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?
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!
Adult Wellness Incentive Program, MMP/Duals
Rate/Fee Schedule Updates: November
Molina’s PA Requirements: Q1 2025
Register for November Provider Webinars
Updates to Molina Clinical Policies, October 2024
Frequently Used Forms
- 2024 Q4 Prior Auth Codification- 2024 Q4 Prior Auth Discontinued
- Q3 Prior Auth Codification - 2024
- Q2 Prior Auth Codification - 2024
- Q1 Prior Auth Codification - 2024
- Q4 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.