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MedicaidAdministrativeMedium impact

Handbook for Providers of Pharmacy Services Re-Issue

Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Nov 4, 2010
We identified it
Jun 21, 2026
Days to comply

Summary

Illinois updated their Pharmacy Services Handbook with four key changes: prescriber NPI is now required on all pharmacy claims, ostomy supplies are no longer billed through the Pharmacy Program, Plan B prescription age limits were revised, and new language was added for Plan B verbal prescriptions.

Action Required

Action needed
Immediately: Billing team must ensure prescriber NPI is included on all pharmacy claims. Stop billing ostomy supplies through the Pharmacy Program - these should now be billed as standard DME. Review updated Plan B prescription requirements for age limits and verbal prescription protocols. Download the updated Handbook for Providers of Pharmacy Services Chapter P-200 from the Illinois Department of Healthcare website.