Provider Notice issued 08/25/2026

Fiscal Year 2026 and 2027 Managed Care Organization Assessment Program Notice of Re-Assessment

This is to inform you that the Department has determined that your managed care organization is subject to the assessment imposed on Illinois managed care organization (MCO) member months under the provisions of 305 ILCS 5/5H.

To ensure stable MCO Provider Assessment revenue to the Department in order to provide continued financial support vital to healthcare providers within the State, the Department initially assessed the MCO Provider Assessment for fiscal years 2026 and 2027 using member month data available at the time of assessment.  The Department recently received the member month data for calendar year 2023 as reported by the Department of Insurance, and therefore, to comply with statute, the Department is reassessing the MCO Provider Assessment for fiscal years 2026 and 2027 using that data.  Additionally, to ensure Federal provider assessment requirements with regards to uniformity, the Department is including in its re-assessment for fiscal year 2026 Fully Integrated Duel Eligible Special Needs Plan (FIDE SNP) member months for all organizations serving this market during the fiscal year.  The assessed FIDE SNP base was calculated by annualizing the reported January 2025 member month data.  Any over- or underpayments of fiscal year 2026 and fiscal year 2027 have been totaled then divided by the monthly installment payments remaining for the 2027 fiscal year beginning with the October 2026 payment.  The September 2026 payment should be made based on the Provider Notice dated June 1, 2026.

Your organization’s re-assessment remittance notices for fiscal years 2026 and 2027, reflecting the managed care organization assessment per statute will be loaded on to the Department’s SharePoint site in the near future. You will receive an automated email from SharePoint (hfs.smtp.noreply@illinois.gov) once the documents have been uploaded to the system.  Directions to access these remittance notices should have already been received via email by each organization’s designated contacts at the end of May 2026.  If you do not have SharePoint access, please contact us immediately at HFS.ProviderAssessmentUnit@illinois.gov or 217-524-7110.  Additionally, the tax tier rates for the re-assessed fiscal year 2026 and 2027 have been published to the Department’s Provider Notice website.  

Each remittance card has the organization’s name, address, contact information, tax identification number, due date, and tax amount owed.  Also included in the notice is a tax calculation worksheet detailing the base year data for each assessment fiscal year.

Laura Phelan, Administrator
Division of Medical Programs 

The tiers for fiscal year 2026 are established as follows:

1) Tier 1 - $115.00 includes the first 4,195,000 member months in a Medicaid MCO during the base year;

2) Tier 2 - $1.30 includes member months over 4,195,000 in a Medicaid MCO during the base year; and

3) Tier 3 - $4.40 includes member months during the base year in an MCO that is not a Medicaid MCO.
 

The tiers for fiscal year 2027 are established as follows:

1) Tier 1 - $116.90 includes the first 4,195,000 member months in a Medicaid MCO during the base year;

2) Tier 2 - $0.90 includes member months over 4,195,000 in a Medicaid MCO during the base year; and

3) Tier 3 - $5.60 includes member months during the base year in an MCO that is not a Medicaid MCO.

HFS currently accepts and encourages ACH Credit/Wire Transfer payments for the monthly Managed Care Organization Assessment fees.  If you do not have the Department’s banking information to initiate payment, please contact us immediately at HFS.ProviderAssessmentUnit@illinois.gov or 217-524-7110.

To ensure proper crediting of the organization’s account, please be sure to include the following underlined information when initiating the monthly Managed Care assessment electronic payments:

ORIG CO NAME: MCO Organization Name
ORIG ID: Taxpayer Identification Number (TIN), unless hard coded as bank account number
ENTRY DESCR: HFS Tax ID, this number can be found on the remittance cards
ENTRY CLASS: CCD 
TRACE NO: Bank Information
ENTRY DATE: yymmdd 
IND ID NO: Bank Information
IND NAME: MCO Assessment Tax, unless hard coded as account/vendor
REMARK: July 2026 MCO Assessment Tax Payment [and] TIN, if not supplied in ORIG ID, above
ORIG BANK: Bank Name

PLEASE NOTE:  Assessment transactions MUST be remitted with a separate transaction from other required HFS payments and designated in the Remarks as such for the Department to credit your accounts accurately.

If you have any questions concerning this information, please do not hesitate to contact the Bureau of Rate Development and Analysis by e-mail at HFS.ProviderAssessmentUnit@illinois.gov, or by telephone at 217-524-7110.

Kathleen Staley, Chief
Bureau of Rate Development and Analysis

Fiscal Year 2027 MCLO Assessment
(Fund 793) Due Dates