Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
  • The Child Support Services Cook Central Office, 36 South Wabash Avenue, Chicago, will close 02/03/2025.  The new Cook Central Office will open at 115 South LaSalle, Chicago, for in-person service on 02/10/2025. 
Elizabeth M. Whitehorn, Director

Provider Notice Issued 07/25/2022

Date:     July 25, 2022 

To:        Enrolled Pharmacies   

Re:       Confirmation of Coverage for Continuous Glucose Monitors per Public Act 102-1093

_________________________________________________________________________________________________________

This notice confirms the Department of Healthcare and Family Services' (HFS) coverage for continuous glucose monitors (CGMs) as required under Public Act 102-1093. Coverage is provided under both Medicaid fee-for-service (FFS) and the HealthChoice Illinois (HCI) managed care plans (MCOs).

The Act requires medically necessary CGMs be provided for individuals diagnosed with type 1 or type 2 diabetes who require insulin for the management of their diabetes. HFS already provides coverage for medically necessary CGMs and insulin, and no program coverage changes are necessary. The criteria for CGM coverage can be found at Criteria and Forms ! HFS (illinois.gov) under the Criteria heading.

Questions regarding the FFS program may be directed to a pharmacy billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565. Questions regarding coverage under an HCI MCO should be directed to the applicable managed care plan.

 

 

Kelly Cunningham, Administrator

Division of Medical Programs

 

 

 

 

 

 

 

 

​