MedicaidAdministrativeMedium impact
Special Needs Children Continuity of Care Beyond Transition to Managed Care February 1, 2020
Illinois Medicaid - HFS·IL · Pediatrics·Provider Notice
Effective date
Feb 1, 2020
We identified it
Jun 20, 2026
Summary
Special Needs Children in Illinois are transitioning from fee-for-service to managed care on February 1, 2020, with a 180-day continuity period allowing current providers to continue treatment even if not in the health plan's network. Providers must check MEDI for eligibility, contact health plans to coordinate care, and follow managed care policies for referrals and preauthorization.
Action Required
By February 1, 2020: Billing team must check child eligibility in MEDI system for health plan assignment and contact assigned managed care plans to coordinate care and verify payment. Providers must follow health plan policies for referrals and obtain preauthorization as required. Non-network providers can continue treating patients for 180 days at fee-for-service rates during transition period.