KodaComplyHome care rules, state by state, in plain EnglishDocuments collected September 22, 2026

Illinois home care rules

Illinois licenses home services (non-medical), home nursing and home health agencies through the Department of Public Health (IDPH). Medicaid home care is run by HFS, the Department on Aging's Community Care Program (CCP) and the DHS Home Services Program, and is paid directly or through five health plans: Aetna Better Health of Illinois, Blue Cross Community Health Plans, CountyCare, Meridian and Molina. Since April 1, 2026, every program checks EVV each quarter, and at least 75% of your visits must be recorded without manual edits.

111 official documents·collected September 22, 2026·checked against them September 22, 2026
License for non-medical home care?YesHome Services Agency license from IDPH · $1,500 fee. IDPH also issues a separate home services placement agency license ($500).
License for home health?YesHome Health Agency license from IDPH · $1,500 every two years. Medicaid enrolls Medicare-certified home health agencies and licensed home nursing agencies.
EVV75% each quarterFree HHAeXchange system or your own linked to it, for personal care and home health. CCP and DRS homemaker agencies joined March 2, 2026.
Medicaid health plans5 LTSS plansAetna Better Health, Blue Cross Community Health Plans, Meridian, Molina (statewide); CountyCare (Cook County only)

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Act nowQuarterly policy effective April 1, 2026

Keep EVV at 75% or better — the July–September quarter closes September 30

Every Illinois Medicaid home care program now measures EVV by state fiscal-year quarter. At least 75% of visits must capture all six federal elements with no manual entry or edit, and claims without visit data also count against you. A first missed quarter brings a notice and required training; three in a row brings a referral to the HFS Office of Inspector General.

What to do: Open your latest Know Your Numbers report this week. Fix failed member placements and cut back manual edits before September 30.
Read this monthGo-live March 2, 2026

CCP and DRS homemaker agencies are now on HHAeXchange

Agencies serving Community Care Program and Home Services Program customers must use the free HHAeXchange system or send visits to it from their own vendor. Agency administrators in HHAeXchange get a "Know Your Numbers" compliance report on the 15th of every month. The free version does not do billing, so keep your current billing process.

What to do: Check that every caregiver has a full Social Security number in HHAeXchange and that your vendor's visits show up in your portal.
Read this monthDraft dated May 20, 2026

Proposed renewal of the elderly waiver (CCP) from October 1, 2026

The draft adds a check of the Adult Protective Services (APS) abuse registry for all provider staff, and says background check results go into IDoA's Training Tracking Portal. It says 2 of a homecare aide's 12 yearly training hours must be dementia training, and updates grievance procedures. It is a draft and is not in effect yet.

What to do: Read Appendix C-2 of the draft and plan how you will add the APS registry check to your hiring steps.
For the recordEVV town hall FAQ, March 26, 2026

HFS has not started EVV-based payment

HFS says it plans to explore EVV claim edits across Illinois Medicaid programs and health plans, but has not started. Agencies will get advance notice and training first. Claims without visit data already count against your quarterly EVV rate.

What to do: Nothing for now. Clean EVV data today will make any later change easier.

Deadlines coming up

Dates taken from the rules and notices as we read them.

7days
September 30, 2026

EVV quarter ends (July 1 to September 30)

Agencies under 75% EVV compliance for the quarter, or with claims lacking visit data, face the next step of the penalty ladder.

8days
October 1, 2026

Proposed start of the renewed elderly (CCP) waiver

Draft only. It would add APS abuse registry checks for all provider staff.