SB3741 EnrolledLRB103 37781 RPS 67910 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 370c as follows:
 
6    (215 ILCS 5/370c)  (from Ch. 73, par. 982c)
7    Sec. 370c. Mental and emotional disorders.
8    (a)(1) On and after January 1, 2022 (the effective date of
9Public Act 102-579), every insurer that amends, delivers,
10issues, or renews group accident and health policies providing
11coverage for hospital or medical treatment or services for
12illness on an expense-incurred basis shall provide coverage
13for the medically necessary treatment of mental, emotional,
14nervous, or substance use disorders or conditions consistent
15with the parity requirements of Section 370c.1 of this Code.
16    (2) Each insured that is covered for mental, emotional,
17nervous, or substance use disorders or conditions shall be
18free to select the physician licensed to practice medicine in
19all its branches, licensed clinical psychologist, licensed
20clinical social worker, licensed clinical professional
21counselor, licensed marriage and family therapist, licensed
22speech-language pathologist, or other licensed or certified
23professional at a program licensed pursuant to the Substance

 

 

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1Use Disorder Act of his or her choice to treat such disorders,
2and the insurer shall pay the covered charges of such
3physician licensed to practice medicine in all its branches,
4licensed clinical psychologist, licensed clinical social
5worker, licensed clinical professional counselor, licensed
6marriage and family therapist, licensed speech-language
7pathologist, or other licensed or certified professional at a
8program licensed pursuant to the Substance Use Disorder Act up
9to the limits of coverage, provided (i) the disorder or
10condition treated is covered by the policy, and (ii) the
11physician, licensed psychologist, licensed clinical social
12worker, licensed clinical professional counselor, licensed
13marriage and family therapist, licensed speech-language
14pathologist, or other licensed or certified professional at a
15program licensed pursuant to the Substance Use Disorder Act is
16authorized to provide said services under the statutes of this
17State and in accordance with accepted principles of his or her
18profession.
19    (3) Insofar as this Section applies solely to licensed
20clinical social workers, licensed clinical professional
21counselors, licensed marriage and family therapists, licensed
22speech-language pathologists, and other licensed or certified
23professionals at programs licensed pursuant to the Substance
24Use Disorder Act, those persons who may provide services to
25individuals shall do so after the licensed clinical social
26worker, licensed clinical professional counselor, licensed

 

 

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1marriage and family therapist, licensed speech-language
2pathologist, or other licensed or certified professional at a
3program licensed pursuant to the Substance Use Disorder Act
4has informed the patient of the desirability of the patient
5conferring with the patient's primary care physician.
6    (4) "Mental, emotional, nervous, or substance use disorder
7or condition" means a condition or disorder that involves a
8mental health condition or substance use disorder that falls
9under any of the diagnostic categories listed in the mental
10and behavioral disorders chapter of the current edition of the
11World Health Organization's International Classification of
12Disease or that is listed in the most recent version of the
13American Psychiatric Association's Diagnostic and Statistical
14Manual of Mental Disorders. "Mental, emotional, nervous, or
15substance use disorder or condition" includes any mental
16health condition that occurs during pregnancy or during the
17postpartum period and includes, but is not limited to,
18postpartum depression.
19    (5) Medically necessary treatment and medical necessity
20determinations shall be interpreted and made in a manner that
21is consistent with and pursuant to subsections (h) through
22(t).
23    (b)(1) (Blank).
24    (2) (Blank).
25    (2.5) (Blank).
26    (3) Unless otherwise prohibited by federal law and

 

 

