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  • 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.
Elizabeth M. Whitehorn, Director

Provider Notice issued 07/26/2024

 

To:
 Participating Durable Medical Equipment and Supplies Providers
​Date July 26, 2024
​Re:
 Durable Medical Equipment and Supplies Providers IMPACT Enrollment Requirements

This notice is a reminder of the Illinois Medicaid enrollment requirements for durable medical equipment and supplies providers.

The Federal Centers for Medicare & Medicaid Services (CMS) categorizes Durable Medical Equipment, Prosthetics, Orthotics and Supply (DMEPOS) providers as high risk. This is a provider type that each State Medicaid Agency (SMA) must also categorize as high risk. Illinois Medicaid providers must be properly enrolled, credentialed and screened before they may serve Illinois Medicaid beneficiaries (42 CFR 455.410).

To ensure Federal requirements are being met, the State of Illinois will be following the Federal requirements when enrolling new DMEPOS providers or revalidating current providers. To be eligible for enrollment with Illinois Medicaid as a DMEPOS provider, providers must meet the following requirements:

  • Obtain and maintain a state license or be exempt from licensure.
  • Be accredited by one of the listed national accreditation organizations recognized by CMS and the Department of Healthcare and Family Services (HFS). Additional information for the DMEPOS Accrediting Organizations can be found on the IMPACT section of the HFS website. 
    • Accreditation Commission for Health Care, Inc.
    • American Board for Certification in Orthotics & Prosthetics, Inc.
    • Board of Certification/Accreditation International
    • Community Health Accreditation Program
    • Healthcare Quality Association of Accreditation
    • National Association of Boards of Pharmacy
    • The Compliance Team, Inc.
    • The Joint Commission
  • Have an onsite visit completed prior to application approval or revalidation.

In addition to these Federal requirements, the documentation on the DME Provider Checklist must be submitted with the provider enrollment application, utilizing the document upload feature in the IMPACT system.

Questions regarding this notice can be directed to the IMPACT Help Desk by calling 877-782-5565, Option 1, 2 and 1. 

 

Kelly Cunningham, Administrator 
Division of Medical Programs