MedicaidAdministrativeLow impact
Revised Long Term Care Provider Agreements
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Jan 30, 2010
We identified it
Jun 21, 2026
Summary
Long Term Care Provider Agreements for nursing facilities and supportive living facilities have been revised to comply with federal regulations requiring enhanced disclosure of ownership, control, business transactions, and criminal conviction information. Providers must complete and return updated agreements within 10 working days.
Action Required
By January 30, 2010: Long term care facilities (nursing facilities and supportive living facilities) must complete revised Form HFS 1432 or HFS 1432B provider agreements and optional Form HFS 1513 Enrollment Disclosure Statement. Download forms from department website, complete disclosure information, print and return to address listed in instructions within 10 working days of notice date.