MedicaidAdministrativeHigh impact
Ordering, Referring, Prescribing - National Provider Identifier (NPI) Requirements - Delay in Implementation to October 1, 2019
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Illinois Medicaid has delayed the requirement for ordering/referring/prescribing (ORP) practitioners to be enrolled in the Medical Assistance Program until October 1, 2019. After this date, claims will be rejected if the ORP information is missing, invalid, or if the ORP is not enrolled with the Department.
Action Required
By October 1, 2019: Billing team must ensure all ordering, referring, and prescribing practitioners are enrolled in the Illinois Medical Assistance Program. Update billing system to include valid ORP information on all Medicaid claims. Verify ORP enrollment status before submitting claims. Claims will be rejected if ORP information is missing, invalid, or if ORP is not enrolled.