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May 2026
Blooming Into Success: Your May Billing Digest
As the season of growth continues, May brings fresh opportunities to stay informed and connected. This month’s digest features important healthcare billing updates, policy changes, compliance guidance, and educational webinars aimed at supporting providers across Illinois. From coding reminders to professional development opportunities, these updates are designed to help your organization continue thriving this spring.
The Illinois Department of Healthcare and Family Services (HFS)
Established maximum daily quantity limits for select Medicaid-certified doula services, including prenatal patient education, postpartum parenting education, advocacy and connection to appropriate resources, and doula support during or after miscarriage or abortion. These limits apply to claims submitted for both Fee-for-Service and HealthChoice Illinois participants and became effective May 1, 2026. Click here to review the full provider notice.
Licensed Certified Professional Midwives (LCPMs) may begin enrolling in IMPACT and billing Medicaid for covered services effective May 1, 2026. Coverage applies to both Fee-for-Service and HealthChoice Illinois plans. Click here to review enrollment, billing guidance, and available training resources
Announced updates to reimbursement methodology for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) serving Wellcare Meridian Dual Align (HMO-DSNP) members. Effective October 1, 2025, reimbursement will be adjusted to pay up to the Medicaid rate following updated guidance from Illinois HFS—click here to review the reimbursement update and payment methodology details.
A small volume of Wellcare Meridian Dual Align (HMO D-SNP) provider payments scheduled for the April 2, 2026, payables cycle were delayed due to a processing issue. Meridian stated the issue has been identified and corrected, and impacted payments are being released as quickly as possible. No action is required from providers at this time—click here to review the full provider notice
Molina Healthcare of Illinois released updated Coordination of Benefits (COB) and Third-Party Liability (TPL) billing guidance effective July 1, 2026. The revised policy reinforces Medicaid as the payer of last resort and outlines updated reimbursement and claim submission requirements for secondary claims. Providers are encouraged to review billing procedures and submit primary payer explanation of benefits (EOB) to help prevent claim denials and processing delay. Click here to review the full provider memo.
CHAMP Software is hosting an Expert Webinar, “Tips and Resources for Improving the Immunization Experience,” on June 17, 2026, from 10:00–11:30 AM. The webinar will review strategies and resources to support positive vaccination experiences and improve patient engagement around immunizations. Healthcare providers, immunization staff, and public health professionals are encouraged to attend. Click here to register.
Illinois Department of Healthcare and Family Services is launching the HFS Stakeholder Webinar Series: Medicaid Changes Under HR 1, a monthly webinar series running May through October 2026 to help stakeholders understand upcoming federal Medicaid changes and implementation timelines. The series will provide guidance on policy updates, customer impact, eligibility considerations, and ongoing support efforts as Illinois prepares for changes taking effect January 1, 2027.
The first session, “Medicaid Overview and HR 1 Changes, Impact, and Timeline,” will take place on May 21, 2026, from 1:00–2:00 PM CST. Registration is required. Click here to register and view upcoming webinar modules.
Molina Healthcare of Illinois invites you to join the upcoming live webinars:
- HCBS and Home Health Billing, May 26, 1:00 PM Register
- Appeals and Grievances Processes, May 27, 1:00 PM Register
- Dental Provider Training, May 28, 10:00 AM Register
- FQHC, RHC, Encounter Clinic Billing, May 28, 1:00 PM Register
- Lactation Consultant Billing, June 2, 1:00 PM Register
- Open Forum Town Hall, June 15, 1:00 PM Register
- Provider Orientation, June 4, 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.
Aetna Better Health of Illinois
Aetna Better Health of Illinois will be conducting their annual Provider Satisfaction Survey from May 31 through July 16, 2026. During this time, provider agencies may receive a survey by mail from Press Ganey regarding their experience working with Aetna Better Health of Illinois.
Providers are encouraged to complete the survey, as feedback helps support ongoing quality improvement efforts and strengthens provider partnership and engagement. Click here to see the provider notice.
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 May 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.
The Q2 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.
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 is sharing a summary of recent news pertinent to your practice/facility.
Memo topics include: Rate/Fee Schedule Updates for May, 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
The May 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.
If you have any QUESTIONS or SUGGESTIONS for TOPICS that you would like to see covered in future issues of the IPHA Billing Digest, please email your suggestions and/or requests to insurancebilling@ipha.com.
Your feedback is valuable and appreciated.
Thank you!
