Provider Notice issued 08/11/2026

Provider Assessment Repayment Updates and Renegotiated Agreement Terms

This notice presents updates to the collection methods and tax repayment policies for unpaid hospital assessment amounts as well as terms for a renegotiated repayment plan.  

Collection of Unpaid Assessments

Hospitals are required to pay assessments to the Department of Healthcare and Family Services (HFS) on inpatient and outpatient services. Hospitals also owe penalty assessments for failure to pay a full assessment when due. HFS is obligated to collect unpaid assessments. Pursuant to 305 ILCS 5/5A-7, HFS may enforce assessment obligations through administrative and/or judicial proceedings, and unpaid assessments become a lien on the assessed hospital’s assets. HFS also collects unpaid assessments by withholding reimbursements or other payments to the hospital, including payments from Managed Care Organizations (MCOs). Public Act 104-0470 provides HFS with the authority to collect unpaid assessments by offsetting or recouping payments to the hospital by any State agency, including State grants.  

Renegotiated Provider Assessment Payment Plan Agreement

HFS may waive collection enforcement requirements when a hospital enters into and remains compliant with a repayment plan or tax deferral plan.  The Public Act allows hospitals to enter into a renegotiated repayment plan with HFS under the terms outlined below. 

Under Public Act 104-0470, hospitals with an unpaid assessment obligation that previously entered into a Provider Assessment Payment Plan Agreement may enter into a renegotiated agreement, under which the total amount must be repaid over 72 months or less in equal monthly installments. Payments may be made through the Automated Clearing House (ACH) or by check on or before the 25th day of each month. Payments must begin within 30 days of the signed agreement date. Hospitals remain required to repay the total amount of their unpaid obligation. 

Hospitals with existing repayment agreements in effect prior to June 1, 2026, may either enter into the renegotiated agreement or follow the terms of their existing agreement. Regardless of whether a repayment plan is renegotiated, noncompliance with a plan without prior written approval from HFS will cause the hospital to be subject to immediate collection action. 

HFS will contact each hospital with an applicable repayment plan regarding its participation in the renegotiation opportunity. 

Public Act 104-0470 also prohibits HFS from entering into any new tax deferral plan with a hospital beginning July 1, 2026, meaning there is no forbearance on payment of assessments. Hospitals with unpaid assessments may still negotiate repayment agreements.

Questions regarding this notice may be directed to the Provider Assessment Unit via e-mail at HFS.ProviderAssessmentUnit@illinois.gov.  

Laura Phelan
Administrator, Division of Medical Program