Traditional MedicareAdministrativeMedium impact
The Medical Electronic Data Interchange (MEDI) system and the Medicaid Managed Long Term Services and Supports (MLTSS) Program
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Summary
This notice explains billing procedures for Medicaid Managed Long Term Services and Supports (MLTSS) program enrollees in the Greater Chicago Region. Providers must identify MLTSS enrollees in the MEDI system and determine whether to bill Medicare, Medicaid Fee-for-Service, or the MLTSS health plan based on the specific service provided.
Action Required
For practices serving dual-eligible patients in Cook, DuPage, Kane, Kankakee, Lake, and Will Counties: Billing staff must check MEDI system for MLTSS enrollment (indicated by Exclusion Code '9' and 'LTSS' in health plan name). Bill Medicare for most medical services, bill MLTSS health plan for long-term care services and non-emergency transportation, and bill Medicaid FFS for other non-Medicare services. Update billing procedures to verify MLTSS status before claim submission.