MedicaidCoverageMedium impact
LTC Provider Handbook Update
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Nov 17, 2005
We identified it
Jun 21, 2026
Summary
Illinois updated its LTC Provider Handbook to clarify that over-the-counter (OTC) drugs and personal care items must be provided by long-term care facilities as part of their Medicaid per diem rate, not billed separately through the pharmacy system. The revised Appendix C-26 now includes a detailed list of these items that facilities must provide.
Action Required
Immediately: Long-term care facilities (ICF and SNF) in Illinois must stop billing Medicaid separately for over-the-counter drugs and personal care items listed in revised Appendix C-26. These items must be provided as part of the facility's Medicaid per diem rate. Review the updated handbook at the Illinois HFS website and ensure billing staff understand these items are no longer billable separately.