Illinois 2023-2024 Regular Session

Illinois Senate Bill SB1831 Compare Versions

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

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1831 Introduced 2/9/2023, by Sen. Elgie R. Sims, Jr. SYNOPSIS AS INTRODUCED: 305 ILCS 66/20-10305 ILCS 66/20-20 Amends the Rebuild Illinois Mental Health Workforce Act. In a provision concerning Medicaid funding for community mental health services, sets forth rate increases, to begin on and after January 1, 2024, for the following rates and services: the Mobile Crisis Response Medicaid Payment rate for all services provided under the S9484 procedure code; the Crisis Intervention Medicaid Payment rate for all levels of services provided under the H2011 procedure code; the Integrated Assessment and Treatment Planning Medicaid Payment rate for all levels of services provided under the H2000 procedure code; the Group and Family Therapy Medicaid Payment rate for all levels of services provided under the H0004 procedure code; the Community Support - Group Medicaid Payment rate for all levels of services provided under the H2015 procedure code; the Telepsychiatry Originating Site Medicaid Payment rate for services provided under the Q3014 procedure code; and the Medication Monitoring Medicaid Payment rate for services provided under the H2010 procedure code for medication monitoring provided by a physician, an advanced practice registered nurse, and all other levels of provider. Provides that no base Medicaid rate payment or any other payment for the provision of Medicaid community mental health services in place on January 1, 2023 shall be diminished or changed to make the reimbursement changes required by the amendatory Act. Provides that any payments required under the amendatory Act that are delayed due to implementation challenges or federal approval shall be made retroactive to January 1, 2024 for the full amount required by the amendatory Act. LRB103 27179 KTG 53549 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1831 Introduced 2/9/2023, by Sen. Elgie R. Sims, Jr. SYNOPSIS AS INTRODUCED: 305 ILCS 66/20-10305 ILCS 66/20-20 305 ILCS 66/20-10 305 ILCS 66/20-20 Amends the Rebuild Illinois Mental Health Workforce Act. In a provision concerning Medicaid funding for community mental health services, sets forth rate increases, to begin on and after January 1, 2024, for the following rates and services: the Mobile Crisis Response Medicaid Payment rate for all services provided under the S9484 procedure code; the Crisis Intervention Medicaid Payment rate for all levels of services provided under the H2011 procedure code; the Integrated Assessment and Treatment Planning Medicaid Payment rate for all levels of services provided under the H2000 procedure code; the Group and Family Therapy Medicaid Payment rate for all levels of services provided under the H0004 procedure code; the Community Support - Group Medicaid Payment rate for all levels of services provided under the H2015 procedure code; the Telepsychiatry Originating Site Medicaid Payment rate for services provided under the Q3014 procedure code; and the Medication Monitoring Medicaid Payment rate for services provided under the H2010 procedure code for medication monitoring provided by a physician, an advanced practice registered nurse, and all other levels of provider. Provides that no base Medicaid rate payment or any other payment for the provision of Medicaid community mental health services in place on January 1, 2023 shall be diminished or changed to make the reimbursement changes required by the amendatory Act. Provides that any payments required under the amendatory Act that are delayed due to implementation challenges or federal approval shall be made retroactive to January 1, 2024 for the full amount required by the amendatory Act. LRB103 27179 KTG 53549 b LRB103 27179 KTG 53549 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1831 Introduced 2/9/2023, by Sen. Elgie R. Sims, Jr. SYNOPSIS AS INTRODUCED:
3	3	305 ILCS 66/20-10305 ILCS 66/20-20 305 ILCS 66/20-10 305 ILCS 66/20-20
4	4	305 ILCS 66/20-10
5	5	305 ILCS 66/20-20
6	6	Amends the Rebuild Illinois Mental Health Workforce Act. In a provision concerning Medicaid funding for community mental health services, sets forth rate increases, to begin on and after January 1, 2024, for the following rates and services: the Mobile Crisis Response Medicaid Payment rate for all services provided under the S9484 procedure code; the Crisis Intervention Medicaid Payment rate for all levels of services provided under the H2011 procedure code; the Integrated Assessment and Treatment Planning Medicaid Payment rate for all levels of services provided under the H2000 procedure code; the Group and Family Therapy Medicaid Payment rate for all levels of services provided under the H0004 procedure code; the Community Support - Group Medicaid Payment rate for all levels of services provided under the H2015 procedure code; the Telepsychiatry Originating Site Medicaid Payment rate for services provided under the Q3014 procedure code; and the Medication Monitoring Medicaid Payment rate for services provided under the H2010 procedure code for medication monitoring provided by a physician, an advanced practice registered nurse, and all other levels of provider. Provides that no base Medicaid rate payment or any other payment for the provision of Medicaid community mental health services in place on January 1, 2023 shall be diminished or changed to make the reimbursement changes required by the amendatory Act. Provides that any payments required under the amendatory Act that are delayed due to implementation challenges or federal approval shall be made retroactive to January 1, 2024 for the full amount required by the amendatory Act.
