If DHS and HFS make timely decisions on less than 96% of the medical benefits applications received during a month, the State must reimburse qualifying applicants for covered medical expenses they paid or someone paid for them.
A person qualifies for reimbursement if DHS and HFS failed to meet the 96% standard for the month in which their application was approved and:
In addition, a long-term care resident may be entitled to reimbursement if DHS did not send a timely approval for billing.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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