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1consistent with the parity requirements of Section 370c.1 of
2this Code, the reimbursing insurer that amends, delivers,
3issues, or renews a group or individual policy of accident and
4health insurance, a qualified health plan offered through the
5health insurance marketplace, or a provider of treatment of
6mental, emotional, nervous, or substance use disorders or
7conditions shall furnish medical records or other necessary
8data that substantiate that initial or continued treatment is
9at all times medically necessary. An insurer shall provide a
10mechanism for the timely review by a provider holding the same
11license and practicing in the same specialty as the patient's
12provider, who is unaffiliated with the insurer, jointly
13selected by the patient (or the patient's next of kin or legal
14representative if the patient is unable to act for himself or
15herself), the patient's provider, and the insurer in the event
16of a dispute between the insurer and patient's provider
17regarding the medical necessity of a treatment proposed by a
18patient's provider. If the reviewing provider determines the
19treatment to be medically necessary, the insurer shall provide
20reimbursement for the treatment. Future contractual or
21employment actions by the insurer regarding the patient's
22provider may not be based on the provider's participation in
23this procedure. Nothing prevents the insured from agreeing in
24writing to continue treatment at his or her expense. When
25making a determination of the medical necessity for a
26treatment modality for mental, emotional, nervous, or

 

 

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1substance use disorders or conditions, an insurer must make
2the determination in a manner that is consistent with the
3manner used to make that determination with respect to other
4diseases or illnesses covered under the policy, including an
5appeals process. Medical necessity determinations for
6substance use disorders shall be made in accordance with
7appropriate patient placement criteria established by the
8American Society of Addiction Medicine. No additional criteria
9may be used to make medical necessity determinations for
10substance use disorders.
11    (4) A group health benefit plan amended, delivered,
12issued, or renewed on or after January 1, 2019 (the effective
13date of Public Act 100-1024) or an individual policy of
14accident and health insurance or a qualified health plan
15offered through the health insurance marketplace amended,
16delivered, issued, or renewed on or after January 1, 2019 (the
17effective date of Public Act 100-1024):
18        (A) shall provide coverage based upon medical
19    necessity for the treatment of a mental, emotional,
20    nervous, or substance use disorder or condition consistent
21    with the parity requirements of Section 370c.1 of this
22    Code; provided, however, that in each calendar year
23    coverage shall not be less than the following:
24            (i) 45 days of inpatient treatment; and
25            (ii) beginning on June 26, 2006 (the effective
26        date of Public Act 94-921), 60 visits for outpatient

 

 

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1        treatment including group and individual outpatient
2        treatment; and
3            (iii) for plans or policies delivered, issued for
4        delivery, renewed, or modified after January 1, 2007
5        (the effective date of Public Act 94-906), 20
6        additional outpatient visits for speech therapy for
7        treatment of pervasive developmental disorders that
8        will be in addition to speech therapy provided
9        pursuant to item (ii) of this subparagraph (A); and
10        (B) may not include a lifetime limit on the number of
11    days of inpatient treatment or the number of outpatient
12    visits covered under the plan.
13        (C) (Blank).
14    (5) An issuer of a group health benefit plan or an
15individual policy of accident and health insurance or a
16qualified health plan offered through the health insurance
17marketplace may not count toward the number of outpatient
18visits required to be covered under this Section an outpatient
19visit for the purpose of medication management and shall cover
20the outpatient visits under the same terms and conditions as
21it covers outpatient visits for the treatment of physical
22illness.
23    (5.5) An individual or group health benefit plan amended,
24delivered, issued, or renewed on or after September 9, 2015
25(the effective date of Public Act 99-480) shall offer coverage
26for medically necessary acute treatment services and medically

 

 

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1necessary clinical stabilization services. The treating
2provider shall base all treatment recommendations and the
3health benefit plan shall base all medical necessity
4determinations for substance use disorders in accordance with
5the most current edition of the Treatment Criteria for
6Addictive, Substance-Related, and Co-Occurring Conditions
7established by the American Society of Addiction Medicine. The
8treating provider shall base all treatment recommendations and
9the health benefit plan shall base all medical necessity
10determinations for medication-assisted treatment in accordance
11with the most current Treatment Criteria for Addictive,
12Substance-Related, and Co-Occurring Conditions established by
13the American Society of Addiction Medicine.
14    As used in this subsection:
15    "Acute treatment services" means 24-hour medically
16supervised addiction treatment that provides evaluation and
17withdrawal management and may include biopsychosocial
18assessment, individual and group counseling, psychoeducational
19groups, and discharge planning.
20    "Clinical stabilization services" means 24-hour treatment,
21usually following acute treatment services for substance
22abuse, which may include intensive education and counseling
23regarding the nature of addiction and its consequences,
24relapse prevention, outreach to families and significant
25others, and aftercare planning for individuals beginning to
26engage in recovery from addiction.

