Illinois House Bill HB4076

Illinois 2023-2024 Regular Session

• Introduced: 5/9/23
• Refer: 2/29/24
• Refer: 5/9/23
• Refer: 5/31/24

Caption

MEDICAID-REDETERMINATIONS

Impact

The introduction of a cloud-based system aims to automate and streamline the process of determining and redetermining eligibility for medical assistance. The system will leverage secure communication platforms to reach out to medical assistance enrollees, ensuring that no individual is overlooked during the redetermination process. This automation is expected to enhance the efficiency and reliability of the eligibility assessments, potentially leading to better service delivery for those relying on medical assistance programs.

Summary

House Bill 4076 amends the Illinois Public Aid Code to introduce a structured process for redetermining the eligibility of medical assistance enrollees who are not covered by specific federal waivers under the Social Security Act. The bill mandates the Department of Innovation and Technology, in collaboration with the Department of Healthcare and Family Services, to hire a certified State vendor to manage this eligibility redetermination process. The selected vendor must meet stringent criteria, including having at least 60% of its ownership residing in Illinois, and must adhere to the standards set forth by the Business Enterprise Program.

Contention

While the bill aims to modernize eligibility determination through automation, it also raises questions about data privacy and the potential for unintended consequences in ensuring that those eligible for assistance remain enrolled. There may be concerns regarding the reliance on automated systems, including how effectively they can respond to the nuanced needs of individuals in various circumstances. Ensuring compliance with both state and federal regulations remains a crucial component, and any failure to align with Centers for Medicare and Medicaid Services standards could jeopardize the entire framework set forth by the bill.