MedicaidAdministrativeMedium impact
CountyCare Program
Illinois Medicaid - HFS·IL · Family Medicine, OB-GYN, General Practice·Provider Notice
Effective date
Oct 1, 2014
We identified it
Jun 20, 2026
Summary
This provider notice clarifies billing responsibilities for CountyCare program participants, specifying that HFS only pays Cook County Health providers for retroactive services before 1/1/14, while CountyCare MCO pays network providers for services after the waiver ended 6/30/14. Family planning and prenatal services have special open access billing rules.
Action Required
Immediately: Review all CountyCare claims with dates of service 11/1/12-12/31/13 from non-CCHHS providers - these should be billed directly to patients, not HFS. For current CountyCare members, ensure family planning and prenatal/delivery claims are submitted directly to CountyCare MCO, not HFS. Update billing procedures to route CountyCare claims to the MCO rather than state Medicaid system.