103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4739
 
Introduced 2/6/2024, by Rep. Terra Costa Howard
 
SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-2.02 new
    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that in order to give providers more time to prepare for and implement changes to the Medicaid Mental Health Fee Schedule and to ensure that the quality and delivery of behavioral health care is not disrupted, the Department of Healthcare and Family Services shall provide an approved Medicaid Mental Health Fee Schedule to all behavioral health care providers no later than 45 days prior to the date such rate change takes effect, unless contrary to federal law and regulation. Requires the Department to obtain federal approval on any Medicaid Mental Health Fee Schedule by submitting all necessary documentation in a timely manner, including, but not limited to, submitting any required State Plan amendments to the federal Centers for Medicare and Medicaid Services. Provides that if the Department is unable to provide 45 days' notice prior to the date such rate change takes effect due to external circumstances beyond the Department's control, the Department must provide a reasonable amount of notice. Provides that nothing in the amendatory Act shall be construed as a requirement to delay or prohibit implementation of rate changes that impact enrollee benefits as determined in the sole discretion of the Department. 


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A BILL FOR
 
HB4739LRB103 37770 KTG 67899 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 5-2.02 as follows:
 
6    (305 ILCS 5/5-2.02 new)
7    Sec. 5-2.02. Notice of changes to Medicaid Mental Health 
8Fee Schedule. In order to give providers more time to prepare 
9for and implement changes to the Medicaid Mental Health Fee 
10Schedule and to ensure that the quality and delivery of 
11behavioral health care is not disrupted, the Department shall 
12do the following:
13        (1) Unless contrary to federal law and regulation, the 
14    Department must provide an approved Medicaid Mental Health 
15    Fee Schedule to all behavioral health care providers no 
16    later than 45 days prior to the date such rate change takes 
17    effect. The Department shall comply with this Section and 
18    attempt to receive federal approval on any Medicaid Mental 
19    Health Fee Schedule by submitting all necessary 
20    documentation in a timely manner, including, but not 
21    limited to, submitting any required State Plan amendments 
22    to the federal Centers for Medicare and Medicaid Services.
23        (2) If the Department is unable to provide 45 days' 
 
 
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1    notice prior to the date such rate change takes effect due 
2    to external circumstances beyond the Department's control, 
3    the Department must provide a reasonable amount of notice. 
4    Claims with a date of service between the date the rate 
5    increase takes effect and the date the fee schedule is 
6    published are not subject to timely filing.
7    Nothing in this Section shall be construed as a 
8requirement to delay or prohibit implementation of rate 
9changes that impact enrollee benefits as determined in the 
10sole discretion of the Department.