IMPACT Provider Enrollment

IMPACT Overview

What is IMPACT?

  • IMPACT = Illinois Medicaid Program Advanced Cloud Technology
  • IMPACT is the Medicaid reimbursement system used to enroll agency and individual providers (IPs).
  • Healthcare and Family Services (HFS) replaced the legacy Medicaid reimbursement system to IMPACT.
  • All Home Services Program (HSP) waiver providers (IP's and Agencies) must enroll in IMPACT to become an eligible Medicaid provider.
  • Any reimbursement for eligible providers from Federal government requires this enrollment to be completed first.

IMPACT & Home Services Program

  • Enrollment in the IMPACT system is a federal requirement under the Affordable Care Act.
  • IMPACT requires all IPs and Agencies working for Home Services Program Customers to ENROLL and REVALIDATE in the system as an eligible Medicaid provider.
  • REVALIDATION will occur at a time determined by HFS.
  • The enrollment of the IPs will be handled in Central Office and by the Individual Provider Unit (IPU)

IMPACT IP Background Screenings

  • IMPACT requires all IPs enrolling to the system must go through a background screening.
  • Certain criminal convictions may affect the IPs ability to work as an eligible Medicaid provider under HSP.
  • Background screening is conducted during both the IMPACT Revalidation and initial Enrollment processes.
  • Enrollment into the IMPACT system is a federal requirement under the Affordable Care Act and failure to comply could result in the Individual Provider being deemed ineligible to serve as a provider under the Home Service Program.


IL488-2262 Waiver Program Provider Agreement English | Spanish
IL488-2263-IMPACT Individual Provider Enrollment Form English | Spanish
IL488-2541: Provider Background Screening Consent Form English | Spanish
IL488-2540: Provider Background Screening Dispute Form English | Spanish

 IMPACT Communication

IMPACT Communications Links Mailed On
IMPACT Enrollment Process to IPs and Customers English | Spanish 05/6/2016
Background Screening Process English | Spanish 1/13/2022
Provider Background Screening Agreement English 1/13/2022

 Ordering a Background Check of an IP

  • Criminal Background checks may be ordered by the Customer who wanted to hire a new IP.
  • HSP will cover the cost of the background check.
  • Please see the following links for more information:

IMPACT - Frequently Asked Questions

  • Why do IPs need to be enrolled in IMPACT?
    • Under the Affordable Care Act (ACA) federal requirement, HSP Individual providers (IPs) / Agencies are required to be enrolled in IMPACT, as a Medicaid provider, to be paid.
  • Do IPs have to enroll themselves in IMPACT?
    • No. IPs DO NOT have to enroll themselves in IMPACT. To ensure the enrollment process is handled timely and with minimal inconvenience to IPs, HSP Central Office will enroll all IPs in the IMPACT system.
  • Will IPs have to wait until they are enrolled in IMPACT before they can start working?
    • All IP's must be approved in the IMPACT system to begin providing services to HSP.
  • What is an NPI?
    • NPI is a 10-digit National Provider Identifier that is required for certain providers to be enrolled in the IMPACT System.
  • Do PAs require a NPI (National Provider Identifier)?
    • No. Only LPNs and RNs require an NPI.
  • Where can IPs receive help to obtain an NPI?
    • LPNs and RNs who need assistance to obtain a NPI can visit NPPES for assistance.
  • Why do IPs have to go through a background screening?
    • A background screening is part of the enrollment process in IMPACT. It is a federal requirement under the Affordable Care Act (ACA). Background screenings are conducted on ALL providers.
  • Do IPs have the option to refuse the background screening?
    • NO. The background screening is a required part of the enrollment process. This is not optional due to federal mandate.
  • Do the IPs have to pay for this background screening?
    • NO. The background screenings are conducted at NO COST to the IP.
  • What does the background screening look for?
    • The background screening looks for criminal convictions listed in CBA (Collective Bargaining Agreement) Section B, Section F and Section G that may affect the IP's ability to be approved to work as an eligible Medicaid provider. Please refer CBA background screening pages for detailed information.
  • Who makes the decision if the IP is an eligible Medicaid provider after the background screening?
    • Central office Staff will work in accordance with CBA (Collective Bargaining Agreement) in making determinations on the background screening results / potential conviction(s). IPs with a potential conviction(s) from Section F of CBA will be referred to the Office of the Inspector General (OIG) at HFS who will review the results and make the final determination.
  • If an IP has a criminal conviction(s) - will he/she be automatically terminated as an IP?
    • No. An IP's status will be determined by the CBA background screening policy. The background screening typically occurs at the time of enrollment or revalidation.
      • Waivable convictions (Section B/G) - Customer must consent to receiving services from the provider.
      • Non-Waivable Convictions (Section F) - OIG (Office of Inspector General) are responsible to review the nature of the offense and determine the IP's eligibility to serve as a Medicaid provider.
  • Who will notify the IP if he/she cannot work as an IP due to background screening results?
    • Central office Staff will notify the IP by sending Provider Background Screening Notification letter with information on the potential convictions if any.
      • Non-Waivable Convictions: IP can dispute or agree with the findings. If Central office staff can't decide on the dispute or agreement, the case will be routed to OIG for a decision. Based on the OIG's decision, IP will be allowed or denied working for that Customer. If denied, OIG will notify the IP that they can't work as a Medicaid provider and provide appeal rights
      • Waivable Convictions: IP can dispute or agree with the findings. Customer may choose to consent or not consent to receive services from the provider.
  • Can the IP appeal OIG's decision?
    • Yes, IPs have the right to appeal on OIG's decision following their appeal process. The appeals process is handled by HFS OIG and not by HSP or DHS.
  • Will the IP receive a letter of denial and appeals process?
    • OIG will reach out to the IP with the necessary denial/appeal paperwork as needed.
  • How can I find a new IP if my selected IP has a background screening issue?
    • When a Customer is trying to find IPs for their service plan tasks, the Customer can talk with their counselor to temporarily utilize a homemaker agency, they can reach out to their local CIL or doctor, or they can place ads in local forums if they feel comfortable doing so.
    • HSP does not keep a list of available IPs at this time.

Additional Resources

* Providers with further questions regarding enrolling to work for a Customer should contact their local DRS office.

DRS Office Locator