MedicaidCoverageLow impact
PROVENGE®
Illinois Medicaid - HFS·IL · Oncology, Urology·Provider Notice
Effective date
Mar 28, 2011
We identified it
Jun 21, 2026
Summary
Illinois Medicaid (Department of Healthcare and Family Services) will not provide coverage for PROVENGE®, the FDA-approved immunotherapy for prostate cancer treatment. This policy was issued March 28, 2011 and affects billing for this specific prostate cancer treatment.
Action Required
Immediately: Stop submitting Illinois Medicaid claims for PROVENGE® immunotherapy treatment. Verify patient insurance coverage before administering PROVENGE® to ensure alternative coverage exists. Update billing system to flag PROVENGE® as non-covered for Illinois Medicaid patients. Contact Bureau of Comprehensive Health Services at 1-877-782-5565 for questions.