State of Illinois
92^nd General Assembly
Legislation

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92_SB0165enr

 
SB165 Enrolled                                 LRB9203947DJpc

 1        AN ACT in relation to 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 5-23 as follows:

 6        (305 ILCS 5/5-23 new)
 7        Sec.  5-23.  Disease management programs and services for
 8    chronic conditions; pilot project.
 9        (a)  In this Section, "disease  management  programs  and
10    services" means services administered to patients in order to
11    improve   their   overall  health  and  to  prevent  clinical
12    exacerbations  and   complications,   using   cost-effective,
13    evidence-based     practice     guidelines     and    patient
14    self-management strategies.  Disease management programs  and
15    services include all of the following:
16             (1)  A population identification process.
17             (2)  Evidence-based   or   consensus-based  clinical
18        practice guidelines, risk identification, and matching of
19        interventions with clinical need.
20             (3)  Patient self-management and disease education.
21             (4)  Process and outcomes  measurement,  evaluation,
22        management, and reporting.
23        (b)  Subject   to   appropriations,  the  Department  may
24    undertake a pilot project  to  study  patient  outcomes,  for
25    patients  with  chronic  diseases, associated with the use of
26    disease  management  programs  and   services   for   chronic
27    condition management. "Chronic diseases" include, but are not
28    limited  to,  diabetes, congestive heart failure, and chronic
29    obstructive pulmonary disease.
30        (c)  The disease management programs and  services  pilot
31    project  shall  examine  whether  chronic  disease management
 
SB165 Enrolled              -2-                LRB9203947DJpc
 1    programs and services  for  patients  with  specific  chronic
 2    conditions do any or all of the following:
 3             (1)  Improve  the patient's overall health in a more
 4        expeditious manner.
 5             (2)  Lower costs in other  aspects  of  the  medical
 6        assistance  program, such as hospital admissions, days in
 7        skilled nursing homes,  emergency-room  visits,  or  more
 8        frequent physician office visits.
 9        (d)  In  carrying  out  the pilot project, the Department
10    shall examine all relevant scientific  literature  and  shall
11    consult  with  health  care  practitioners including, but not
12    limited to, physicians, surgeons, registered pharmacists, and
13    registered nurses.
14        (e)  The Department shall consult with  medical  experts,
15    disease advocacy groups, and academic institutions to develop
16    criteria  to  be  used  in  selecting  a vendor for the pilot
17    project.
18        (f)  The pilot project may  not  use  any  company  whose
19    primary  purpose  is to market specific products or services,
20    other  than  disease  management  services  to   the   entity
21    responsible for the patient's health care coverage.
22        (g)  The  Department  of  Public  Aid  may adopt rules to
23    implement this Section.
24        (h)  This  Section  is  repealed  10  years   after   the
25    effective  date  of  this  amendatory Act of the 92nd General
26    Assembly.

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