Traditional MedicareAdministrativeLow impact
Medicare Part D Copayment Billing for SLF and CILA Residents
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
May 1, 2006
We identified it
Jun 21, 2026
Summary
Illinois HFS now allows electronic processing of copay-only claims for Medicare Part D residents in SLFs and CILAs. Pharmacies must first bill Medicare Part D to determine copayments ($1-$5), then submit copay claims to HFS using specific NCPDP 5.1 form fields.
Action Required
This 2006 pharmacy-specific policy does not require action from medical billing teams. It applies only to pharmacies billing copayments for residents in Supportive Living Facilities (SLFs) and Community Integrated Living Arrangements (CILAs) in Illinois.