April 2026

New Season, Clearer Claims: Your April Billing Digest

April brings a fresh season of updates, trainings, and opportunities to stay informed across the healthcare landscape. As we move deeper into spring, providers can look forward to new policy changes, important compliance reminders, and a wide range of educational webinars designed to support continued learning and operational excellence. This month’s updates highlight key billing and regulatory changes across Illinois Medicaid programs, along with upcoming training sessions to help strengthen clinical, coding, and administrative expertise.

Billing Requirements Reminders for Substance Use, Prevention, and Recovery Providers (SUPRs)

Meridian will validate all claims received on or after February 26, 2026, based on regulatory rules established by Illinois Healthcare and Family Services (HFS) for SUPR providers; these rules apply to providers registered with HFS as provider type 075. Additional guidance is available in the Illinois Association of Medicaid Health Plan’s (IAMHP) Comprehensive Billing Guide under the “Coding Requirements” section of the Substance Use Prevention and Recovery Services (SUPR) chapter—click here to view the provider notice.

Molina Healthcare of Illinois (Molina) routinely reviews clinical documentation for substance use disorders (SUD) to ensure diagnoses match documented findings. Providers may be asked to review records and submit corrected claims if needed. This process supports accurate documentation and coding and does not imply inappropriate care. Click here to view the provider notice.

The Illinois Department of Healthcare and Family Services (HFS) will implement Advanced Communication Engine (ACE) Member Edits for claims submitted to HealthChoice Illinois (HCI) Managed Care Organizations (MCOs) to streamline claim submission processes; these edits do not apply to the Medicaid Fee-for-Service program. Implementation will occur in phases by MCO beginning April 23, 2026—click here to view the tentative implementation schedule.

The Illinois Association of Medicaid Health Plans (IAMHP), in collaboration with the Illinois Department of Healthcare and Family Services (HFS), has released an informational notice introducing a standardized template for contracting and payment processing. The template is intended for all Illinois Medical Assistance providers who currently contract, or are considering contracting, with a Medicaid managed care organization (MCO), and is designed to streamline the collection of key provider information. Click here to read the full notice.

National Government Services (NGS) Rebrands to Wellpoint Federal

National Government Services (NGS), a subsidiary of Elevance Health, has rebranded to Wellpoint Federal effective April 1, 2026. The name change reflects a shift toward delivering enterprise-scale solutions across the federal healthcare landscape, while continuing to support key functions such as Medicare claims processing, data management, financial services, and IT systems. Click here to read the full press release.

The Center for Health Care Strategies hosts a webinar on May 6, 2026, at 1:00 PM: “Innovations in Substance Use Care Delivery for Medicaid Members: A No Wrong Door Approach.” Experts from Maine, Massachusetts, and New Jersey will highlight innovations in emergency response, correctional re-entry, rural and unhoused support, and nurse-led primary care integration. Click here to register.

Meridian, in partnership with Centene, is offering a Q2 2026 Clinical Documentation Improvement (CDI) webinar series focused on strengthening coding accuracy and advancing risk adjustment methodologies. These sessions provide ongoing education to support providers, coders, billers, and administrative staff as clinical documentation standards continue to evolve. This no-cost series is available to all Meridian partners. Click here to view the full training schedule and register

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

• Utilization Management Process  |  April 29, 1:00 PM Register
• Dental Provider Training  |  April 30, 11 AM Register
• D-SNP Reimbursement  |  May 4, 1:00 AM Register
• Doula Billing  |  May 5, 1:00 PM Register
• Provider Orientation  |  May 7, 2:00 AM Register
• Social Determinants of Health  |  May 11, 1:00 PM Register
• Avoiding Common Denials  |  May 12, 1:00 PM Register
• CCBHC program in Medicaid  |  May 13, 2:00 PM Register
• CMHC and SURP Billing |  May 18, 1:00 p.m. Register
• Quality Improvement, HEDIS, and More  |  May 18, 2:00 PM 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.

The Illinois Rural Health Association is hosting a webinar on April 22, 2026, from 2:00 PM to 3:00 PM covering the latest legislative and regulatory health policy updates and trends affecting the Rural Health Clinic (RHC) program. Topics include telehealth, Medicare Advantage, and strategies for RHCs to engage in federal advocacy. Click here to register.

The Center for Health Care Strategies created a pre-recorded Medicare Advantage Policy Basics training series to support Medicaid staff and partners in building Medicare expertise. These modules provide on-demand guidance for improving care for the 12+ million Americans dually eligible for Medicare and Medicaid. Click here to view the training series.

Aetna Better Health of Illinois

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 April 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

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.

Humana’s Medicare Stars Learning team is pleased to offer a series of live, facilitated educational sessions throughout 2026 to help providers stay informed and up to date. Click here to learn more and register.

Meridian

Monthly Provider Check-In can be found here.

Join Meridian’s live monthly session to stay informed on the latest updates for providers. Click here to register for the live session.

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.

Molina

Molina is sharing a summary of recent news pertinent to your practice/facility. Memo topics include: Rate/Fee Schedule Updates for April, 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 April 2026 issue of Network News contains important notifications and updates for healthcare providers.

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.