Illinois 2023-2024 Regular Session

Illinois House Bill HB0547 Compare Versions

Only one version of the bill is available at this time.

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1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB0547 Introduced , by Rep. Emanuel Chris Welch SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-16 from Ch. 23, par. 5-16 Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning managed care. LRB103 04117 KTG 49123 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB0547 Introduced , by Rep. Emanuel Chris Welch SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-16 from Ch. 23, par. 5-16 305 ILCS 5/5-16 from Ch. 23, par. 5-16 Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning managed care. LRB103 04117 KTG 49123 b LRB103 04117 KTG 49123 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB0547 Introduced , by Rep. Emanuel Chris Welch SYNOPSIS AS INTRODUCED:
3	3	305 ILCS 5/5-16 from Ch. 23, par. 5-16 305 ILCS 5/5-16 from Ch. 23, par. 5-16
4	4	305 ILCS 5/5-16 from Ch. 23, par. 5-16
5	5	Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning managed care.
6	6	LRB103 04117 KTG 49123 b LRB103 04117 KTG 49123 b
7	7	LRB103 04117 KTG 49123 b
8	8	A BILL FOR
9	9	HB0547LRB103 04117 KTG 49123 b HB0547 LRB103 04117 KTG 49123 b
10	10	HB0547 LRB103 04117 KTG 49123 b
11	11	1 AN ACT concerning public aid.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Illinois Public Aid Code is amended by
15	15	5 changing Section 5-16 as follows:
16	16	6 (305 ILCS 5/5-16) (from Ch. 23, par. 5-16)
17	17	7 Sec. 5-16. Managed Care. The The Illinois Department may
18	18	8 develop and implement a Primary Care Sponsor System consistent
19	19	9 with the provisions of this Section. The purpose of this
20	20	10 managed care delivery system shall be to contain the costs of
21	21	11 providing medical care to Medicaid recipients by having one
22	22	12 provider responsible for managing all aspects of a recipient's
23	23	13 medical care. This managed care system shall have the
24	24	14 following characteristics:
25	25	15 (a) The Department, by rule, shall establish criteria
26	26	16 to determine which clients must participate in this
27	27	17 program;
28	28	18 (b) Providers participating in the program may be paid
29	29	19 an amount per patient per month, to be set by the Illinois
30	30	20 Department, for managing each recipient's medical care;
31	31	21 (c) Providers eligible to participate in the program
32	32	22 shall be physicians licensed to practice medicine in all
33	33	23 its branches, and the Illinois Department may terminate a
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37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB0547 Introduced , by Rep. Emanuel Chris Welch SYNOPSIS AS INTRODUCED:
38	38	305 ILCS 5/5-16 from Ch. 23, par. 5-16 305 ILCS 5/5-16 from Ch. 23, par. 5-16
39	39	305 ILCS 5/5-16 from Ch. 23, par. 5-16
40	40	Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning managed care.
41	41	LRB103 04117 KTG 49123 b LRB103 04117 KTG 49123 b
42	42	LRB103 04117 KTG 49123 b
43	43	A BILL FOR
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49	49	305 ILCS 5/5-16 from Ch. 23, par. 5-16
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68	68	1 provider's participation if the provider is determined to
69	69	2 have failed to comply with any applicable program standard
70	70	3 or procedure established by the Illinois Department;
71	71	4 (d) Each recipient required to participate in the
72	72	5 program must select from a panel of primary care providers
73	73	6 or networks established by the Department in their
74	74	7 communities;
75	75	8 (e) A recipient may change his designated primary care
76	76	9 provider:
77	77	10 (1) when the designated source becomes
78	78	11 unavailable, as the Illinois Department shall
79	79	12 determine by rule; or
80	80	13 (2) when the designated primary care provider
81	81	14 notifies the Illinois Department that it wishes to
82	82	15 withdraw from any obligation as primary care provider;
83	83	16 or
84	84	17 (3) in other situations, as the Illinois
85	85	18 Department shall provide by rule;
86	86	19 (f) The Illinois Department shall, by rule, establish
87	87	20 procedures for providing medical services when the
88	88	21 designated source becomes unavailable or wishes to
89	89	22 withdraw from any obligation as primary care provider
90	90	23 taking into consideration the need for emergency or
91	91	24 temporary medical assistance and ensuring that the
92	92	25 recipient has continuous and unrestricted access to
93	93	26 medical care from the date on which such unavailability or
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104	104	1 withdrawal becomes effective until such time as the
105	105	2 recipient designates a primary care source;
106	106	3 (g) Only medical care services authorized by a
107	107	4 recipient's designated provider, except for emergency
108	108	5 services, services performed by a provider that is owned
109	109	6 or operated by a county and that provides non-emergency
110	110	7 services without regard to ability to pay and such other
111	111	8 services as provided by the Illinois Department, shall be
112	112	9 subject to payment by the Illinois Department. The
113	113	10 Illinois Department shall enter into an intergovernmental
114	114	11 agreement with each county that owns or operates such a
115	115	12 provider to develop and implement policies to minimize the
116	116	13 provision of medical care services provided by county
117	117	14 owned or operated providers pursuant to the foregoing
118	118	15 exception.
119	119	16 The Illinois Department shall seek and obtain necessary
120	120	17 authorization provided under federal law to implement such a
121	121	18 program including the waiver of any federal regulations.
122	122	19 The Illinois Department may implement the amendatory
123	123	20 changes to this Section made by this amendatory Act of 1991
124	124	21 through the use of emergency rules in accordance with the
125	125	22 provisions of Section 5.02 of the Illinois Administrative
126	126	23 Procedure Act. For purposes of the Illinois Administrative
127	127	24 Procedure Act, the adoption of rules to implement the
128	128	25 amendatory changes to this Section made by this amendatory Act
129	129	26 of 1991 shall be deemed an emergency and necessary for the
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140	140	1 public interest, safety and welfare.
141	141	2 The Illinois Department may establish a managed care
142	142	3 system demonstration program, on a limited basis, as described
143	143	4 in this Section. The demonstration program shall terminate on
144	144	5 June 30, 1997. Within 30 days after the end of each year of the
145	145	6 demonstration program's operation, the Illinois Department
146	146	7 shall report to the Governor and the General Assembly
147	147	8 concerning the operation of the demonstration program.
148	148	9 (Source: P.A. 87-14; 88-490.)
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