100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB3381

 

Introduced , by Rep. Sara Feigenholtz

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-30.6 new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that notwithstanding any other provision of the Code, the Department of Healthcare and Family Services shall not require Medicaid managed care organizations, including managed care community networks, to cover material changes to the medical assistance program, including, but not limited to, additional services, increases to rates, or substantive changes to utilization controls, until capitation rates have been updated accordingly and are deemed actuarially sound. Provides that the prohibition does not apply to services for which the Department reimburses Medicaid managed care organizations directly without regard to capitation payments.


LRB100 10908 KTG 21144 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB3381LRB100 10908 KTG 21144 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5adding Section 5-30.6 as follows:
 
6    (305 ILCS 5/5-30.6 new)
7    Sec. 5-30.6. Updates to capitation rates; managed care
8organizations. Notwithstanding any other provision of this
9Code, the Department shall not require Medicaid managed care
10organizations, including managed care community networks, to
11cover material changes to the medical assistance program,
12including, but not limited to, additional services, increases
13to rates, or substantive changes to utilization controls
14required under this Article, until capitation rates have been
15updated accordingly and are deemed actuarially sound. The
16prohibition in the preceding sentence does not apply to
17services for which the Department reimburses Medicaid managed
18care organizations directly without regard to capitation
19payments.