Welcome, Illinois Medicare-Medicaid Plan Providers
Illinois' Medicare-Medicaid Plan is Statewide!
Molina Healthcare of Illinois is participating in a program with the Centers for Medicare & Medicaid Services (CMS) and the Illinois Department of Healthcare and Family Services (HFS) called the Medicare-Medicaid Alignment Initiative (MMAI). This program benefits our members by providing the convenience of coordinated care with one Primary Care Provider (PCP) and one ID card.
In Illinois, Molina's Medicare-Medicaid Plan (MMP) is called Molina Dual Options.
Contracted providers are an essential part of delivering quality care to our members, and we value our provider partnerships.
Do you have a contract with Molina Healthcare of Illinois for MMP? Click here to Join Our Network! Contact the Provider Network Management team at (855) 866-5462 with questions.
Need a Prior Authorization?
PA Lookup tool is under maintenance.
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Become a Molina Provider
Would you like to become a Medicare-Medicaid Plan (MMP)/Dual Options provider with Molina? Visit our page called Join Our Network for step-by-step instructions.
Provider Education Series
Molina Healthcare of Illinois hosts provider training sessions throughout the year. Our webinars are free and open to all network providers and their medical and office staff.
Registration is quick and easy! Click here to view and register for upcoming sessions.
Medicare Compliance Program
Molina Compliance Hotline: (866) 606-3889 or Molinahealthcare.AlertLine.com
Reporting Compliance and Fraud, Waste, or Abuse
Molina Medicare Compliance Program
Code of Business Conduct and Ethics
Medicare Compliance Issues Policy
Document Retention and Destruction Policy
Medicare Fraud, Waste, and Abuse Plan
FDR Compliance Auditing Policy
Automated Critical Updates! We know you’re busy. Sign up to receive provider news delivered to your inbox. Click to get started:
What's New?
Illinois Provider Feedback Survey!
Recap of February Provider News
Rate/Fee Schedule Updates: March 2024
Update: Optum-Change Healthcare Outage
Updates to Molina Clinical Policies, February
Recap of January Provider News
Billing With the Correct Auth Number
Molina’s PA Requirements: 2Q 2024
Frequently Used Forms
- Q1 Prior Auth Codification - 2024- Q4 Prior Auth Codification - 2023
- Q3 Prior Auth Codification - 2023
- Q2 Prior Auth Codification - 2023
- Q1 Prior Auth Codification - 2023
- Provider Manual (Medicaid| MMP)
- Drug Formulary (Medicaid| MMP)
- Illinois Service Area - Hospital
- Illinois Service Area - Ancillary
- Illinois Service Area - FQHC
- Illinois Service Area - Contracting
- Illinois Service Area - Quality
- Medical Prior Auth Request Form
Find more frequently used forms here.