MedicaidReimbursementHigh impact
Hospital Rate Reform - Claims Processing Update and Additional Rate Reform Guidance
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is releasing held inpatient claims under new payment methodologies starting August 4, 2014, while outpatient claims remain on hold for further testing. Hospitals no longer need to report actual acquisition cost on 340B drugs for outpatient claims, and normal newborn claims are now eligible for payment including disproportionate share payments.
Action Required
Immediately: Monitor for release of held inpatient claims with discharge dates on/after July 1, 2014. Stop reporting actual acquisition cost (AAC) on 340B-purchased drugs for outpatient institutional claims but continue reporting AAC for renal dialysis claims. Continue billing all 340B-purchased drugs with UD modifier. Begin billing normal newborn claims for payment including disproportionate share payments. Contact Bureau of Hospital and Provider Services at 1-877-782-5565 for cash flow assistance if needed.