MedicaidAdministrativeMedium impact
Universal Provider Roster Submission Requirements for Illinois Medicaid Managed
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 1, 2019
We identified it
Jun 20, 2026
Summary
Illinois Medicaid Managed Care Organizations now require all providers to use a standardized roster template for provider enrollment and updates. New providers must submit the roster with their IMPACT application, while existing providers must submit monthly updates for any changes to provider status, names, locations, or new additions to their practice.
Action Required
Immediately: Illinois providers must download and use the standardized IAMHP Provider Roster Template for all HealthChoice Illinois MCO submissions. Submit roster with IMPACT applications for new providers. Billing team must establish monthly roster submission process for any provider changes including name changes, location updates, or new providers joining practice. Access template at IAMHP Provider Roster Template and FAQs.pdf. Contact HFS Bureau of Managed Care at 217-524-7478 with questions.