MedicaidAdministrativeMedium impact
Revision of Form HFS 1409 Prior Approval Request and Availability on the Website
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 26, 2016
We identified it
Jun 20, 2026
Summary
The Illinois Department of Health and Family Services has updated Form HFS 1409 Prior Approval Request with a new format (revision R-11-15) but no content changes. Paper versions are no longer available from the warehouse - providers must download and print the PDF-fillable version from the website.
Action Required
Immediately: Download the new HFS 1409 Prior Approval Request form (revision R-11-15) from the Illinois HFS Medical Forms webpage. Replace any old versions in your office and ensure all staff use only the new PDF-fillable format for prior authorization requests. Verify patient enrollment in fee-for-service vs managed care plans using electronic eligibility systems before submitting requests.