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Elizabeth M. Whitehorn, Director

Provider Notice Issued 07/13/2020

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Date:    July 13, 2020

 

To:       All Medical Assistance Program Providers

 

Re:      Charging Participants for Personal Protective Equipment

 

 

 

 

This notice states the Department’s position regarding providers charging Medicaid participants for personal protective equipment (PPE). This applies to participants covered under both traditional fee-for-service and managed care plans.

 

Federal Medicaid regulations at 42 CFR Part 447.15, and HFS administrative rule at 89 Ill. Admin. Code Section 140.12 (i) require that providers accept Medicaid payment as payment in full. The PPE required for providers to perform medical, dental, or non-emergency transportation services is considered part of the service. If the provider bills HFS for that service, the provider cannot then bill the participant for the PPE separately. Any increased expense for PPE cannot be passed to Medicaid participants.

 

The Department will continue to monitor the situation and will take appropriate action as necessary.

 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, your DentaQuest provider representative or to the applicable MMAI or HealthChoice Illinois managed care plan.

 

 

 

Kelly Cunningham

Interim Medicaid Administrator