Update: Effective Oct. 1, 2019, Prescriptions for Medicaid Members Denied if Provider is Not Registered with IMPACT

Posted September 17, 2019 (Updated November 11, 2019)

The Illinois Department of Healthcare and Family Services (HFS) is delaying implementation of the ordering/referring/prescribing requirements, from Oct. 1, 2019, to Jan. 1, 2020.

As mentioned in the Dec. 28, 2018, provider notice, the Illinois Department of Healthcare and Family Services (HFS) is requiring all ordering or referring physicians or other professionals (ORP) to enroll in the Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system.

Effective with claim receipt dates or dates of service beginning Oct. 1, 2019, HFS will reject pharmacy claims submitted through the pharmacy point-of-sale system if the prescribing practitioner identified on the pharmacy claim is not enrolled in the IMPACT system. Blue Cross and Blue Shield of Illinois (BCBSIL) will align our process with HFS.

It’s imperative that all providers responsible for writing a prescription for a Medicaid member are registered and approved in IMPACT by Oct. 1, 2019. For more information, see the provider notice on the HFS website or call the Bureau of Professional and Ancillary Services at 877-782-5565.