 

 

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1    (6) An issuer of a group health benefit plan may provide or
2offer coverage required under this Section through a managed
3care plan.
4    (6.5) An individual or group health benefit plan amended,
5delivered, issued, or renewed on or after January 1, 2019 (the
6effective date of Public Act 100-1024):
7        (A) shall not impose prior authorization requirements,
8    including limitations on dosage, other than those
9    established under the Treatment Criteria for Addictive,
10    Substance-Related, and Co-Occurring Conditions
11    established by the American Society of Addiction Medicine,
12    on a prescription medication approved by the United States
13    Food and Drug Administration that is prescribed or
14    administered for the treatment of substance use disorders;
15        (B) shall not impose any step therapy requirements,
16    other than those established under the Treatment Criteria
17    for Addictive, Substance-Related, and Co-Occurring
18    Conditions established by the American Society of
19    Addiction Medicine, before authorizing coverage for a
20    prescription medication approved by the United States Food
21    and Drug Administration that is prescribed or administered
22    for the treatment of substance use disorders;
23        (C) shall place all prescription medications approved
24    by the United States Food and Drug Administration
25    prescribed or administered for the treatment of substance
26    use disorders on, for brand medications, the lowest tier

 

 

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1    of the drug formulary developed and maintained by the
2    individual or group health benefit plan that covers brand
3    medications and, for generic medications, the lowest tier
4    of the drug formulary developed and maintained by the
5    individual or group health benefit plan that covers
6    generic medications; and
7        (D) shall not exclude coverage for a prescription
8    medication approved by the United States Food and Drug
9    Administration for the treatment of substance use
10    disorders and any associated counseling or wraparound
11    services on the grounds that such medications and services
12    were court ordered.
13    (7) (Blank).
14    (8) (Blank).
15    (9) With respect to all mental, emotional, nervous, or
16substance use disorders or conditions, coverage for inpatient
17treatment shall include coverage for treatment in a
18residential treatment center certified or licensed by the
19Department of Public Health or the Department of Human
20Services.
21    (c) This Section shall not be interpreted to require
22coverage for speech therapy or other habilitative services for
23those individuals covered under Section 356z.15 of this Code.
24    (d) With respect to a group or individual policy of
25accident and health insurance or a qualified health plan
26offered through the health insurance marketplace, the

 

 

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1Department and, with respect to medical assistance, the
2Department of Healthcare and Family Services shall each
3enforce the requirements of this Section and Sections 356z.23
4and 370c.1 of this Code, the Paul Wellstone and Pete Domenici
5Mental Health Parity and Addiction Equity Act of 2008, 42
6U.S.C. 18031(j), and any amendments to, and federal guidance
7or regulations issued under, those Acts, including, but not
8limited to, final regulations issued under the Paul Wellstone
9and Pete Domenici Mental Health Parity and Addiction Equity
10Act of 2008 and final regulations applying the Paul Wellstone
11and Pete Domenici Mental Health Parity and Addiction Equity
12Act of 2008 to Medicaid managed care organizations, the
13Children's Health Insurance Program, and alternative benefit
14plans. Specifically, the Department and the Department of
15Healthcare and Family Services shall take action:
16        (1) proactively ensuring compliance by individual and
17    group policies, including by requiring that insurers
18    submit comparative analyses, as set forth in paragraph (6)
19    of subsection (k) of Section 370c.1, demonstrating how
20    they design and apply nonquantitative treatment
21    limitations, both as written and in operation, for mental,
22    emotional, nervous, or substance use disorder or condition
23    benefits as compared to how they design and apply
24    nonquantitative treatment limitations, as written and in
25    operation, for medical and surgical benefits;
26        (2) evaluating all consumer or provider complaints

 

 

