In the wake of new counties being added to the Medicaid Managed Care program (HealthChoice Illinois) effective April 1, the Illinois Pharmacists Association (IPhA) is in regular contact with the Department of Health and Family Services about challenges with patient transitions from fee-for-service to managed care. IPhA indicates that pharmacies having unresolved issues with Medicaid recipients can email IPhA. Please include the Recipient Identification Number (RIN), which MCO (not PBM) and any relevant notes. To file a complaint so that it is on the record, visit the HFS webpage and complete Illinois’ Medicaid Managed Care Organization (MCO) Provider Complaint Form. IPhA also encourages Medicaid recipients who need to enroll or call HealthChoice Illinois with questions to call 877-912-8880 (TTY: 1-866-565-8576) Monday to Friday from 8:00 AM to 7:00 PM.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.