IMPACT Provider Enrollment

IMPACT Overview

What is IMPACT?

  • IMPACT is an acronym that stands for  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.

IMPACT Forms

IL488-2262 Waiver Program Provider Agreement English | Spanish
IL488-2263-IMPACT Individual Provider Enrollment Form IL488-2263English | 202401Spanish
IL488-2541: Provider Background Screening Consent Form Il488-254English | Il488-254Spanish
IL488-2540: Provider Background Screening Dispute Form IL488-2540English | Il488-2540Spanish
IL488-2252: Individual Provider Payment Policies IL488-2252English | IL488-2252Spanish
IMPACT Revalidation Forms Packet (Printable) Download Here (pdf)

 IMPACT Communication

IMPACT Communications Links Mailed On
IMPACT Enrollment Process to IPs and Customers IL-DRS2016English | IL-DRS2016Spanish 05/6/2016
Background Screening Process Il14048English | 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:

Frequently Asked Questions

IMPACT Enrollment

  • 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.

IMPACT Revalidations

  • What are Revalidations?
    • Revalidations are the federal requirement that Medicaid providers must re-enroll in the IMPACT system to maintain their eligibility to provide services to Home Services Program (HSP).
    • Revalidations must be performed every 5 years for HSP Providers and Agencies.
    • Due to the Public Health Emergency for COVID-19 the revalidation period for HSP providers was previously delayed.
  • Who must Revalidate?
    • Individual providers (IPs) such as Personal Assistants, Registered Nurses, Licensed Practical Nurses, and Certified Nurse Aides.
    • Agency providers including but not limited to Homemaker, Home Health/Nursing, and Home Modification providers will also be required to revalidate.
  • When does Revalidation Start?
    • Revalidation due dates has been set to begin on Aug 1, 2024 (Due dates are per HFS).
    • Starting July 18, 2024, First group of 
      • HSP Individual Providers will receive USPS letters and emails (for those who have emails in our system) notice to inform them of their upcoming revalidation period.
      • HSP Agency Providers will receive emails from HFS.
  • How do IP's Revalidate?
    • When Provider receives the first reminder, they must complete the DHS Forms and return them to the local office asap. Go to IMPACT Forms section to download. 
      • IL488-1413 HSP Provider Agreement
      • IL488-2262 Waiver Program Provider Agreement
      • IL488-2263 Impact Individual Provider Enrollment Form
      • IL488-2252 IP Payment Policies
      • Copies of valid government issued photo id (Example : Driving License)
      • Social security number verification. (Example : SSN)
    • Provider must send a separate IL488-2252 should be completed for each IP/Customer relationship.
  • How do Agencies (Home Maker/Home Health/Other) Revalidate? 
  • What if an Agency or IP does not submit their revalidation in the appropriate time frame?
    • IMPACT and DHS/HSP will change their status to "Inactive"
    • They will no longer be able to be paid with state funds and will not be considered a Medicaid Provider.
  • When will revalidations end?
    • Revalidations are required every 5 years based on their initial approval date.
  • If a provider works for multiple customers, will they need consent for waivable crimes for each customer?
    • Yes, any customer that does not consent will have that IP end dated for that one customer.
  • Do Nurse IP's have to revalidate?
    • Yes, LPN/RN/CNA must revalidate.
    • If a provider does one of LPN/RN and one of PA/CNA, they must complete two separate revalidations likely at different times.
  • Do Suspended IP's revalidate?
    • Yes, if they do not revalidate by the due date mentioned in the "Revalidation Reminder Letter" IP will become inactive and they will not be able to work/be paid by HSP.
    • After becoming Inactive, if a Provider wants to work for a HSP customer, they have to start their enrollment process from the beginning by completing a full IP Packet.

Additional Resources

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