Illinois General Assembly - Full Text of HB1365
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Full Text of HB1365  94th General Assembly

HB1365 94TH GENERAL ASSEMBLY


 


 
94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB1365

 

Introduced 02/09/05, by Rep. Dave Winters

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-4.2   from Ch. 23, par. 5-4.2

    Amends the Illinois Public Aid Code. In provisions concerning ambulance service payments under the Medicaid program, provides that for ambulance services provided to a Medicaid recipient on or after January 1, 2006, the Department of Public Aid shall reimburse providers of medical transportation services provided to a disabled person by means of a medi-car, regardless of whether the person has a physical disability or a mental or cognitive disability. Provides that the Department or its authorized prior approval agent shall determine that a person is disabled and eligible for transportation by means of a medi-car if a physician licensed to practice medicine in all its branches certifies to the Department in writing that the person has a physical disability or a mental or cognitive disability.


LRB094 05553 DRJ 35602 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB1365 LRB094 05553 DRJ 35602 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 changing Section 5-4.2 as follows:
 
6     (305 ILCS 5/5-4.2)  (from Ch. 23, par. 5-4.2)
7     Sec. 5-4.2. Ambulance services payments. For ambulance
8 services provided to a recipient of aid under this Article on
9 or after January 1, 1993, the Illinois Department shall
10 reimburse ambulance service providers at rates calculated in
11 accordance with this Section. It is the intent of the General
12 Assembly to provide adequate reimbursement for ambulance
13 services so as to ensure adequate access to services for
14 recipients of aid under this Article and to provide appropriate
15 incentives to ambulance service providers to provide services
16 in an efficient and cost-effective manner. Thus, it is the
17 intent of the General Assembly that the Illinois Department
18 implement a reimbursement system for ambulance services that,
19 to the extent practicable and subject to the availability of
20 funds appropriated by the General Assembly for this purpose, is
21 consistent with the payment principles of Medicare. To ensure
22 uniformity between the payment principles of Medicare and
23 Medicaid, the Illinois Department shall follow, to the extent
24 necessary and practicable and subject to the availability of
25 funds appropriated by the General Assembly for this purpose,
26 the statutes, laws, regulations, policies, procedures,
27 principles, definitions, guidelines, and manuals used to
28 determine the amounts paid to ambulance service providers under
29 Title XVIII of the Social Security Act (Medicare).
30     For ambulance services provided to a recipient of aid under
31 this Article on or after January 1, 1996, the Illinois
32 Department shall reimburse ambulance service providers based

 

 

HB1365 - 2 - LRB094 05553 DRJ 35602 b

1 upon the actual distance traveled if a natural disaster,
2 weather conditions, road repairs, or traffic congestion
3 necessitates the use of a route other than the most direct
4 route.
5     Notwithstanding any other provision of this Section, for
6 ambulance services provided to a recipient of aid under this
7 Article on or after January 1, 2006, the Department of Public
8 Aid shall reimburse providers of medical transportation
9 services provided to a disabled person by means of a medi-car,
10 regardless of whether the person has a physical disability or a
11 mental or cognitive disability. For purposes of this paragraph,
12 the Department or its authorized prior approval agent shall
13 determine that a person is disabled and eligible for
14 transportation by means of a medi-car if a physician licensed
15 to practice medicine in all its branches certifies to the
16 Department in writing that the person has a physical disability
17 or a mental or cognitive disability.
18     For purposes of this Section, "ambulance services"
19 includes medical transportation services provided by means of
20 an ambulance, medi-car, service car, or taxi.
21     This Section does not prohibit separate billing by
22 ambulance service providers for oxygen furnished while
23 providing advanced life support services.
24 (Source: P.A. 88-104; 89-43, eff. 1-1-96.)