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Provider Notice Issued 10/05/2022

Date:   October 5, 2022      

To:       All Participating Medical Assistance Program Providers          

Re:      Universal Provider Roster Submission Requirements for Illinois Medicaid Managed Care Organizations


The Illinois Department of Healthcare and Family Services (HFS) is committed to ensuring the highest standards of care and access for Medicaid beneficiaries. To ensure this commitment and streamline the process, the provider enrollment roster template has been standardized across all HealthChoice Illinois Managed Care Organizations, thereby ensuring timely updates to the directory and accurate payment to providers pursuant to 305 ILCS 5/5-30.1 (g-10)(1).

Medicaid providers must complete the standardized roster when adding providers to all HealthChoice Illinois network listings. It is prudent to complete and send the roster to the MCO at the same time you complete your IMPACT application to assist with more timely credentialing and provider load. Current providers who have changes or updates to their provider's status, such as provider name changes, office location updates, new providers joining a practice, etc., must complete the standardized roster on a monthly basis. Timely updates will ensure the MCOs' directories are current, and accurate payments to providers can be made. All licensed roster staff providing direct care services in your organization must be added to the roster.

The universal format addresses the information needs of individual providers, group practices and facilities. Additionally, the format ensures compliance with recent Centers for Medicare & Medicaid Services rules on the scope of information that should be made available to Medicaid beneficiaries in provider directories. The provider roster cannot be used for credentialing physicians. Effective January 1, 2018, HFS assumed the primary responsibility for credentialing through the State's IMPACT registration system.

The standardized roster can be accessed here, along with a list of Frequently Asked Questions about the roster as prepared by the MCOs:  IAMHP Provider Roster Template and FAQs.pdf

Questions regarding this notice may be directed to HFS' Bureau of Managed Care at  217-524-7478.

Kelly Cunningham, Administrator
Division of Medical Programs 


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JB Pritzker, Governor • Theresa Eagleson, Director

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