Bill Sponsors: IL SB1321 | 2019-2020 | 101st General Assembly
Bill Title: Amends the Illinois Public Aid Code. Permits the Department of Healthcare and Family Services to require medical assistance recipients to pay a federally approved co-payment for services (rather than prohibiting co-payments for medical assistance services and generic drugs). Removes a provision requiring the Department to authorize nutritionists and certified diabetes educators to counsel senior diabetes patients at the patient's home. Requires the Department to confer with stakeholders to discuss the development of alternative value-based payment models that move away from fee-for-service and reward health outcomes and improved quality and provide flexibility in how providers meet the needs of the individuals they serve. Requires the Department to meet with mental health providers and other specified persons no later than July 1, 2019 to discuss the development of value-based payment models. Contains provisions concerning an extended period for claims submissions outside the standard filing requirements; a dispute resolution process; annual publications on the Department's website of each Medicaid managed care organization's (MCO's) calculated medical loss ratios; a MCO's liability effective date; updated provider directories from MCOs; operational guidelines to enhance and improve operation performance of the State's Medicaid managed care program; and health care information released to managed care organizations. Contains provisions concerning managed care claim rejection and denial management; pay stub information to verify eligibility for medical assistance; other acceptable information to verify continued eligibility for medical assistance; a review of the Medicaid redetermination process in order to identify changes that can increase the use of ex parte redetermination processing; reporting requirements; and audits for the State's Integrated Eligibility System; provisional eligibility for Medicaid long-term care services. Removes a provision concerning third party liability recoveries. Requires the Department of Healthcare and Family Services to implement, by October 1, 2019, a methodology effective for dates of service July 1, 2019 and later to reimburse hospitals for inpatient stays extended beyond medical necessity. Makes other changes. Amends the Department of Healthcare and Family Services Law of the Civil Administrative Code of Illinois. Extends the completion date for a study the Department of Healthcare and Family Services must complete on long-term care trends and other matters. Amends the Illinois Procurement Code. Requires the Chief Procurement Officer to work with the Department of Healthcare and Family Services to identify an appropriate method of source selection to execute a contract for technology that will analyze claim denials in the Medicaid managed care program. Amends the Illinois Banking Act and the Illinois Credit Union Act. Makes changes to provisions concerning the furnishing of financial records by a bank or credit union to determine a person's eligibility or continued eligibility for Medicaid long-term care benefits. Amends the Children's Health Insurance Program Act and the Covering ALL KIDS Health Insurance Act. Adds provisions concerning pay stubs and other acceptable information to determine a person's eligibility for the benefits provided under those Acts. Effective immediately.
Spectrum: Moderate Partisan Bill (Democrat 19-5)
Status: (Passed) 2019-08-05 - Public Act . . . . . . . . . 101-0209 [SB1321 Detail]
Text: Latest bill text (Chaptered) [HTML]
Spectrum: Moderate Partisan Bill (Democrat 19-5)
Status: (Passed) 2019-08-05 - Public Act . . . . . . . . . 101-0209 [SB1321 Detail]
Text: Latest bill text (Chaptered) [HTML]
