Illinois General Assembly

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 Bill Status of HB6213  99th General Assembly


Short Description:  MEDICAID-PROVIDER DIRECTORY

House Sponsors
Rep. Carol Ammons - Robyn Gabel - Jaime M. Andrade, Jr. - Jay Hoffman - Camille Y. Lilly, Will Guzzardi, Elizabeth Hernandez, Silvana Tabares, Jehan Gordon-Booth, Sonya M. Harper, Lou Lang, Litesa E. Wallace, Linda Chapa LaVia, Rita Mayfield, La Shawn K. Ford, Gregory Harris, Eddie Lee Jackson, Sr., Arthur Turner, Kathleen Willis, Edward J. Acevedo, Michelle Mussman, Laura Fine, Cynthia Soto, Mary E. Flowers, Robert Martwick, William Davis, Kelly M. Cassidy, Emanuel Chris Welch, Al Riley, Elaine Nekritz, Daniel J. Burke, Natalie A. Manley, Patricia R. Bellock, Tom Demmer and Dwight Kay

Senate Sponsors
(Sen. Daniel Biss - David Koehler - Jacqueline Y. Collins - Melinda Bush, Laura M. Murphy, Emil Jones, III, Heather A. Steans, John G. Mulroe, Linda Holmes, Mattie Hunter, William Delgado, Ira I. Silverstein, Toi W. Hutchinson, Pat McGuire, Julie A. Morrison, Pamela J. Althoff, Scott M. Bennett and Donne E. Trotter)

Last Action
DateChamber Action
  8/5/2016HousePublic Act . . . . . . . . . 99-0725

Statutes Amended In Order of Appearance
305 ILCS 5/5-30.1
305 ILCS 5/5-30.3 new


Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires each Medicaid Managed Care Entity (MMCE) contracted by the Department of Healthcare and Family Services to: (i) make available on the entity's website a provider directory in a machine readable file and format; (ii) make provider directories publicly accessible without the necessity of providing a password, a username, or personally identifiable information; (iii) make available through an electronic provider directory, for each Medicaid Managed Care Entity Plan offered by the entity, certain information in an easily understandable and searchable format, including the contact information and website URLs, if applicable, of all health care professionals, hospitals, pharmacies, and facilities that provide services to Medicaid recipients under the Medicaid Managed Care Entity Plan. Requires each MMCE to ensure that all information included in a print version of the provider directory is updated at least monthly and that the electronic provider directory is updated no later than 3 business days after the MMCE receives updated provider information. Provides that non-compliance with these and other specified requirements may subject the MMCE to certain sanctions. Requires the Department's client enrollment services broker to post certain information on the broker's website, including, information explaining the circumstances under which a Medicaid enrollee can file a grievance or request a hearing to appeal an adverse action by the Department or the MMCE; information on the Medicaid eligibility redetermination process; and information on Medicaid care coordination. Requires the Department to create a consumer quality comparison tool to assist enrollees with Medicaid Managed Care Entity Plan selection. Effective immediately.

House Floor Amendment No. 1
Replaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires each Medicaid Managed Care Entity contracted by the Department of Healthcare and Family Services to: (i) make available on the entity's website a provider directory in a machine readable file and format; (ii) make provider directories publicly accessible without the necessity of providing a password, a username, or personally identifiable information; (iii) comply with all federal and State statutes and regulations pertaining to provider directories within Medicaid Managed Care; and (iv) request, at least annually, provider office hours for certain provider types, including hospitals and facilities, pharmacies, and durable medical equipment suppliers that are not hospitals. Contains provisions requiring the print and online version of the consumer quality comparison tool to use a quality rating system developed by the Department to reflect Medicaid Managed Care Entities' individual Plan performance. Requires the Department to make the consumer quality comparison tool available for consumer use no later than January 1, 2018. Effective immediately.

Senate Committee Amendment No. 1
Replaces everything after the enacting clause. Reinserts the provisions of the engrossed bill, with the following changes: Removes the term "clinical interest" and its definition. Makes changes to the definition of "composite domains". Defines "facilities" (instead of "facility type") and "hospitals" (instead of "hospital type"). Requires each Medicaid Managed Care Entity to comply with certain federal regulations pertaining to provider directories within Medicaid Managed Care. Requires the client enrollment services broker to have certain information available and searchable through the integrated provider directory on its website as soon as possible but no later than January 1, 2017. Provides that if the Department of Healthcare and Family Services (rather than the client enrollment services broker) receives a report that identifies an inaccuracy in the integrated provider directory, the Department (rather than the client enrollment services broker) shall provide the information about the reported inaccuracy to the appropriate Medicaid Managed Care Entity within 3 business days after the reported inaccuracy is received. Requires a Medicaid Managed Care Entity that receives a report that certain formulary information is inaccurate to investigate the report and correct any inaccurate information displayed in the electronic formulary (rather than requiring the Medicaid Managed Care Entity to investigate and report any incorrect information, as necessary, no later than the third business day after the date the report is received). Provides that if a Medicaid enrollee calls the client enrollment services broker with questions regarding formularies, the client enrollment services broker shall offer a brief description of what a formulary is and shall refer the Medicaid enrollee to the appropriate Medicaid Managed Care Entity regarding his or her questions about a specific entity's formulary. Makes changes concerning a printed version of the consumer quality comparison tool and a quality rating system developed by the Department to reflect each Medicaid Managed Care Entities' individual Plan performance. Effective immediately.

