MedicaidAdministrativeLow impact
New Provider Agreements
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Feb 28, 2014
We identified it
Jun 20, 2026
Summary
ICF/IID providers must complete and submit a new Long Term Care Provider Agreement (Form HFS 1432) by February 28, 2014. The new agreements eliminate expiration dates and merge ICF/IID and Nursing Facility agreements into one form.
Action Required
By February 28, 2014: ICF/IID providers must complete and submit Form HFS 1432 (Long Term Care Provider Agreement) to Healthcare and Family Services Bureau of Long Term Care at 201 South Grand Avenue East, Springfield, Illinois 62762-0002. Mark appropriate provider type box on the form.