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Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Criteria and Forms

As a result of Public Act 097-0689 (pdf), referred to as the Save Medicaid Access and Resources Together (SMART) Act, the department must develop utilization controls, including prior approval, for specialty drugs, oncolytic drugs, drugs for the treatment of HIV or AIDS, immunosuppressant drugs, and biological products in order to maximize savings on these drugs.

Forms

Criteria

*This section is currently under review.  New criteria will be posted as soon as possible.

Some drugs that previously required special prior approval forms no longer require them. If the drug is not listed above, please submit prior approval requests using the regular prior approval form.

By phone: 1-800-252-8942
By fax: 1-217-524-7264