Senate Floor Amendment No. 2
Requires the client enrollment services broker to use the Medicaid provider number for all providers with a Medicaid Provider number to populate the provider information in the integrated provider directory (rather than requiring the client enrollment services broker to use the Medicaid provider number to populate the provider information in the integrated provider directory). In a provision concerning grievances and appeals, requires the Department to display prominently on its website consumer-oriented information describing how a Medicaid enrollee can file a complaint or grievance, request a fair hearing for any adverse action taken by the Department or a Medicaid Managed Care Entity, and access free legal assistance or other assistance made available by the State for Medicaid enrollees to pursue an action (rather than requiring the Department to require the client enrollment services broker to display prominently on the client enrollment services broker's website a description of where a Medicaid enrollee can access information on how to file a complaint or grievance or request a fair hearing for any adverse action taken by the Department or the Medicaid Managed Care Entity).

Actions 
DateChamber Action
  2/11/2016HouseFiled with the Clerk by Rep. Carol Ammons
  2/11/2016HouseFirst Reading
  2/11/2016HouseReferred to Rules Committee
  2/16/2016HouseAdded Chief Co-Sponsor Rep. Robyn Gabel
  2/16/2016HouseAdded Chief Co-Sponsor Rep. Jaime M. Andrade, Jr.
  2/16/2016HouseAdded Chief Co-Sponsor Rep. Jay Hoffman
  2/16/2016HouseAdded Co-Sponsor Rep. Will Guzzardi
  2/16/2016HouseAdded Co-Sponsor Rep. Elizabeth Hernandez
  2/16/2016HouseAdded Co-Sponsor Rep. Silvana Tabares
  2/16/2016HouseAdded Co-Sponsor Rep. Jehan Gordon-Booth
  2/16/2016HouseAdded Co-Sponsor Rep. Sonya M. Harper
  2/16/2016HouseAdded Co-Sponsor Rep. Lou Lang
  2/16/2016HouseAdded Co-Sponsor Rep. Litesa E. Wallace
  2/16/2016HouseAdded Co-Sponsor Rep. Linda Chapa LaVia
  2/16/2016HouseAdded Co-Sponsor Rep. Rita Mayfield
  2/16/2016HouseAdded Co-Sponsor Rep. La Shawn K. Ford
  2/16/2016HouseAdded Co-Sponsor Rep. Gregory Harris
  2/24/2016HouseAdded Co-Sponsor Rep. Eddie Lee Jackson, Sr.
  3/1/2016HouseAdded Chief Co-Sponsor Rep. Camille Y. Lilly
  3/3/2016HouseAdded Co-Sponsor Rep. Arthur Turner
  3/10/2016HouseAdded Co-Sponsor Rep. Kathleen Willis
  3/16/2016HouseAdded Co-Sponsor Rep. Edward J. Acevedo
  3/18/2016HouseAdded Co-Sponsor Rep. Michelle Mussman
  3/23/2016HouseAssigned to Human Services Committee
  3/24/2016HouseAdded Co-Sponsor Rep. Laura Fine
  3/24/2016HouseAdded Co-Sponsor Rep. Cynthia Soto
  3/29/2016HouseAdded Co-Sponsor Rep. Mary E. Flowers
  4/4/2016HouseAdded Co-Sponsor Rep. Robert Martwick
  4/4/2016HouseAdded Co-Sponsor Rep. William Davis
  4/5/2016HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  4/5/2016HouseDo Pass / Short Debate Human Services Committee; 014-000-000
  4/5/2016HousePlaced on Calendar 2nd Reading - Short Debate
  4/6/2016HouseAdded Co-Sponsor Rep. Emanuel Chris Welch
  4/7/2016HouseAdded Co-Sponsor Rep. Al Riley
  4/11/2016HouseAdded Co-Sponsor Rep. Elaine Nekritz
  4/14/2016HouseAdded Co-Sponsor Rep. Daniel J. Burke
  4/15/2016HouseAdded Co-Sponsor Rep. Natalie A. Manley
  4/15/2016HouseHouse Floor Amendment No. 1 Filed with Clerk by Rep. Carol Ammons
  4/15/2016HouseHouse Floor Amendment No. 1 Referred to Rules Committee
  4/15/2016HouseSecond Reading - Short Debate
  4/15/2016HouseHeld on Calendar Order of Second Reading - Short Debate
  4/18/2016HouseHouse Floor Amendment No. 1 Rules Refers to Human Services Committee
  4/19/2016HouseHouse Floor Amendment No. 1 Recommends Be Adopted Human Services Committee; 014-000-000
  4/19/2016HouseAdded Co-Sponsor Rep. Patricia R. Bellock
  4/19/2016HouseAdded Co-Sponsor Rep. Tom Demmer
  4/21/2016HouseHouse Floor Amendment No. 1 Adopted
