MedicaidCoverageHigh impact
Coverage Changes Resulting from the Save Medicaid Access and Resources Together (SMART) Act
Illinois Medicaid - HFS·IL · Chiropractic, Psychiatry, Optometry +3 more·Provider Notice
Effective date
Jul 1, 2012
We identified it
Jun 20, 2026
Summary
The SMART Act implements significant changes to Medicaid long-term care coverage effective July 1, 2012, including a 2.7% average rate decrease for nursing facilities, discontinuation of bed reserve payments, and restrictions on prescription medications to four per 30-day period with only 14-day supplies for long-term care residents.
Action Required
By July 1, 2012: Billing team must update reimbursement rates for Medicaid nursing facility claims (expect average 2.7% decrease). Stop billing for bed reserve services except for ICF/DD residents under 21. Update medication dispensing to restrict long-term care residents to 14-day supplies maximum. Remove adult chiropractic and group psychotherapy from covered services for most facilities. Update prior authorization processes for prescription exceptions beyond four medications per 30-day period.