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1    regarding mental, emotional, nervous, or substance use
2    disorder or condition coverage for possible parity
3    violations;
4        (3) performing parity compliance market conduct
5    examinations or, in the case of the Department of
6    Healthcare and Family Services, parity compliance audits
7    of individual and group plans and policies, including, but
8    not limited to, reviews of:
9            (A) nonquantitative treatment limitations,
10        including, but not limited to, prior authorization
11        requirements, concurrent review, retrospective review,
12        step therapy, network admission standards,
13        reimbursement rates, and geographic restrictions;
14            (B) denials of authorization, payment, and
15        coverage; and
16            (C) other specific criteria as may be determined
17        by the Department.
18    The findings and the conclusions of the parity compliance
19market conduct examinations and audits shall be made public.
20    The Director may adopt rules to effectuate any provisions
21of the Paul Wellstone and Pete Domenici Mental Health Parity
22and Addiction Equity Act of 2008 that relate to the business of
23insurance.
24    (e) Availability of plan information.
25        (1) The criteria for medical necessity determinations
26    made under a group health plan, an individual policy of

 

 

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1    accident and health insurance, or a qualified health plan
2    offered through the health insurance marketplace with
3    respect to mental health or substance use disorder
4    benefits (or health insurance coverage offered in
5    connection with the plan with respect to such benefits)
6    must be made available by the plan administrator (or the
7    health insurance issuer offering such coverage) to any
8    current or potential participant, beneficiary, or
9    contracting provider upon request.
10        (2) The reason for any denial under a group health
11    benefit plan, an individual policy of accident and health
12    insurance, or a qualified health plan offered through the
13    health insurance marketplace (or health insurance coverage
14    offered in connection with such plan or policy) of
15    reimbursement or payment for services with respect to
16    mental, emotional, nervous, or substance use disorders or
17    conditions benefits in the case of any participant or
18    beneficiary must be made available within a reasonable
19    time and in a reasonable manner and in readily
20    understandable language by the plan administrator (or the
21    health insurance issuer offering such coverage) to the
22    participant or beneficiary upon request.
23    (f) As used in this Section, "group policy of accident and
24health insurance" and "group health benefit plan" includes (1)
25State-regulated employer-sponsored group health insurance
26plans written in Illinois or which purport to provide coverage

 

 

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1for a resident of this State; and (2) State employee health
2plans.
3    (g) (1) As used in this subsection:
4    "Benefits", with respect to insurers, means the benefits
5provided for treatment services for inpatient and outpatient
6treatment of substance use disorders or conditions at American
7Society of Addiction Medicine levels of treatment 2.1
8(Intensive Outpatient), 2.5 (Partial Hospitalization), 3.1
9(Clinically Managed Low-Intensity Residential), 3.3
10(Clinically Managed Population-Specific High-Intensity
11Residential), 3.5 (Clinically Managed High-Intensity
12Residential), and 3.7 (Medically Monitored Intensive
13Inpatient) and OMT (Opioid Maintenance Therapy) services.
14    "Benefits", with respect to managed care organizations,
15means the benefits provided for treatment services for
16inpatient and outpatient treatment of substance use disorders
17or conditions at American Society of Addiction Medicine levels
18of treatment 2.1 (Intensive Outpatient), 2.5 (Partial
19Hospitalization), 3.5 (Clinically Managed High-Intensity
20Residential), and 3.7 (Medically Monitored Intensive
21Inpatient) and OMT (Opioid Maintenance Therapy) services.
22    "Substance use disorder treatment provider or facility"
23means a licensed physician, licensed psychologist, licensed
24psychiatrist, licensed advanced practice registered nurse, or
25licensed, certified, or otherwise State-approved facility or
26provider of substance use disorder treatment.

