102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5053

 

Introduced 1/27/2022, by Rep. LaToya Greenwood

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.05d new
305 ILCS 5/5-5.05e new
305 ILCS 5/5-5.05f new
305 ILCS 5/5-5.05g new
305 ILCS 5/5-5.05h new
305 ILCS 5/5-5.06c new
305 ILCS 5/5-5.06d new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop a program designed to provide over-the-phone academic detailing and clinical consultation from a qualified provider to behavioral health providers and providers in academic medical settings who need assistance on how best to care for patients with a severe mental illness or a developmental disability. Requires the Department to track all inpatient and residential detoxification and treatment beds that are available for medical assistance beneficiaries and for provider referrals. Requires the Department to record provider trainings and publish the trainings online within one month of the training, whenever feasible, to be available on demand for staff who are unable to attend. Provides that beginning on January 1, 2023, the Department shall cover services rendered by virtual peer support specialists under the medical assistance program for behavioral health and substance use support. Requires the Department and the Department of Human Services to collaborate to review coverage and billing requirements for substance use prevention and recovery and mental health services with the goal of identifying disparities and streamlining coverage and billing requirements to reduce the administrative burden for providers and medical assistance beneficiaries. Requires the Department to increase the rate for prenatal and postpartum visits to no less than the rate for an adult well visit, including any applicable add-ons, beginning on January 1, 2023. Requires the Department to evaluate the rate for external cephalic versions and increase the rate by an amount determined by the Department to promote safer birthing options for pregnant individuals, beginning on January 1, 2023.


LRB102 25685 KTG 34979 b

 

 

A BILL FOR

 

HB5053LRB102 25685 KTG 34979 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 Sections 5-5.05d, 5-5.05e, 5-5.05f, 5-5.05g, 5-5.05h,
65-5.06c, and 5-5.06d as follows:
 
7    (305 ILCS 5/5-5.05d new)
8    Sec. 5-5.05d. Academic detailing for behavioral health
9providers. The Department shall develop, in collaboration with
10associations representing behavioral health providers, a
11program designed to provide over-the-phone academic detailing
12and clinical consultation from a qualified provider to
13behavioral health providers and providers in academic medical
14settings who need assistance on how best to care for patients
15with a severe mental illness or a developmental disability.
16The Department shall include the phone number established
17under the program on its website and notify providers that the
18service is available. The Department may create an in-person
19option if adequate staff is available. To the extent
20practicable, the Department shall build upon this service to
21address worker shortages and the availability of specialty
22services.
 

 

 

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1    (305 ILCS 5/5-5.05e new)
2    Sec. 5-5.05e. Tracking beds for detoxification and
3treatment. The Department shall track, or contract with an
4organization to track by level of care, all inpatient and
5residential detoxification and treatment beds that are
6available for medical assistance beneficiaries and for
7provider referrals. The Department shall update the tracking
8daily and publish the availability of beds by level of care on
9its website.
 
10    (305 ILCS 5/5-5.05f new)
11    Sec. 5-5.05f. Access to on demand training. To improve
12access to provider education, the Department shall record
13provider trainings and publish the trainings online within one
14month of the training, whenever feasible, to be available on
15demand for staff who are unable to attend.
 
16    (305 ILCS 5/5-5.05g new)
17    Sec. 5-5.05g. Medical assistance coverage for virtual peer
18supports. Beginning on January 1, 2023, the Department shall
19cover services rendered by virtual peer support specialists
20under the medical assistance program for behavioral health and
21substance use support. The Department shall allow
22reimbursement for services delivered through video
23conferencing or by phone. As used in this Section, a "peer
24support specialist" means an individual who:

 

 

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1        (1) is a self-identified current or former recipient
2    of behavioral health services who has the ability to
3    support other individuals diagnosed with a mental illness
4    or substance use disorder;
5        (2) is affiliated with a community mental health
6    center, behavioral health clinic, substance use prevention
7    and recovery provider agency, or federally qualified
8    health center; and
9            (A) is certified in accordance with applicable
10        State law to provide peer support services in
11        behavioral health settings; or
12            (B) is certified as qualified to furnish peer
13        support services under a certification process
14        consistent with the National Practice Guidelines for
15        Peer Supporters and inclusive of the core competencies
16        identified by the Substance Abuse and Mental Health
17        Services Administration in the Core Competencies for
18        Peer Workers in Behavioral Health Services.
 
19    (305 ILCS 5/5-5.05h new)
20    Sec. 5-5.05h. Alignment of substance use prevention and
21recovery and mental health policy. The Department and the
22Department of Human Services shall collaborate to review
23coverage and billing requirements for substance use prevention
24and recovery and mental health services with the goal of
25identifying disparities and streamlining coverage and billing

 

 

HB5053- 4 -LRB102 25685 KTG 34979 b

1requirements to reduce the administrative burden for providers
2and medical assistance beneficiaries.
 
3    (305 ILCS 5/5-5.06c new)
4    Sec. 5-5.06c. Access to prenatal and postpartum care. To
5ensure access to high quality prenatal and postpartum care and
6to promote continuity of care for pregnant individuals, the
7Department shall increase the rate for prenatal and postpartum
8visits to no less than the rate for an adult well visit,
9including any applicable add-ons, beginning on January 1,
102023.
 
11    (305 ILCS 5/5-5.06d new)
12    Sec. 5-5.06d. External cephalic version rate. To encourage
13provider use of external cephalic versions and decrease the
14rates of cesarean sections in Illinois, the Department shall
15evaluate the rate for external cephalic versions and increase
16the rate by an amount determined by the Department to promote
17safer birthing options for pregnant individuals, beginning on
18January 1, 2023.