 | September 2026 | |
| |
| Provider Portal  Prior Authorization Provider Notices Provider Manual Practice Updates |
| |
| |
| HFS Toolkit: Preparing ACA adults for Medicaid changes |  | | On September 1, the Department of Healthcare and Family Services (HFS) began sending notifications to adults enrolled through the Affordable Care Act (ACA) Medicaid expansion about federal changes that take effect in 2027, including new work requirements. After their first redetermination date in 2027, ACA adults must also renew coverage every six months. Use the HR1 Phase 2 Toolkit from HFS to help prepare ACA adult patients for changes. Find work requirements, eligibility changes, and exemption details, along with flyers to support patient education. | |  | | | |
| |
| Be a behavioral health champion | | | |
| |
| Making claims and payment information easier to find | | Our provider website features a wealth of information to support claims and business operations, and now it is easier to navigate. Visit our updated web page, with resources for: | | • | Claims submission | | • | Global claims issues and resolution status | | • | Electronic payments and remittances | | • | Claim disputes | | • | Payment policies | | |  | | | |
| |
| Reflecting on our 2026 Provider Town Halls |  | | Our 2026 Provider Town Halls wrapped up last month with a packed house in Burr Ridge. Thank you to the hundreds of providers and staff who connected with us at events across the state, asked thoughtful questions, and shared feedback that strengthens our partnership. These interactions help inform best practices for provider and member support. P.S., Missed one of our in-person events? Watch for details to register for our virtual town hall. | | | |
| |
| Back-to-school immunization reminder | | Remember that October 15 is the deadline for most children in Illinois schools to submit required immunization documentation. This year’s deadline arrives as the U.S. experiences its highest number of measles infections since 1991, and continued vigilance can help maintain our low case count in Illinois. Primary care providers are families' most trusted source of vaccine information. Find helpful resources in the Recharging Routine Immunizations toolkit from the Illinois Association of Medicaid Health Plans (IAMHP). IAMHP Immunization Toolkit | | | |
| |
| September Quality Education webinars | | This month, our Quality Improvement (QI) team experts are covering: | | • | Bi-directional Electronic Health Record (EHR) connectivity | | • | Meridian’s Food is Medicine Programs | | • | Live demo of web-based QI tools and resources for Meridian and our family of plans | | | Register: September 24 at 9 a.m. | | | |
| | QI spotlight: Encouraging the age 1 dental visit | | National recommendations call for all children to have their first dental visit by age 1—it’s critical for early identification of potential dental disease, cavity prevention, and parental education about dental hygiene. Yet studies show only a small fraction of Medicaid-enrolled children visit the dentist before their first birthday. Help promote the importance of early childhood dental care with families and look out for upcoming resources to help identify in-network dentists who serve young children. | | | | | |
| |
| Updated YouthCare provider manual |  | | Our newest edition of the YouthCare provider manual includes important updates, such as: | | • | Updated information about mobile crisis response procedures | | • | New details about language assistance resources and alternative formats | | • | The most current utilization management guidance for providers | | | YouthCare Manuals, Forms, and Resources | | | |
| |
| Fee schedule updates, rate changes, & billing updates | | Claim alerts and known issues are posted on our website, along with updates about proactively reprocessing claims. Claims should not be resubmitted unless otherwise indicated. For billing questions, contact your assigned Provider Engagement representative. If your practice doesn’t have an assigned representative, please complete our intake form. | | | | |
| |
| In case you missed it | | • | Prior Auth updates: | | | | • | Review the PDL Updates page for updated HFS formulary changes to extended-release capsules for ADHD and new quantity limits on at-home COVID tests. | | • | Find actionable insights in our research study, where we asked nearly 700 Medicaid-eligible adults about trust in healthcare and preventive care barriers. | | • | Home health providers: HFS is hosting an Electronic Visit Verification (EVV) town hall on September 30 at 1 p.m. to share updates on EVV policies and procedures. | | • | Review the new HFS evidence-based screening guidelines for Tardive Dyskinesia. | | • | Join us in celebrating the 2025 Meridian Physician & Practitioner Award winners who were recognized for their outstanding achievements in delivering essential preventive services. | | |
| |
| Meridian and our family of plans connect communities across the state to the whole‑health care they need, right where they are. | |
| |
| |
| Meridian complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity). | |
| |
| |
| |
