← Back to list
Federal Rule on Gender Affirming Care for Young People
Act
by Oct 13, 2026
Effective date
Oct 13, 2026
Identified
Oct 7, 2026
Summary
Effective October 13, 2026, a new federal rule restricts Medicaid coverage of gender affirming care for youth. Illinois HFS will bridge the coverage gap using state-only funds through the end of state fiscal year 2027 (June 30, 2027), with future funding decisions deferred to the budget process. Billing teams must continue following existing billing instructions while HFS handles federal compliance on the back end by not claiming federal matching dollars on affected claims.
Get alerts when payers change rules like this one
We check Illinois Medicaid - HFS and other payers every day and email you when a change matches your specialty and state.
Get Illinois Medicaid - HFS alertsPolicy Monitoring is free. No card required.
What to do
by Oct 13, 2026 · 3 steps
01Billing team should verify current applicability of existing billing instructions referenced in the 01/09/2020 Provider Notice and 11/26/2024 Provider Notice for gender affirming care services.
02Continue submitting all related service claims to Medicaid fee-for-service and Medicaid Managed Care Organizations (MCOs) as directed; HFS will apply federal compliance adjustments on the back end by declining to claim federal matching dollars.
03Note that state-only fund coverage extends only through the end of state fiscal year 2027 (June 30, 2027); contact the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable MCO for clarification on future funding status after that date.
Original notice
Federal Rule on Gender Affirming Care for Young People
hfs.illinois.gov · Always check the source before changing claims.