7	7	LRB103 27179 KTG 53549 b LRB103 27179 KTG 53549 b
8	8	LRB103 27179 KTG 53549 b
9	9	A BILL FOR
10	10	SB1831LRB103 27179 KTG 53549 b SB1831 LRB103 27179 KTG 53549 b
11	11	SB1831 LRB103 27179 KTG 53549 b
12	12	1 AN ACT concerning public aid.
13	13	2 Be it enacted by the People of the State of Illinois,
14	14	3 represented in the General Assembly:
15	15	4 Section 5. The Rebuild Illinois Mental Health Workforce
16	16	5 Act is amended by changing Sections 20-10 and 20-20 as
17	17	6 follows:
18	18	7 (305 ILCS 66/20-10)
19	19	8 Sec. 20-10. Medicaid funding for community mental health
20	20	9 services. Medicaid funding for the specific community mental
21	21	10 health services listed in this Act shall be adjusted and paid
22	22	11 as set forth in this Act. Such payments shall be paid in
23	23	12 addition to the base Medicaid reimbursement rate and add-on
24	24	13 payment rates per service unit.
25	25	14 (a) The payment adjustments shall begin on July 1, 2022
26	26	15 for State Fiscal Year 2023 and shall continue for every State
27	27	16 fiscal year thereafter.
28	28	17 (1) Individual Therapy Medicaid Payment rate for
29	29	18 services provided under the H0004 Code:
30	30	19 (A) The Medicaid total payment rate for individual
31	31	20 therapy provided by a qualified mental health
32	32	21 professional shall be increased by no less than $9 per
33	33	22 service unit.
34	34	23 (B) The Medicaid total payment rate for individual
35	35
36	36
37	37
38	38	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB1831 Introduced 2/9/2023, by Sen. Elgie R. Sims, Jr. SYNOPSIS AS INTRODUCED:
39	39	305 ILCS 66/20-10305 ILCS 66/20-20 305 ILCS 66/20-10 305 ILCS 66/20-20
40	40	305 ILCS 66/20-10
41	41	305 ILCS 66/20-20
42	42	Amends the Rebuild Illinois Mental Health Workforce Act. In a provision concerning Medicaid funding for community mental health services, sets forth rate increases, to begin on and after January 1, 2024, for the following rates and services: the Mobile Crisis Response Medicaid Payment rate for all services provided under the S9484 procedure code; the Crisis Intervention Medicaid Payment rate for all levels of services provided under the H2011 procedure code; the Integrated Assessment and Treatment Planning Medicaid Payment rate for all levels of services provided under the H2000 procedure code; the Group and Family Therapy Medicaid Payment rate for all levels of services provided under the H0004 procedure code; the Community Support - Group Medicaid Payment rate for all levels of services provided under the H2015 procedure code; the Telepsychiatry Originating Site Medicaid Payment rate for services provided under the Q3014 procedure code; and the Medication Monitoring Medicaid Payment rate for services provided under the H2010 procedure code for medication monitoring provided by a physician, an advanced practice registered nurse, and all other levels of provider. Provides that no base Medicaid rate payment or any other payment for the provision of Medicaid community mental health services in place on January 1, 2023 shall be diminished or changed to make the reimbursement changes required by the amendatory Act. Provides that any payments required under the amendatory Act that are delayed due to implementation challenges or federal approval shall be made retroactive to January 1, 2024 for the full amount required by the amendatory Act.
43	43	LRB103 27179 KTG 53549 b LRB103 27179 KTG 53549 b
44	44	LRB103 27179 KTG 53549 b
45	45	A BILL FOR
46	46
47	47
48	48
49	49
50	50
51	51	305 ILCS 66/20-10
52	52	305 ILCS 66/20-20
53	53
54	54
55	55
56	56	LRB103 27179 KTG 53549 b
57	57
58	58
59	59
60	60
61	61
62	62
63	63
64	64
65	65
66	66	SB1831 LRB103 27179 KTG 53549 b
67	67
68	68
69	69	SB1831- 2 -LRB103 27179 KTG 53549 b SB1831 - 2 - LRB103 27179 KTG 53549 b
70	70	SB1831 - 2 - LRB103 27179 KTG 53549 b
71	71	1 therapy provided by a mental health professional shall
72	72	2 be increased by no less then $9 per service unit.
73	73	3 (2) Community Support - Individual Medicaid Payment
74	74	4 rate for services provided under the H2015 Code: All
75	75	5 community support - individual services shall be increased
76	76	6 by no less than $15 per service unit.
77	77	7 (3) Case Management Medicaid Add-on Payment for
78	78	8 services provided under the T1016 code: All case
79	79	9 management services rates shall be increased by no less
80	80	10 than $15 per service unit.
81	81	11 (4) Assertive Community Treatment Medicaid Add-on
82	82	12 Payment for services provided under the H0039 code: The
83	83	13 Medicaid total payment rate for assertive community
84	84	14 treatment services shall increase by no less than $8 per
85	85	15 service unit.
86	86	16 (5) Medicaid user-based directed payments.
87	87	17 (A) For each State fiscal year, a monthly directed
88	88	18 payment shall be paid to a community mental health
89	89	19 provider of community support team services based on
90	90	20 the number of Medicaid users of community support team
91	91	21 services documented by Medicaid fee-for-service and
92	92	22 managed care encounter claims delivered by that
93	93	23 provider in the base year. The Department of
94	94	24 Healthcare and Family Services shall make the monthly
95	95	25 directed payment to each provider entitled to directed
96	96	26 payments under this Act by no later than the last day
97	97
98	98
99	99
100	100
101	101
102	102	SB1831 - 2 - LRB103 27179 KTG 53549 b
103	103
104	104
105	105	SB1831- 3 -LRB103 27179 KTG 53549 b SB1831 - 3 - LRB103 27179 KTG 53549 b
106	106	SB1831 - 3 - LRB103 27179 KTG 53549 b
107	107	1 of each month throughout each State fiscal year.
108	108	2 (i) The monthly directed payment for a
109	109	3 community support team provider shall be
110	110	4 calculated as follows: The sum total number of
111	111	5 individual Medicaid users of community support
112	112	6 team services delivered by that provider
113	113	7 throughout the base year, multiplied by $4,200 per
114	114	8 Medicaid user, divided into 12 equal monthly
115	115	9 payments for the State fiscal year.
116	116	10 (ii) As used in this subparagraph, "user"
117	117	11 means an individual who received at least 200
118	118	12 units of community support team services (H2016)
119	119	13 during the base year.
120	120	14 (B) For each State fiscal year, a monthly directed
121	121	15 payment shall be paid to each community mental health
122	122	16 provider of assertive community treatment services
123	123	17 based on the number of Medicaid users of assertive
124	124	18 community treatment services documented by Medicaid
125	125	19 fee-for-service and managed care encounter claims
126	126	20 delivered by the provider in the base year.
127	127	21 (i) The monthly direct payment for an
128	128	22 assertive community treatment provider shall be
129	129	23 calculated as follows: The sum total number of
130	130	24 Medicaid users of assertive community treatment
131	131	25 services provided by that provider throughout the
132	132	26 base year, multiplied by $6,000 per Medicaid user,
133	133
134	134
135	135
136	136
137	137
138	138	SB1831 - 3 - LRB103 27179 KTG 53549 b
139	139
140	140
141	141	SB1831- 4 -LRB103 27179 KTG 53549 b SB1831 - 4 - LRB103 27179 KTG 53549 b
142	142	SB1831 - 4 - LRB103 27179 KTG 53549 b
143	143	1 divided into 12 equal monthly payments for that
144	144	2 State fiscal year.
145	145	3 (ii) As used in this subparagraph, "user"
146	146	4 means an individual that received at least 300
147	147	5 units of assertive community treatment services
148	148	6 during the base year.
149	149	7 (C) The base year for directed payments under this
150	150	8 Section shall be calendar year 2019 for State Fiscal
151	151	9 Year 2023 and State Fiscal Year 2024. For the State
152	152	10 fiscal year beginning on July 1, 2024, and for every
153	153	11 State fiscal year thereafter, the base year shall be
154	154	12 the calendar year that ended 18 months prior to the
155	155	13 start of the State fiscal year in which payments are
156	156	14 made.
157	157	15 (b) Subject to federal approval, a one-time directed
158	158	16 payment must be made in calendar year 2023 for community
159	159	17 mental health services provided by community mental health
160	160	18 providers. The one-time directed payment shall be for an
161	161	19 amount appropriated for these purposes. The one-time directed
162	162	20 payment shall be for services for Integrated Assessment and
163	163	21 Treatment Planning and other intensive services, including,
164	164	22 but not limited to, services for Mobile Crisis Response,
165	165	23 crisis intervention, and medication monitoring. The amounts
166	166	24 and services used for designing and distributing these
167	167	25 one-time directed payments shall not be construed to require
168	168	26 any future rate or funding increases for the same or other
169	169
170	170
171	171
172	172
173	173
174	174	SB1831 - 4 - LRB103 27179 KTG 53549 b
175	175
176	176
177	177	SB1831- 5 -LRB103 27179 KTG 53549 b SB1831 - 5 - LRB103 27179 KTG 53549 b
178	178	SB1831 - 5 - LRB103 27179 KTG 53549 b
179	179	1 mental health services.
180	180	2 (c) The following payment adjustments shall begin on
181	181	3 January 1, 2024 and shall continue thereafter.
182	182	4 (1) The Mobile Crisis Response Medicaid Payment rate
183	183	5 for all services provided under the S9484 procedure code
184	184	6 shall be increased by no less than $200 per service unit
185	185	7 for on-site services. Off-site rates for these services
186	186	8 must be increased by an amount which at least maintains
187	187	9 the current differential between on-site and off-site
188	188	10 services as represented on the July 1, 2022 fee schedule.
189	189	11 (2) The Crisis Intervention Medicaid Payment rate for
190	190	12 all levels of services provided under the H2011 procedure
191	191	13 code shall be increased by no less than $8 per service unit
192	192	14 for on-site services. Off-site rates for these services
193	193	15 must be increased by an amount which at least maintains
194	194	16 the current differential between on-site and off-site
195	195	17 services as represented on the July 1, 2022 fee schedule.
196	196	18 (3) The Integrated Assessment and Treatment Planning
197	197	19 Medicaid Payment rate for all levels of services provided
198	198	20 under the H2000 procedure code shall be increased by no
199	199	21 less than $7 per service unit for on-site services.
200	200	22 Off-site rates for these services must be increased by an
201	201	23 amount which at least maintains the current differential
202	202	24 between on-site and off-site services as represented on
203	203	25 the July 1, 2022 fee schedule.
204	204	26 (4) The Group and Family Therapy Medicaid Payment rate
205	205
206	206
207	207
208	208
209	209
210	210	SB1831 - 5 - LRB103 27179 KTG 53549 b
211	211
212	212
213	213	SB1831- 6 -LRB103 27179 KTG 53549 b SB1831 - 6 - LRB103 27179 KTG 53549 b
214	214	SB1831 - 6 - LRB103 27179 KTG 53549 b
215	215	1 for all levels of services provided under the H0004
216	216	2 procedure code shall be increased by no less than $3 per
217	217	3 service unit for on-site services. Off-site rates for
218	218	4 these services must be increased by an amount which at
219	219	5 least maintains the current differential between on-site
220	220	6 and off-site services as represented on the July 1, 2022
221	221	7 fee schedule. This increase does not apply to individual
222	222	8 therapy services which were increased July 1, 2022 in
223	223	9 accordance with paragraph (1) of subsection (a).
224	224	10 (5) The Community Support - Group Medicaid Payment
225	225	11 rate for all levels of services provided under the H2015
226	226	12 procedure code shall be increased by no less than $3 per
227	227	13 service unit for on-site services. Off-site rates for
228	228	14 these services must be increased by an amount which at
229	229	15 least maintains the current differential between on-site
230	230	16 and off-site services as represented on the July 1, 2022
231	231	17 fee schedule. This increase does not apply to Community
232	232	18 Support - Individual services which were increased July 1,
233	233	19 2022 in accordance with paragraph (2) of subsection (a).
234	234	20 (6) The Telepsychiatry Originating Site Medicaid
235	235	21 Payment rate for services provided under the Q3014
236	236	22 procedure code shall be increased by no less than $10 per
237	237	23 service unit for on-site services. Off-site rates for
238	238	24 these services must be increased by an amount which at
239	239	25 least maintains the current differential between on-site
240	240	26 and off-site services as represented on the July 1, 2022
241	241
242	242
243	243
244	244
245	245
246	246	SB1831 - 6 - LRB103 27179 KTG 53549 b
247	247
248	248
249	249	SB1831- 7 -LRB103 27179 KTG 53549 b SB1831 - 7 - LRB103 27179 KTG 53549 b
250	250	SB1831 - 7 - LRB103 27179 KTG 53549 b
251	251	1 fee schedule.
