MedicaidPrior AuthHigh impact
Revisions to DME Questionnaires and Prior Approval Form
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Sep 30, 2009
We identified it
Jun 21, 2026
Summary
Illinois Department of Healthcare and Family Services has updated DME prior authorization forms. The HFS 2240 Equipment Prior Approval Request form is being discontinued and merged into the revised HFS 1409 form, plus new questionnaire requirements for hospital beds and updated CPAP/BIPAP forms.
Action Required
By September 30, 2009: Stop using obsolete HFS 2240 form - switch to revised HFS 1409 for all DME prior authorization requests. Immediately begin using new HFS 3905 Hospital Bed Questionnaire for any hospital bed prior approvals (requests will be returned without this form). Update to revised HFS 3701F CPAP/BIPAP Questionnaire that includes heated/non-heated humidification options. Download all new forms from http://www.hfs.illinois.gov/medicalforms/.