Illinois Department of Human Services
Division of Developmental Disabilities
IMPACT Provider Enrollment System - New System Now In Effect
The purpose of this Information Bulletin is to make DD Medicaid providers aware of changes in the provider enrollment system and new National Provider Identifier (NPI) requirements for residential and Developmental Training Providers.
To modernize the Medicaid provider enrollment system to meet federal requirements in the Affordable Care Act (ACA), Illinois is implementing a new web-based system known as IMPACT. IMPACT replaces the paper-based applications used to enroll, add services or make modifications in the Medicaid provider enrollment system. Additional documentation may be required for the Division to approve applications in IMPACT and to obtain access to the DHS billing software.
Enrollment information in the old system has been converted to IMPACT. The Illinois Department of Healthcare and Family Services (HFS) requires that providers revalidate their information. The deadline for completing the revalidation is December 31, 2015. PowerPoint presentations have been posted to the DHS web site to assist DD Waiver providers with completing the revalidation.Please see Important IMPACT Information for All Providers.
New NPI Requirements
HFS has broadened the NPI requirements to include
- All Residential and Developmental Training providers.
- Intermediate Care Facilities for a person with a Developmental Disability (ICF/DD),
- Community Integrated Living Arrangements (CILA),
- Community Living Facilities (CLF),
- Child Group Home (CGH),
- Developmental Training (DT).
Providers must have an NPI in order to revalidate or enroll in IMPACT. Providers can apply for an NPI through the National Plan and Provider Enumeration System (NPPES).
Changing Enrollment Types
Providers have been assigned enrollment types in IMPACT based on the presence or absence of an NPI in the older enrollment system. Due the change in NPI requirements, some agencies may need to change their enrollment type from an Atypical Agency (no NPI) to a Facility, Agency, and Organization (FAO). Please contact the Provider Enrollment Unit at DHS.DDDMedPRov@illinois.gov if the assigned enrollment type needs to be changed.
GROUPS and Rendering/Servicing Providers:
Any billing provider that submits claims and/or receives payments for other providers is required to enroll in the IMPACT system. This includes billing providers that are not providing Medicaid services themselves. A business entity that is functioning in the DD waiver programs solely as the billing provider for counseling, behavioral intervention and treatment, physical, occupational and speech therapy services will need to enroll in IMPACT as a "Group."
Approval Process and Notifications of Approval
IMPACT applications for providers that have an NPI will be initially reviewed by HFS. Email notifications will be sent to providers once HFS approves their portion of the review. The IMPACT approval notice does not indicate that the Division of Developmental Disabilities (DDD) has approved or will approve the application. Providers will be notify via email when DDD has approved the application.
Revalidation for Intermediate Care Facilities for persons with Developmental Disabilities (ICF/DD)
ICF/DD providers are required to revalidate in IMPACT. Please view the FAO PowerPoint Presentation available at Important IMPACT Information for All Providers and use the Provider Mapping Spreadsheet to determine the Specialty. ICF/DD providers will need to associate with DDD by associating to the DDD MCO (IMPACT ID: 3000006). Questions regarding the revalidation process for ICF/DDs should be directed to the IMPACT Help Desk or the HFS Bureau of Long Term Care at (217) 782-4235.
The conversion to IMPACT is underway. Materials have been shared with providers and informational sessions via webinars have been made available. This Information Bulletin is effective immediately upon posting in its final version.