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Retaining a Copy of the Medical Certification for Non Emergency Ambulance (MCA) Form
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 13, 2014
We identified it
Jun 20, 2026
Summary
Illinois hospitals must retain copies of Medical Certification for Non Emergency Ambulance (MCA) forms in their records. The state's Office of Inspector General will now recover ambulance service payments from hospitals that cannot provide MCA forms during audits or whose medical records don't support the criteria selected.
Action Required
Immediately: Hospital billing teams must establish procedures to retain copies of all completed MCA forms in patient records. Medical records staff must ensure documentation supports criteria selected on MCA forms. Failure to maintain forms or supporting documentation will result in ambulance service payment recoveries during OIG audits.