This notice states the Department’s position regarding providers charging Medicaid participants for personal protective equipment (PPE).
This notice states the Department’s position regarding providers charging Medicaid participants for personal protective equipment (PPE). This applies to participants covered under both traditional fee-for-service and managed care plans.
Federal Medicaid regulations at 42 CFR Part 447.15
, and HFS administrative rule at 89 Ill. Admin. Code Section 140.12 (i)
require that providers accept Medicaid payment as payment in full. The PPE required for providers to perform medical, dental, or non-emergency transportation services is considered part of the service. If the provider bills HFS for that service, the provider cannot then bill the participant for the PPE separately. Any increased expense for PPE cannot be passed to Medicaid participants.
The Department will continue to monitor the situation and will take appropriate action as necessary.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service issues, your DentaQuest provider representative or to the applicable MMAI
or HealthChoice Illinois
managed care plan.