 

 

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1    (2) A group health insurance policy, an individual health
2benefit plan, or qualified health plan that is offered through
3the health insurance marketplace, small employer group health
4plan, and large employer group health plan that is amended,
5delivered, issued, executed, or renewed in this State, or
6approved for issuance or renewal in this State, on or after
7January 1, 2019 (the effective date of Public Act 100-1023)
8shall comply with the requirements of this Section and Section
9370c.1. The services for the treatment and the ongoing
10assessment of the patient's progress in treatment shall follow
11the requirements of 77 Ill. Adm. Code 2060.
12    (3) Prior authorization shall not be utilized for the
13benefits under this subsection. The substance use disorder
14treatment provider or facility shall notify the insurer of the
15initiation of treatment. For an insurer that is not a managed
16care organization, the substance use disorder treatment
17provider or facility notification shall occur for the
18initiation of treatment of the covered person within 2
19business days. For managed care organizations, the substance
20use disorder treatment provider or facility notification shall
21occur in accordance with the protocol set forth in the
22provider agreement for initiation of treatment within 24
23hours. If the managed care organization is not capable of
24accepting the notification in accordance with the contractual
25protocol during the 24-hour period following admission, the
26substance use disorder treatment provider or facility shall

 

 

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1have one additional business day to provide the notification
2to the appropriate managed care organization. Treatment plans
3shall be developed in accordance with the requirements and
4timeframes established in 77 Ill. Adm. Code 2060. If the
5substance use disorder treatment provider or facility fails to
6notify the insurer of the initiation of treatment in
7accordance with these provisions, the insurer may follow its
8normal prior authorization processes.
9    (4) For an insurer that is not a managed care
10organization, if an insurer determines that benefits are no
11longer medically necessary, the insurer shall notify the
12covered person, the covered person's authorized
13representative, if any, and the covered person's health care
14provider in writing of the covered person's right to request
15an external review pursuant to the Health Carrier External
16Review Act. The notification shall occur within 24 hours
17following the adverse determination.
18    Pursuant to the requirements of the Health Carrier
19External Review Act, the covered person or the covered
20person's authorized representative may request an expedited
21external review. An expedited external review may not occur if
22the substance use disorder treatment provider or facility
23determines that continued treatment is no longer medically
24necessary.
25    If an expedited external review request meets the criteria
26of the Health Carrier External Review Act, an independent

 

 

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1review organization shall make a final determination of
2medical necessity within 72 hours. If an independent review
3organization upholds an adverse determination, an insurer
4shall remain responsible to provide coverage of benefits
5through the day following the determination of the independent
6review organization. A decision to reverse an adverse
7determination shall comply with the Health Carrier External
8Review Act.
9    (5) The substance use disorder treatment provider or
10facility shall provide the insurer with 7 business days'
11advance notice of the planned discharge of the patient from
12the substance use disorder treatment provider or facility and
13notice on the day that the patient is discharged from the
14substance use disorder treatment provider or facility.
15    (6) The benefits required by this subsection shall be
16provided to all covered persons with a diagnosis of substance
17use disorder or conditions. The presence of additional related
18or unrelated diagnoses shall not be a basis to reduce or deny
19the benefits required by this subsection.
20    (7) Nothing in this subsection shall be construed to
21require an insurer to provide coverage for any of the benefits
22in this subsection.
23    (h) As used in this Section:
24    "Generally accepted standards of mental, emotional,
25nervous, or substance use disorder or condition care" means
26standards of care and clinical practice that are generally

 

 

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1recognized by health care providers practicing in relevant
2clinical specialties such as psychiatry, psychology, clinical
3sociology, social work, addiction medicine and counseling, and
4behavioral health treatment. Valid, evidence-based sources
5reflecting generally accepted standards of mental, emotional,
6nervous, or substance use disorder or condition care include
7peer-reviewed scientific studies and medical literature,
8recommendations of nonprofit health care provider professional
9associations and specialty societies, including, but not
10limited to, patient placement criteria and clinical practice
11guidelines, recommendations of federal government agencies,
12and drug labeling approved by the United States Food and Drug
13Administration.
14    "Medically necessary treatment of mental, emotional,
15nervous, or substance use disorders or conditions" means a
16service or product addressing the specific needs of that
17patient, for the purpose of screening, preventing, diagnosing,
18managing, or treating an illness, injury, or condition or its
19symptoms and comorbidities, including minimizing the
20progression of an illness, injury, or condition or its
21symptoms and comorbidities in a manner that is all of the
22following:
23        (1) in accordance with the generally accepted
24    standards of mental, emotional, nervous, or substance use
25    disorder or condition care;
26        (2) clinically appropriate in terms of type,

