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Elizabeth M. Whitehorn, Director

Provider Notice issued 03/05/2024

 

To:
 Enrolled Pharmacies
​Date: ​March 5, 2024
​Re: Change Healthcare Outage – No Post Approval Required

The Illinois Department of Healthcare and Family Services (HFS) continues to experience a system outage as noted in the provider notice dated February 22, 2024. This outage directly affects our fee-for-service pharmacy billing system.

HFS would like to thank our pharmacy partners who have been working tirelessly to ensure Medicaid customers receive their necessary medications. During this system outage, medications, including medications that normally require prior authorization, will not be subject to a post approval process. HFS will pay all clean claims submitted once the PBMS system is operational. Prescriptions filled in good faith will be paid in full as soon as the issue is resolved. At this time, HFS cannot provide an estimate on when the system issue will be resolved.

We want to reiterate that pharmacies should continue to check eligibility, which they can do by checking one of the following resources:

·MEDI – www.myhfs.illinois.gov

·AVRS – 800-842-1461

·Recipient Eligibility Verification (REV) System

·During business hours, calling 800-252-8942 or 877-782-5565 Option 7

Additionally, pharmacists should take special care to consult with their patients regarding their current medications, and health and medication history to reduce the risk of adverse events.

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

 

 

Kelly Cunningham, Administrator
Division of Medical Programs