MedicaidAdministrativeMedium impact
Clarification of Hospital Fee-for-Service Billing for Illinois Department of Corrections (IDOC) and Illinois Department of Juvenile Justice (IDJJ) Inmates
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jul 1, 2008
We identified it
Jun 21, 2026
Summary
For Illinois hospitals treating IDOC and IDJJ inmates, an exception to the July 2008 billing rule requires that outpatient services by salaried physicians and APNs must be billed under the hospital's name and NPI, not the individual practitioner's NPI. Claims submitted under physician/APN names for these inmates will be rejected.
Action Required
Illinois hospitals: Immediately update billing procedures to ensure all outpatient services for IDOC and IDJJ inmates by salaried physicians and APNs are billed under the hospital's name and fee-for-service NPI only. Do not bill under individual practitioner names/NPIs for this patient population as claims will be rejected.