 2020: Hospital billing teams should monitor payment timing and procedures from MCOs as directed payments and pass-through payments begin. Contact HFS.Hospitals@Illinois.gov with questions about the new payment structure. Prepare for additional methodology changes effective July 1, 2020.