  4/21/2016HousePlaced on Calendar Order of 3rd Reading - Short Debate
  4/21/2016HouseAdded Co-Sponsor Rep. Dwight Kay
  4/22/2016HouseThird Reading - Short Debate - Passed 108-000-000
  4/25/2016SenateArrive in Senate
  4/25/2016SenatePlaced on Calendar Order of First Reading
  4/25/2016SenateChief Senate Sponsor Sen. Daniel Biss
  4/25/2016SenateFirst Reading
  4/25/2016SenateReferred to Assignments
  5/3/2016SenateAssigned to Human Services
  5/4/2016SenateAdded as Alternate Co-Sponsor Sen. Laura M. Murphy
  5/5/2016SenateAdded as Alternate Chief Co-Sponsor Sen. David Koehler
  5/5/2016SenateAdded as Alternate Chief Co-Sponsor Sen. Jacqueline Y. Collins
  5/6/2016SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. Daniel Biss
  5/6/2016SenateSenate Committee Amendment No. 1 Referred to Assignments
  5/10/2016SenateAdded as Alternate Co-Sponsor Sen. Emil Jones, III
  5/10/2016SenateSenate Committee Amendment No. 1 Assignments Refers to Human Services
  5/10/2016SenateSenate Committee Amendment No. 1 Adopted
  5/11/2016SenateDo Pass as Amended Human Services; 007-000-000
  5/11/2016SenatePlaced on Calendar Order of 2nd Reading May 12, 2016
  5/11/2016SenateAdded as Alternate Co-Sponsor Sen. Heather A. Steans
  5/11/2016SenateAdded as Alternate Co-Sponsor Sen. John G. Mulroe
  5/12/2016SenateAdded as Alternate Co-Sponsor Sen. Linda Holmes
  5/12/2016SenateAdded as Alternate Co-Sponsor Sen. Mattie Hunter
  5/12/2016SenateAdded as Alternate Co-Sponsor Sen. William Delgado
  5/17/2016SenateAdded as Alternate Co-Sponsor Sen. Ira I. Silverstein
  5/17/2016SenateSenate Floor Amendment No. 2 Filed with Secretary by Sen. Daniel Biss
  5/17/2016SenateSenate Floor Amendment No. 2 Referred to Assignments
  5/17/2016SenateAdded as Alternate Co-Sponsor Sen. Toi W. Hutchinson
  5/18/2016SenateAdded as Alternate Co-Sponsor Sen. Pat McGuire
  5/18/2016SenateAdded as Alternate Co-Sponsor Sen. Julie A. Morrison
  5/19/2016SenateAdded as Alternate Co-Sponsor Sen. Pamela J. Althoff
  5/19/2016SenateAdded as Alternate Chief Co-Sponsor Sen. Melinda Bush
  5/20/2016SenateAdded as Alternate Co-Sponsor Sen. Scott M. Bennett
  5/24/2016SenateSenate Floor Amendment No. 2 Assignments Refers to Human Services
  5/25/2016SenateSenate Floor Amendment No. 2 Recommend Do Adopt Human Services; 008-000-000
  5/25/2016SenateSecond Reading
  5/25/2016SenateSenate Floor Amendment No. 2 Adopted; Biss
  5/25/2016SenatePlaced on Calendar Order of 3rd Reading May 26, 2016
  5/26/2016SenateAdded as Alternate Co-Sponsor Sen. Donne E. Trotter
  5/27/2016SenateThird Reading - Passed; 053-000-000
  5/29/2016HouseArrived in House
  5/29/2016HousePlaced on Calendar Order of Concurrence Senate Amendment(s) 1, 2
  5/29/2016HouseSenate Committee Amendment No. 1 Motion Filed Concur Rep. Carol Ammons
  5/29/2016HouseSenate Floor Amendment No. 2 Motion Filed Concur Rep. Carol Ammons
  5/29/2016HouseSenate Committee Amendment No. 1 Motion to Concur Referred to Rules Committee
  5/29/2016HouseSenate Floor Amendment No. 2 Motion to Concur Referred to Rules Committee
  5/30/2016HouseSenate Committee Amendment No. 1 Motion to Concur Rules Referred to Human Services Committee
  5/30/2016HouseSenate Floor Amendment No. 2 Motion to Concur Rules Referred to Human Services Committee
  5/30/2016HouseSenate Committee Amendment No. 1 Motion to Concur Recommends Be Adopted Human Services Committee; 013-000-000
  5/30/2016HouseSenate Floor Amendment No. 2 Motion to Concur Recommends Be Adopted Human Services Committee; 013-000-000
  5/31/2016HouseSenate Committee Amendment No. 1 House Concurs 117-000-000
  5/31/2016HouseSenate Floor Amendment No. 2 House Concurs 117-000-000
  5/31/2016HouseHouse Concurs
  5/31/2016HousePassed Both Houses
  6/27/2016HouseSent to the Governor
  8/5/2016HouseGovernor Approved
  8/5/2016HouseEffective Date August 5, 2016
  8/5/2016HousePublic Act . . . . . . . . . 99-0725

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