MedicaidAdministrativeMedium impact
Chapter P-200, Handbook for Providers of Pharmacy Services Revision to Recipient Restriction Referrals – HFS1662
Illinois Medicaid - HFS·IL · Pharmacy, Family Medicine, General Practice·Provider Notice
Effective date
Feb 18, 2014
We identified it
Jun 20, 2026
Summary
Illinois Healthcare and Family Services updated the billing process for restricted Medicaid participants who receive prescriptions from physicians other than their designated primary care physician. Pharmacies must now obtain and retain HFS 1662 authorization forms for 7 years and use specific NCPDP billing fields to identify both the prescribing specialist and the restricted primary care physician.
Action Required
Immediately: Pharmacy billing staff must obtain HFS 1662 forms (Primary Care Provider Authorization) from healthcare.illinois.gov or by calling 800-325-8823 before dispensing medications prescribed by specialists for Medicaid participants restricted to specific primary care physicians. Update billing system to use NCPDP fields 411-DB for prescribing physician and 421-DL for primary care physician. Retain all HFS 1662 forms (paper or electronic) for 7 years for auditing purposes. Claims without proper authorization will be denied.