 

 

SB3741 Enrolled- 18 -LRB103 37781 RPS 67910 b

1    frequency, extent, site, and duration; and
2        (3) not primarily for the economic benefit of the
3    insurer, purchaser, or for the convenience of the patient,
4    treating physician, or other health care provider.
5    "Utilization review" means either of the following:
6        (1) prospectively, retrospectively, or concurrently
7    reviewing and approving, modifying, delaying, or denying,
8    based in whole or in part on medical necessity, requests
9    by health care providers, insureds, or their authorized
10    representatives for coverage of health care services
11    before, retrospectively, or concurrently with the
12    provision of health care services to insureds.
13        (2) evaluating the medical necessity, appropriateness,
14    level of care, service intensity, efficacy, or efficiency
15    of health care services, benefits, procedures, or
16    settings, under any circumstances, to determine whether a
17    health care service or benefit subject to a medical
18    necessity coverage requirement in an insurance policy is
19    covered as medically necessary for an insured.
20    "Utilization review criteria" means patient placement
21criteria or any criteria, standards, protocols, or guidelines
22used by an insurer to conduct utilization review.
23    (i)(1) Every insurer that amends, delivers, issues, or
24renews a group or individual policy of accident and health
25insurance or a qualified health plan offered through the
26health insurance marketplace in this State and Medicaid

 

 

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1managed care organizations providing coverage for hospital or
2medical treatment on or after January 1, 2023 shall, pursuant
3to subsections (h) through (s), provide coverage for medically
4necessary treatment of mental, emotional, nervous, or
5substance use disorders or conditions.
6    (2) An insurer shall not set a specific limit on the
7duration of benefits or coverage of medically necessary
8treatment of mental, emotional, nervous, or substance use
9disorders or conditions or limit coverage only to alleviation
10of the insured's current symptoms.
11    (3) All medical necessity determinations made by the
12insurer concerning service intensity, level of care placement,
13continued stay, and transfer or discharge of insureds
14diagnosed with mental, emotional, nervous, or substance use
15disorders or conditions shall be conducted in accordance with
16the requirements of subsections (k) through (u).
17    (4) An insurer that authorizes a specific type of
18treatment by a provider pursuant to this Section shall not
19rescind or modify the authorization after that provider
20renders the health care service in good faith and pursuant to
21this authorization for any reason, including, but not limited
22to, the insurer's subsequent cancellation or modification of
23the insured's or policyholder's contract, or the insured's or
24policyholder's eligibility. Nothing in this Section shall
25require the insurer to cover a treatment when the
26authorization was granted based on a material

 

 

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1misrepresentation by the insured, the policyholder, or the
2provider. Nothing in this Section shall require Medicaid
3managed care organizations to pay for services if the
4individual was not eligible for Medicaid at the time the
5service was rendered. Nothing in this Section shall require an
6insurer to pay for services if the individual was not the
7insurer's enrollee at the time services were rendered. As used
8in this paragraph, "material" means a fact or situation that
9is not merely technical in nature and results in or could
10result in a substantial change in the situation.
11    (j) An insurer shall not limit benefits or coverage for
12medically necessary services on the basis that those services
13should be or could be covered by a public entitlement program,
14including, but not limited to, special education or an
15individualized education program, Medicaid, Medicare,
16Supplemental Security Income, or Social Security Disability
17Insurance, and shall not include or enforce a contract term
18that excludes otherwise covered benefits on the basis that
19those services should be or could be covered by a public
20entitlement program. Nothing in this subsection shall be
21construed to require an insurer to cover benefits that have
22been authorized and provided for a covered person by a public
23entitlement program. Medicaid managed care organizations are
24not subject to this subsection.
25    (k) An insurer shall base any medical necessity
26determination or the utilization review criteria that the

