February 2026

Collaboration Counts — Building Connections in Billing

February may be the shortest month of the year, but here’s a reminder that strong connections make all the difference. In healthcare billing, success depends on coordination — between providers, billing teams, payers, and support staff — to keep claims moving and reimbursements on track.

In this edition of the Third-Party Billing Digest, we’re sharing updates, reminders, and practical tips to help strengthen those connections and keep your billing operations running smoothly. Let’s make every connection count.

Important News from Illinois Department of Healthcare and Family Services (HFS)

Illinois HFS: Updates to Dental Benefits for Members Under 21

The Illinois Department of Healthcare and Family Services (HFS) has released updates to dental benefits covered for members under the age of 21. The revised Exhibits A–C: Dental Benefits Covered – January 2026 outline covered services and benefit changes for eligible children and adolescents. Providers are encouraged to review the updated exhibits to ensure services are billed in accordance with current coverage guidelines. To review the updated Dental Benefits Covered (Exhibits A–C – January 2026), click here.

EVV Policy Update for Home Health Care Providers

Updated Electronic Visit Verification (EVV) policies for Home Health Care Services (HHCS) and Personal Care Services (PCS) providers will become effective April 1, 2026. This applies to providers billing State Plan Medicaid, HealthChoice Illinois (HCI) MCOs, and FIDE-SNP MCOs. Providers must be enrolled in the IMPACT system and use the State-selected EVV vendor, HHAeXchange (HHA), or another qualified vendor. Service codes in scope are listed in the Home Health Fee Schedule and HHA’s Illinois Information Hub.

Review the full provider notice here.

12-Month Contraceptive Supply Now Allowed

Beginning January 1, 2026, the Illinois Department of Healthcare and Family Services (HFS) will allow a maximum 12-month supply of contraceptives to be dispensed at once. This applies to both prescription and over-the-counter (OTC) FDA-approved drugs, devices, and products, excluding male condoms.

The change applies to fee-for-service (FFS) Medicaid as well as Managed Care Organization (MCO) plans, helping improve access and continuity of care for members.

For more details, review the HFS notification here.

A complete list of HFS Provider Notices can be found here.

If you have not already subscribed to receive email notifications from HFS when new Provider Notices are posted, you may subscribe here. To learn more about the many helpful resources available to healthcare providers, please visit the HFS Provider website.

The Centers for Medicare and Medicaid Services (CMS) is transitioning the Clinical Laboratory Improvement Amendments (CLIA) program into a fully electronic format. Effective March 1, 2026, paper fee coupons and CLIA certificates will no longer be mailed, and payments must be submitted online. Check payments will no longer be accepted.

Laboratories and providers performing testing should enroll in CMS email notifications to receive electronic fee coupons and certificates. Failure to transition may result in billing or certification issues. For additional information about the CLIA program updates and electronic transition, click here.

The Centers for Medicare and Medicaid Services (CMS) updated Rural Health Clinic (RHC) guidance for CY 2026, including direct supervision via telehealth, revised payment rates, new behavioral health HCPCS codes, and discontinued codes with alternatives. RHCs can continue billing telehealth services with G2025 through December 31, 2026. Learn more and view the full PDF here.

Blue Cross and Blue Shield of Illinois is hosting the Q1 Community Stakeholder Committee Meeting on Thursday, February 19, 2026, from 1:00–2:30 PM CST via Zoom. This session is an opportunity for stakeholders to provide feedback on cultural humility, helping BCCHP strengthen support for the communities it serves. Participants are encouraged to complete a brief cultural humility survey to share insights and guide ongoing initiatives. Register here to receive Zoom instructions and a calendar invite.

The Centers for Medicare and Medicaid Services (CMS) is hosting the 2026 CMS Burden Reduction Conference on Wednesday, February 25, 2026, from 9:00 AM – 1:00 PM ET. Federal leaders, health provider organizations, and patient-facing clinicians will discuss opportunities to reduce administrative burden and strengthen access to quality care across the healthcare system. Click here to register.

The National Association of State and Territorial AIDS Directors (NASTAD) is hosting a webinar on Wednesday, March 4, 2026, from 2:00–3:00 PM ET to introduce two new supplemental PrEP billing and coding guides: CMS National Coverage Determination for PrEP and Lenacapavir (LEN) for PrEP. These supplements build on the 2023 PrEP, PEP, and Other HIV Prevention Strategies guide, incorporating updated coverage, new billing codes, and the addition of Lenacapavir (LEN). The webinar will review both guides, showcase essential resources, and provide answers to participants’ billing questions. To register for this webinar, please click here.

