Illinois General Assembly - Bill Status for HB4681

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions requiring the Department of Healthcare and Family Services to issue a purchase of care solicitation for Accountable Care Entities (ACE), makes the following changes: (i) extends the number of months an ACE shall be paid care coordination fees on a per member per month basis from "the first 18 months of operation" to "the first 24 months of operation"; (ii) extends the time period an ACE shall be paid on a pre-paid capitation basis for all medical assistance covered services from "in months 19 through 36 of operation" to "in months 25 through 48 of operation"; (iii) provides that in the fifth (rather than the fourth) and subsequent years of operation, unless the ACE selects a shorter period, an ACE shall convert to a Managed Care Community Network (MCCN); and (iv) provides that (a) the Department shall not require an ACE to connect to the Illinois Health Information Exchange (ILHIE) or to an Illinois regional Health Information Exchange that is connected to the ILHIE until the fifth and subsequent years of operation, unless the ACE selects a shorter period; and (b) in the third year and subsequent years of program operation, the Department shall establish an annual process to allow an ACE to expand its system capacity and number of participating providers and to provide an opportunity for the ACE to increase enrollment levels. Effective immediately.

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