MedicaidAdministrativeMedium impact
Standardized “Provider Roster” Template
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Aug 6, 2018
We identified it
Jun 20, 2026
Summary
Illinois Medicaid MCOs have launched a standardized provider roster template that all providers must use when submitting information for claims payment, care coordination, and directory purposes. This replaces individual MCO-specific roster formats and eliminates duplicate data entry since some information is now transmitted directly from the HFS IMPACT system.
Action Required
Immediately: Illinois providers contracting with Medicaid MCOs must switch to using the new standardized provider roster template when submitting provider information updates. Download the new template format and discontinue use of old MCO-specific roster forms. Update practice workflows to use the single standardized format for all Illinois Medicaid MCO submissions.