MedicaidReimbursementMedium impact
Pharmacy Reimbursement Changes Effective July 1, 2012
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is reducing pharmacy reimbursement rates by 2.7% effective July 1, 2012, implementing new maximum pricing structures with different dispensing fees for generic ($5.50) versus brand name drugs ($2.40).
Action Required
By July 1, 2012: Pharmacy billing staff must update reimbursement expectations in billing systems to reflect new maximum pricing structure - generic drugs will receive $5.50 dispensing fee and brand name drugs $2.40 dispensing fee. Contact Bureau of Pharmacy Services at 1-877-782-5565 option 7 for questions about reimbursement calculations.