MedicaidAdministrativeLow impact
Recipient Restriction Program Primary Care Provider Authorization Form (HFS 1662)
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, Internal Medicine +1 more·Provider Notice
Effective date
Dec 28, 2010
We identified it
Jun 21, 2026
Summary
Healthcare and Family Services will no longer mail Primary Care Provider Authorization forms (HFS 1662) to providers and pharmacies. The form is now only available for download from the HFS website and is used for referring Restricted Recipient Program (RRP) clients to other providers.
Action Required
Immediately: Primary care providers treating Medicaid RRP clients must download HFS 1662 forms from the HFS website Medical Programs Forms page instead of waiting for mailed forms. Contact RRP hotline at 1-800-325-8823 if experiencing download issues. This only affects providers who refer restricted Medicaid clients to other providers for services they cannot provide themselves.