MedicaidCoverageMedium impact
Eligibility Change in the State Hemophilia Program Effective January 1, 2014
Illinois Medicaid - HFS·IL · Hematology·Provider Notice
Effective date
Jan 1, 2014
We identified it
Jun 20, 2026
Summary
The Illinois State Hemophilia Program eligibility requirements changed due to the Affordable Care Act, requiring patients to obtain and provide proof of health coverage. The program will now serve as secondary payer only after patients meet ACA obligations, with Medicare remaining an exception where the program stays secondary.
Action Required
Immediately: Billing team must verify that Illinois hemophilia patients have primary insurance coverage before submitting claims to State Hemophilia Program. Update patient eligibility verification process to require proof of health coverage for all hemophilia patients except those with Medicare primary. Direct uninsured patients to Expanded Medicaid or Health Insurance Marketplace before processing State Hemophilia Program claims.