Illinois HFS is hosting a quarterly EVV Townhall webinar on March 26, 2026, from 9:00–11:00 a.m. (CST). The State and HHAeXchange (HHA) will provide updates on EVV policies, compliance requirements, authorizations, portal navigation, and EDI setup. Click here to register.

The Illinois Rural Health Association is hosting a webinar on March 17, 2026, from 2:00–3:00 PM, covering the new End-of-Life Options for Terminally Ill Patients Act. The session highlights its impact on clinicians, hospice programs, and public health systems in rural communities and provides practical guidance on how the law intersects with hospice and palliative care.

Fee for non-members: $55 (includes the webinar and a 12-month individual membership). Click here to register.

Meridian is offering a no-cost webinar series through its parent company, Centene, for providers, coders, billers, and administrative staff as best practices in clinical documentation and coding continues to evolve. These sessions will help enhance understanding of risk adjustment methodologies, accurate and compliant documentation, and coding strategies aligned with regulatory standards. Attendees may also earn continuing education credits (CEUs) while strengthening skills to improve payment accuracy and reduce compliance risks. To learn more and see the full list of webinars, please click here.

Molina Healthcare of Illinois invites you to join the upcoming live webinars:

• Dental Provider Training, February 19th, 11:00 a.m. Register
• CMHC and SUPR Town Hall, February 19th, 1:00 p.m. Register
• Quality Improvement, HEDIS and More, February 23rd, 1:00 p.m. Register
• HCBS and Home Health Billing, February 24th, 1:00 p.m. Register
• Appeals and Grievances Processes, February 25th, 1:00 p.m. Register
• Dental Provider Training, February 26th, 10:30 a.m. Register
• FQHC, RHC, Encounter Clinic Billing, February 26th, 1:00 p.m. Register

Looking for additional sessions? Explore the full 2026 schedule of live webinars exclusively for Illinois providers and register for provider updates to receive notices for upcoming trainings.

Aetna Better Health of Illinois

Effective February 1, 2026, Office Ally will no longer be a cost-free option for claims submissions using payor ID 68024. This change applies only to current Office Ally users who submit claims for this payor ID. Aetna Better Health® of Illinois had previously partnered with Office Ally to provide free claim submissions due to the Change Healthcare outage, but this service will now be sunsetting.

Providers may register and submit claims directly via Connect Center or Availity.

Aetna Better Health® of Illinois is committed to supporting providers with claims-related issues during the redetermination process. This support includes assistance with claims submissions for members during their redetermination window. Click here to see the provider notice.

Contact your Provider Relations representative with any questions.

BlueCross BlueShield of Illinois

The January 2026 issue of Blue Review is available here. If you have not already subscribed to receive this publication, you may sign up here. 

To contact your Provider Network Consultant, visit Provider Network Consultant Assignments for more information.

Humana

Requirements for the 2026 prior authorization and notification lists (PALs) are now available. Click here to review Illinois Prior Authorization and Notification List.

The Q1 2026 issue of Humana Physician News is available here. If you have not already subscribed to receive publications from Humana, you may sign up here.

Meridian

Monthly Provider Check-In can be found here.

Contact your assigned Provider Engagement Administrator or representative for support. For those without an assigned representative, complete this intake form or contact Meridian using the information here.

To see the complete list of 2026 trainings please click here.

Molina             

The first quarter 2026 Molina Healthcare of Illinois Provider Newsletter is here, featuring key updates on the digital-only prior authorization process, IAMHP’s new roster template, Model of Care training, Molina in the community, and much more.

Read the full newsletter here.

Molina is sharing a summary of recent news pertinent to your practice/facility. Memo topics include: Rate/Fee Schedule Updates for January, Updates to Molina Clinical Policies, and much more! You can find the ‘Memo Roundup’ here.

To register for Illinois provider updates, so you don’t miss any bulletins, Click Here.

Contact your dedicated Provider Relations Manager or email the Provider Relations team at MHILProviderNetworkManagement@MolinaHealthcare.com. To help identify your dedicated Provider Relations Manager, visit Molina's Service Area map.

United Healthcare

The February 2026 issue of Network News contains important notifications and updates for healthcare providers.

The February 2026 Reimbursement Policy Update can be found here.

The News Your Way feature allows you to customize your subscription to receive information and updates specific to your role, specialty, and state. Click here to subscribe or update your preferences.