March 2026

Spring Forward with Secure Billing Practices

As we move into March and the start of spring, it’s the perfect time to refresh routines and reinforce the security practices that protect billing operations. Staying informed and proactive helps ensure claims are processed smoothly while safeguarding sensitive information.

In this edition of the Third-Party Billing Digest, you will find important updates, reminders, and resources to help keep your billing processes secure and on track.

Communication Roadmap: Disputes/Appeals, Recoveries, and More

Molina Healthcare of Illinois (Molina) is reminding providers about the correct submission methods and contact information for disputes, appeals, recoveries, and other provider communications to help ensure requests are routed and processed efficiently. Click here to see the provider notice.

Prior Authorization Changes for Some Commercial and Government Program Members

Blue Cross and Blue Shield of Illinois is updating prior authorization requirements for some commercial non-HMO, Medicare Advantage, and Community Health Plan members based on routine utilization reviews and coding updates. Changes for Medicare Advantage members take effect April 1, 2026. Click here to review the provider update.

Blue Cross and Blue Shield of Illinois ask providers to resubmit Medicaid claims for Blue Cross Community Health Plans members that were incorrectly rejected due to invalid National Drug Codes (NDC) for dates of service Aug. 1, 2025–Feb. 22, 2026. Claims may be resubmitted within 90 days. Click here for resubmission instructions and additional details.

The Centers for Medicare and Medicaid Services (CMS) has extended the application deadline for the GENErating cost Reductions for U.S. Medicaid (GENEROUS) Model from March 31 to April 30, 2026. The initiative aims to lower Medicaid drug costs, improve care quality and outcomes, and expand access to critical medications. Click here to learn more.

The Centers for Medicare and Medicaid Services (CMS) clarified billing for Hepatitis C virus screening in adults. Medicare will pay for HCPCS code G0567 with modifier QW for CLIA-waived labs, and without QW for non-CLIA-waived labs, retroactive to June 27, 2024. The policy itself hasn’t changed, and your Medicare Administrative Contact (MAC) will adjust claims that you report. Click here for more information.

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS): Temporary Enrollment Moratorium on Medical Supply Companies

On February 27, CMS implemented a temporary nationwide enrollment moratorium on DMEPOS medical supply companies. The moratorium will remain in effect for six months and may be extended in six-month increments. Any initial enrollment or change in majority ownership applications that violate the moratorium will be denied. Click here for more information.

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

BlueCross BlueShield of Illinois has created a resource on documentation and coding for Healthcare Effectiveness Data and Information Set measures through Availity Essentials. Accurate and complete coding is an important step in capturing members’ health status.

To access the resource: Sign in to Availity Essentials and visit Payer Spaces. You can download the Quality Care 2026 resource from the Resources section under Quality Improvement.

The March 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.

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

Molina

Molina Healthcare of Illinois (Molina) reminds providers that, based on current respiratory syncytial virus (RSV) surge data and guidance from the Illinois Department of Public Health (IDPH), the RSV season has been extended. To protect high-risk individuals during the tail end of the season, RSV vaccination is recommended through March 31, 2026. Click here to see the provider memo.

Molina Healthcare of Illinois (Molina) reminds providers that the 30th Edition of the MCG Care Guidelines takes effect on April 30, 2026. Providers can access the guidelines through the Availity Essentials Portal via MCG Cite Guideline Transparency. Click here to view the provider memo.

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 March 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.  

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

• Open Forum Town Hall  |  March 17, 1:00 PM Register
• Dental Provider Training  |  March 19, 2:30 PM Register
• Quality Improvement  |  HEDIS and More, March 23, 1:00 PM Register
• Dental Provider Training  |  March 25, 11:00 AM Register
• FQHC, RHC, encounter Clinic Billing  |  March 26, 1:00 PM Register
• Dental Provider Training  |  March 31, 10:30 AM Register
• Lactation Consultant Billing  |  April 7, 1:00 PM Register
• Roster and Credentialing  |  April 14, 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.

Molina Healthcare of Illinois reminds providers that the Centers for Medicare and Medicaid Services (CMS) offers web-based training and resources on Home and Community-Based Services (HCBS) topics to support understanding of HCBS program requirements. Click here to view the list of training resources.

County Health Rankings & Roadmaps (CHR&R) is hosting a webinar on March 31, 2026, at 2:00 PM to guide participants through the latest data and action resources. This session will help communities understand what’s driving health and well-being in their county and state and identify strategies that improve health, equity, and longevity. Click here to register.

The 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.