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Elizabeth M. Whitehorn, Director

Provider Notice issued 07/18/05

To: Participating Pharmacies

Date: July 18, 2005

Re: Pharmacy Changes for Participants in the Managed Care Program

 

Effective August 1, 2005, the pharmaceutical benefit will be carved out of the department's voluntary managed care program. All drugs dispensed by a pharmacy to any Medicaid, FamilyCare or KidCare participant enrolled in a Managed Care Organization (MCO) must be billed directly to HealthCare and Family Services (HFS) for dates of service August 1, 2005, and after. Amerigroup, Family Health Network, Harmony Health Plan, Humana or United HealthCare are currently the only Illinois Medicaid MCOs.

Pharmacies must bill HFS directly using the recipient's Recipient Identification Number (RIN) even though the MediPlan and KidCare identification cards will continue to list the MCO name under the recipient name and number on the back of the card. If an MCO enrollee does not have their MediPlan or KidCare card, you may look up their RIN by using the NCPDP 5.1 eligibility inquiry that may be supported by your pharmacy claims submission software or by going through the HFS online eligibility system, MEDI, at the following Web site:

 

                                     http://www.myhfs.illinois.gov

 

As you can see, the name of the Department of Public Aid (DPA) has changed to Healthcare and Family Services (HFS). You will see the new name on forms, letters and the Internet. Until existing form supplies are exhausted, we will continue to use materials bearing the former DPA name and logo. Either version of documents should be considered official regardless of the name they bear.

 

Only our name has changed. HFS's programs, staff, office locations, mailing addresses and phone numbers remain the same as DPA's. We believe our new name more clearly reflects our mission of service to the State of Illinois including providing access to health care for over two million Illinoisans. We deeply appreciate your participation in our programs and we hope this change poses no inconvenience or confusion for you.

 

Providers wishing to receive e-mail notification, when new provider information has been posted by the department, may register at the following HFS Web site: http://www.hfs.illinois.gov/provrel

 

Questions regarding this notice may be directed to the Bureau of Pharmacy Services at 1-877-782-5565.

 

Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs