104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026 SB1737 Introduced 2/5/2025, by Sen. Laura Fine SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-30.19 new Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025. LRB104 10358 KTG 20433 b A BILL FOR 104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026 SB1737 Introduced 2/5/2025, by Sen. Laura Fine SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-30.19 new 305 ILCS 5/5-30.19 new Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025. LRB104 10358 KTG 20433 b LRB104 10358 KTG 20433 b A BILL FOR
104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026 SB1737 Introduced 2/5/2025, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-30.19 new 305 ILCS 5/5-30.19 new
305 ILCS 5/5-30.19 new
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025.
LRB104 10358 KTG 20433 b LRB104 10358 KTG 20433 b
LRB104 10358 KTG 20433 b
A BILL FOR
SB1737LRB104 10358 KTG 20433 b SB1737 LRB104 10358 KTG 20433 b
SB1737 LRB104 10358 KTG 20433 b
1 AN ACT concerning public aid.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Public Aid Code is amended by
5 adding Section 5-30.19 as follows:
6 (305 ILCS 5/5-30.19 new)
7 Sec. 5-30.19. Durable medical equipment; MCO reimbursement
8 requirement. The Department shall require Medicaid managed
9 care organizations to reimburse at no less than 100% of the
10 Medical Assistance program's Durable Medical Equipment fee
11 schedule for the same service or item of durable medical
12 equipment, complex rehab technology, prosthetics, orthotics,
13 or supplies. This reimbursement requirement shall also apply
14 to a Medicaid managed care organization's subcontractors and
15 third-party administrators. The Department has the authority
16 to implement the reimbursement requirement on and after July
17 1, 2025 and prior to the completion of any regulatory process
18 undertaken in order to effect such change.
104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026 SB1737 Introduced 2/5/2025, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-30.19 new 305 ILCS 5/5-30.19 new
305 ILCS 5/5-30.19 new
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025.
LRB104 10358 KTG 20433 b LRB104 10358 KTG 20433 b
LRB104 10358 KTG 20433 b
A BILL FOR
305 ILCS 5/5-30.19 new
LRB104 10358 KTG 20433 b
SB1737 LRB104 10358 KTG 20433 b