 

 

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1insurer, and any entity acting on the insurer's behalf,
2applies to determine the medical necessity of health care
3services and benefits for the diagnosis, prevention, and
4treatment of mental, emotional, nervous, or substance use
5disorders or conditions on current generally accepted
6standards of mental, emotional, nervous, or substance use
7disorder or condition care. All denials and appeals shall be
8reviewed by a professional with experience or expertise
9comparable to the provider requesting the authorization.
10    (l) For medical necessity determinations relating to level
11of care placement, continued stay, and transfer or discharge
12of insureds diagnosed with mental, emotional, and nervous
13disorders or conditions, an insurer shall apply the patient
14placement criteria set forth in the most recent version of the
15treatment criteria developed by an unaffiliated nonprofit
16professional association for the relevant clinical specialty
17or, for Medicaid managed care organizations, patient placement
18criteria determined by the Department of Healthcare and Family
19Services that are consistent with generally accepted standards
20of mental, emotional, nervous or substance use disorder or
21condition care. Pursuant to subsection (b), in conducting
22utilization review of all covered services and benefits for
23the diagnosis, prevention, and treatment of substance use
24disorders an insurer shall use the most recent edition of the
25patient placement criteria established by the American Society
26of Addiction Medicine.

 

 

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1    (m) For medical necessity determinations relating to level
2of care placement, continued stay, and transfer or discharge
3that are within the scope of the sources specified in
4subsection (l), an insurer shall not apply different,
5additional, conflicting, or more restrictive utilization
6review criteria than the criteria set forth in those sources.
7For all level of care placement decisions, the insurer shall
8authorize placement at the level of care consistent with the
9assessment of the insured using the relevant patient placement
10criteria as specified in subsection (l). If that level of
11placement is not available, the insurer shall authorize the
12next higher level of care. In the event of disagreement, the
13insurer shall provide full detail of its assessment using the
14relevant criteria as specified in subsection (l) to the
15provider of the service and the patient.
16    Nothing in this subsection or subsection (l) prohibits an
17insurer from applying utilization review criteria that were
18developed in accordance with subsection (k) to health care
19services and benefits for mental, emotional, and nervous
20disorders or conditions that are not related to medical
21necessity determinations for level of care placement,
22continued stay, and transfer or discharge. If an insurer
23purchases or licenses utilization review criteria pursuant to
24this subsection, the insurer shall verify and document before
25use that the criteria were developed in accordance with
26subsection (k).

 

 

SB3741 Enrolled- 23 -LRB103 37781 RPS 67910 b

1    (n) In conducting utilization review that is outside the
2scope of the criteria as specified in subsection (l) or
3relates to the advancements in technology or in the types or
4levels of care that are not addressed in the most recent
5versions of the sources specified in subsection (l), an
6insurer shall conduct utilization review in accordance with
7subsection (k).
8    (o) This Section does not in any way limit the rights of a
9patient under the Medical Patient Rights Act.
10    (p) This Section does not in any way limit early and
11periodic screening, diagnostic, and treatment benefits as
12defined under 42 U.S.C. 1396d(r).
13    (q) To ensure the proper use of the criteria described in
14subsection (l), every insurer shall do all of the following:
15        (1) Educate the insurer's staff, including any third
16    parties contracted with the insurer to review claims,
17    conduct utilization reviews, or make medical necessity
18    determinations about the utilization review criteria.
19        (2) Make the educational program available to other
20    stakeholders, including the insurer's participating or
21    contracted providers and potential participants,
22    beneficiaries, or covered lives. The education program
23    must be provided at least once a year, in-person or
24    digitally, or recordings of the education program must be
25    made available to the aforementioned stakeholders.
26        (3) Provide, at no cost, the utilization review

 

 