252	252	2 (7) Medication Monitoring Medicaid Payment rate for
253	253	3 services provided under the H2010 procedure code:
254	254	4 (A) The Medicaid total payment rate for medication
255	255	5 monitoring provided by a physician shall be increased
256	256	6 by no less than $25.11 per service unit for on-site
257	257	7 services. Off-site rates for these services must be
258	258	8 increased by an amount which at least maintains the
259	259	9 current differential between on-site and off-site
260	260	10 services as represented on the July 1, 2022 fee
261	261	11 schedule.
262	262	12 (B) The Medicaid total payment rate for medication
263	263	13 monitoring provided by an advanced practice registered
264	264	14 nurse shall be increased by no less than $18.07 per
265	265	15 service unit for on-site services. Off-site rates for
266	266	16 these services must be increased by an amount which at
267	267	17 least maintains the current differential between
268	268	18 on-site and off-site services as represented on the
269	269	19 July 1, 2022 fee schedule.
270	270	20 (C) The Medicaid total payment rate for medication
271	271	21 monitoring provided by all other levels of provider
272	272	22 shall be increased by no less than $15.00 per service
273	273	23 unit for on-site services. Off-site rates for these
274	274	24 services must be increased by an amount which at least
275	275	25 maintains the current differential between on-site and
276	276	26 off-site services as represented on the July 1, 2022
277	277
278	278
279	279
280	280
281	281
282	282	SB1831 - 7 - LRB103 27179 KTG 53549 b
283	283
284	284
285	285	SB1831- 8 -LRB103 27179 KTG 53549 b SB1831 - 8 - LRB103 27179 KTG 53549 b
286	286	SB1831 - 8 - LRB103 27179 KTG 53549 b
287	287	1 fee schedule.
288	288	2 (Source: P.A. 102-699, eff. 4-19-22; 102-1118, eff. 1-18-23.)
289	289	3 (305 ILCS 66/20-20)
290	290	4 Sec. 20-20. Base Medicaid rates or add-on payments.
291	291	5 (a) For services under subsection (a) of Section 20-10: .
292	292	6 No base Medicaid rate or Medicaid rate add-on payment or
293	293	7 any other payment for the provision of Medicaid community
294	294	8 mental health services in place on July 1, 2021 shall be
295	295	9 diminished or changed to make the reimbursement changes
296	296	10 required by this Act. Any payments required under this Act
297	297	11 that are delayed due to implementation challenges or federal
298	298	12 approval shall be made retroactive to July 1, 2022 for the full
299	299	13 amount required by this Act.
300	300	14 (b) For directed payments under subsection (b) of Section
301	301	15 20-10: .
302	302	16 No base Medicaid rate payment or any other payment for the
303	303	17 provision of Medicaid community mental health services in
304	304	18 place on January 1, 2023 shall be diminished or changed to make
305	305	19 the reimbursement changes required by this Act. The Department
306	306	20 of Healthcare and Family Services must pay the directed
307	307	21 payment in one installment within 60 days of receiving federal
308	308	22 approval.
309	309	23 (c) For directed payments under subsection (c) of Section
310	310	24 20-10:
311	311	25 No base Medicaid rate payment or any other payment for the
312	312
313	313
314	314
315	315
316	316
317	317	SB1831 - 8 - LRB103 27179 KTG 53549 b
318	318
319	319
320	320	SB1831- 9 -LRB103 27179 KTG 53549 b SB1831 - 9 - LRB103 27179 KTG 53549 b
321	321	SB1831 - 9 - LRB103 27179 KTG 53549 b
322	322	1 provision of Medicaid community mental health services in
323	323	2 place on January 1, 2023 shall be diminished or changed to make
324	324	3 the reimbursement changes required by this amendatory Act of
325	325	4 the 103rd General Assembly. Any payments required under this
326	326	5 amendatory Act of the 103rd General Assembly that are delayed
327	327	6 due to implementation challenges or federal approval shall be
328	328	7 made retroactive to January 1, 2024 for the full amount
329	329	8 required by this amendatory Act of the 103rd General Assembly.
330	330	9 (Source: P.A. 102-699, eff. 4-19-22; 102-1118, eff. 1-18-23.)
331	331
332	332
333	333
334	334
335	335
336	336	SB1831 - 9 - LRB103 27179 KTG 53549 b