MedicaidAdministrativeHigh impact
Prescriber National Provider Identifier (NPI) Requirements Effective July 1, 2019
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Starting July 1, 2019, Illinois Medicaid will deny pharmacy claims if the prescribing provider is not enrolled with the Department. Pharmacies can request a one-time override by calling 877-782-5565 to allow time for patients to find enrolled prescribers or for prescribers to complete enrollment.
Action Required
Before July 1, 2019: All providers prescribing to Illinois Medicaid patients must complete enrollment via IMPACT system if not already enrolled. Billing team should verify all prescribing providers are enrolled with Illinois Medicaid. For non-enrolled prescribers, pharmacies can request one-time override by calling 877-782-5565. Failure to have enrolled prescribers will result in pharmacy claim denials with 'Prescriber Not Enrolled' message.