MedicaidAdministrativeLow impact
New Provider Agreements
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Jul 30, 2014
We identified it
Jun 20, 2026
Summary
Illinois Medicaid requires Supportive Living Facilities (SLFs) to complete and submit new Provider Agreements and Enrollment Disclosure Statements by July 30, 2014. This is an administrative requirement for SLF providers to maintain their Medicaid provider status.
Action Required
By July 30, 2014: Supportive Living Facilities must complete and submit Form HFS 1432B (Long Term Care Provider Agreement) and Form HFS 1513 (Enrollment Disclosure Statement) to Healthcare and Family Services Bureau of Long Term Care at 201 South Grand Avenue East Springfield, Illinois 62762-0002. Contact 217-782-0545 with questions.