MedicaidPrior AuthLow impact
Illinois Health Connect Referral System Implementation and Direct Access Service Billing Requirements
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, OB-GYN·Provider Notice
Effective date
Oct 1, 2009
We identified it
Jun 21, 2026
Summary
Illinois Health Connect is implementing a regional rollout of referral requirements for PCPs seeing IHC participants not on their panel, starting October 1, 2009. Direct access services are available without referrals, and a new modifier U5 is required for OB/GYN services provided by PCPs.
Action Required
This is a 2009 policy that is no longer relevant for current billing operations. No action required as this policy has been superseded by current Illinois Medicaid guidelines.