MedicaidAdministrativeHigh impact
Care Coordination Enrollment for Children, Families and ACA Adults
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2014
We identified it
Jun 20, 2026
Summary
Illinois is implementing mandatory managed care enrollment for Medicaid beneficiaries in five regions, requiring providers to contract with managed care networks and verify patient enrollment status to ensure proper billing and payment. Billing procedures will vary based on the type of care coordination entity (MCO/MCCN vs ACE/CSN CCE).
Action Required
Immediately: Illinois providers must regularly check REV System, AVRS, and MEDI systems to verify Medicaid patient enrollment in care coordination plans. Contact managed care organizations in your region to begin contracting process. For MCO/MCCN enrollees: bill the managed care entity directly and follow their utilization policies. For ACE/CSN CCE enrollees: continue billing the state as before. Failure to contract with networks may result in delayed or denied payments.