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MedicaidAdministrativeMedium impact

Medicaid Presumptive Eligibility (MPE) and the Obstetric Patient

Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine, General Practice·Provider Notice
Effective date
Jul 17, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid is reminding providers that pregnant women with Medicaid Presumptive Eligibility (MPE) should receive full prenatal care without delay while their full Medicaid application is being processed. For patients near their due date still awaiting final determination, providers should email hfs.aca@illinois.gov with specific patient information for expedited review.

Action Required

Action needed
Immediately: Billing team should ensure pregnant patients with MPE coverage receive full outpatient/ambulatory services, specialty care, supplies, and prescriptions without delay. Front desk staff should email hfs.aca@illinois.gov with 'MPE' in subject line for patients near due date awaiting final determination, including patient's application number and first three letters of first/last name (or DOB and name letters if no application number). Do not have patients reapply.