MedicaidReimbursementHigh impact
Change in FQHC and RHC Wrap Around Payment
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2013
We identified it
Jun 20, 2026
Summary
Effective January 1, 2013, Illinois HFS will stop paying the $12 wrap around payment to FQHCs and RHCs because contracted MCOs will now compensate these providers at 100% of reasonable costs directly. FQHCs and RHCs must verify new billing procedures with their contracted MCOs.
Action Required
By December 31, 2012: FQHCs and RHCs must contact their contracted MCOs to verify new billing procedures since the $12 wrap around payment from HFS will end. Billing teams should update payment expectations and reconciliation processes to reflect direct MCO compensation at 100% reasonable costs starting January 1, 2013.