Provider Notice Issued 09/23/2025

After receiving federal approval of the hospital preprint for state directed payments and pursuant to Public Act 104-0007, the Department of Healthcare and Family Services (HFS) is updating the hospital assessment program retroactive to January 1, 2025.  This update includes increases to the Managed Care Access Payments (MCAP) made to hospitals through the HealthChoice Illinois Managed Care Organizations (MCO) and increases in the monthly hospital assessments paid by the hospitals.  HFS will work with the MCOs to turn around payment to the hospitals promptly after receiving payment from HFS.   

The regular October payments will be the first full month to reflect the increases in the regular MCAP payments.  The October through December payments will be posted as usual, the week prior to October 1st.  HFS will cycle through the retroactive, incremental catch-up payments for the months of January through September as funding and available cash allow.  Below is a schedule for the retroactive incremental payments to the hospitals as well as the due dates for the incremental assessment payments due from the hospitals, with the goal to have all retroactive payments distributed and assessments collected during this calendar year.  

*In order for the following schedules to work, it is essential that ALL hospitals submit their assessment payments timely to HFS on or before the due dates.  

Updating Hospital MCAP and Schedule of Payment Distribution

Updated Pools and Rates

All hospitals remain in the classification that they were assigned for CY 2025, and the methodologies for calculating the payments remain the same.  It is only the pool amounts and rates that are being updated, resulting in higher overall payment amounts.  HFS has posted the updated Calendar Year 2025 Pool Amounts and Rates applicable to each hospital classification, and all payment update files described below to HFS’s Directed Payment Reports website, under the link titled ‘January – September 2025 Retroactive Updates.’  

Updated Quarterly / Monthly Calculated Payments

The updated Quarterly/Monthly calculations utilizing the updated pools and rates for the quarters January – March, April – June, and July – September have been posted to HFS’s website.  These calculations have the same utilization as the original payment calculations; only the pool amounts and rates have been updated to calculate the new payment amounts.  The new calculations are posted in the same manner and format as the usual quarterly postings, with PDFs and an excel file for each classification’s calculations.

Retroactive Incremental Payment Calculations

The incremental, catch-up payment amounts for January through September have been posted to HFS’s website.  Each quarter has a file that contains the original amount paid, the newly calculated amounts, and the difference (incremental payment amount) for each month within that quarter.  Each hospitals’ amounts are displayed according to each MCO’s payments so that hospitals will know the payment amount to expect from each MCO for each monthly catch-up payment.  

Schedule for MCAP Payments for the Remainder of Calendar Year 2025

Please note: Due to the amount of additional payment to hospitals and funding available to make the payments, the retroactive monthly payments are not in chronological order.  The dates listed below are the dates that HFS will initiate payment to the MCOs.  The MCOs may not receive the payment in their accounts until the following business day.  The MCOs will have a reasonable amount of time to account for the payments and distribute them to the hospitals.  Therefore, hospitals should not expect to receive payment until 7 to 10 business days after the MCAP payment dates listed below.  

MCAP Payment Dates Scheduled Payment

September 22, 2025 APRIL 2025 Retroactive Payment
October 9, 2025 Regular October Payment at New Amounts
October 10, 2025 MAY Retroactive Payment
October 15, 2025 JANUARY Retroactive Payment
October 30, 2025 FEBRUARY Retroactive Payment
November 4, 2025 MARCH and JUNE combined Retroactive Payment
November 12, 2025 Regular November Payment at New Amounts
November 13, 2025 JULY Retroactive Payment
November 21, 2025 AUGUST Retroactive Payment
November 25, 2025 SEPTEMBER Retroactive Payment
December 9, 2025 Regular December Payment at New Amounts

The Department may have to adjust this schedule if assessment payments are not received from all hospitals on time.  Hospitals are encouraged to submit the assessment payments promptly after receiving the payments for each month above to keep this schedule viable.  Any necessary changes to the schedule will be communicated to the hospitals via a provider notice.

Updating Assessment Amounts Due and Assessment Payment Schedule

Updating Assessment Amounts

Per Public Act 104-0007, the 2015 cost reports continue to be the base for the hospital inpatient and outpatient assessments; however, the amount of inpatient bed day and percentage of outpatient net revenues have increased.  HFS has calculated the new monthly assessment amounts and the incremental difference between the new amounts due and the amounts previously paid.  These amounts will be mailed to each hospital in the same manner as previous assessment calculations.  Please look for these notices to arrive later this week or early next week.  For an electronic copy, hospitals can email HFS.ProviderAssessmentUnit@Illinois.gov.

The required method of payment will be through facility-initiated ACH Credit/Wire Transfer.  If your facility does not have HFS’s banking information in order to initiate these monthly assessment payments, please contact us immediately at the HFS.ProviderAssessmentUnit email address above.

Pursuant to Public Act Public Act 104-0007 and Ill. Admin. Code tit. 89, § 140.80, failure to pay the retroactive tax amounts within 30 days of the due date will result in recoupment of future retroactive payments in the amount of the missed payment. 

Schedule for Assessment Payments for the Remainder of Calendar Year 2025

Assessment Due Date Scheduled Payment

September 24 Regular September Tax Due at Old Amounts
October 9 April Incremental Tax Due
October 24 Regular October Tax Due at New Amounts
October 27 May Incremental Tax Due
November 3 January Incremental Tax Due
November 17 February Incremental Tax Due
November 21 March and June Combined Incremental Tax Due
November 26 Regular November Tax Due at New Amounts
December 1 July Incremental Tax Due
December 8 August Incremental Tax Due
December 12 September Incremental Tax Due
December 23 Regular December Tax Due at New Amounts

It is imperative that hospitals submit the assessment due on or before the due date to maintain the payment schedule.  Any changes in the scheduled MCAP payments due to late or unpaid assessment submissions may result in changes to the assessment due dates above.  HFS will communicate any changes to the due dates via a provider notice.  

Laura Phelan, Administrator
Division of Medical Programs