SB3741 Enrolled- 24 -LRB103 37781 RPS 67910 b

1    criteria and any training material or resources to
2    providers and insured patients upon request. For
3    utilization review criteria not concerning level of care
4    placement, continued stay, and transfer or discharge used
5    by the insurer pursuant to subsection (m), the insurer may
6    place the criteria on a secure, password-protected website
7    so long as the access requirements of the website do not
8    unreasonably restrict access to insureds or their
9    providers. No restrictions shall be placed upon the
10    insured's or treating provider's access right to
11    utilization review criteria obtained under this paragraph
12    at any point in time, including before an initial request
13    for authorization.
14        (4) Track, identify, and analyze how the utilization
15    review criteria are used to certify care, deny care, and
16    support the appeals process.
17        (5) Conduct interrater reliability testing to ensure
18    consistency in utilization review decision making that
19    covers how medical necessity decisions are made; this
20    assessment shall cover all aspects of utilization review
21    as defined in subsection (h).
22        (6) Run interrater reliability reports about how the
23    clinical guidelines are used in conjunction with the
24    utilization review process and parity compliance
25    activities.
26        (7) Achieve interrater reliability pass rates of at

 

 

SB3741 Enrolled- 25 -LRB103 37781 RPS 67910 b

1    least 90% and, if this threshold is not met, immediately
2    provide for the remediation of poor interrater reliability
3    and interrater reliability testing for all new staff
4    before they can conduct utilization review without
5    supervision.
6        (8) Maintain documentation of interrater reliability
7    testing and the remediation actions taken for those with
8    pass rates lower than 90% and submit to the Department of
9    Insurance or, in the case of Medicaid managed care
10    organizations, the Department of Healthcare and Family
11    Services the testing results and a summary of remedial
12    actions as part of parity compliance reporting set forth
13    in subsection (k) of Section 370c.1.
14    (r) This Section applies to all health care services and
15benefits for the diagnosis, prevention, and treatment of
16mental, emotional, nervous, or substance use disorders or
17conditions covered by an insurance policy, including
18prescription drugs.
19    (s) This Section applies to an insurer that amends,
20delivers, issues, or renews a group or individual policy of
21accident and health insurance or a qualified health plan
22offered through the health insurance marketplace in this State
23providing coverage for hospital or medical treatment and
24conducts utilization review as defined in this Section,
25including Medicaid managed care organizations, and any entity
26or contracting provider that performs utilization review or

 

 

SB3741 Enrolled- 26 -LRB103 37781 RPS 67910 b

1utilization management functions on an insurer's behalf.
2    (t) If the Director determines that an insurer has
3violated this Section, the Director may, after appropriate
4notice and opportunity for hearing, by order, assess a civil
5penalty between $1,000 and $5,000 for each violation. Moneys
6collected from penalties shall be deposited into the Parity
7Advancement Fund established in subsection (i) of Section
8370c.1.
9    (u) An insurer shall not adopt, impose, or enforce terms
10in its policies or provider agreements, in writing or in
11operation, that undermine, alter, or conflict with the
12requirements of this Section.
13    (v) The provisions of this Section are severable. If any
14provision of this Section or its application is held invalid,
15that invalidity shall not affect other provisions or
16applications that can be given effect without the invalid
17provision or application.
18(Source: P.A. 102-558, eff. 8-20-21; 102-579, eff. 1-1-22;
19102-813, eff. 5-13-22; 103-426, eff. 8-4-23.)
 
20    Section 10. The Illinois Public Aid Code is amended by
21changing Section 5-5 as follows:
 
22    (305 ILCS 5/5-5)
23    Sec. 5-5. Medical services. The Illinois Department, by
24rule, shall determine the quantity and quality of and the rate

 

 

SB3741 Enrolled- 27 -LRB103 37781 RPS 67910 b

1of reimbursement for the medical assistance for which payment
2will be authorized, and the medical services to be provided,
3which may include all or part of the following: (1) inpatient
4hospital services; (2) outpatient hospital services; (3) other
5laboratory and X-ray services; (4) skilled nursing home
6services; (5) physicians' services whether furnished in the
7office, the patient's home, a hospital, a skilled nursing
8home, or elsewhere; (6) medical care, or any other type of
9remedial care furnished by licensed practitioners; (7) home
10health care services; (8) private duty nursing service; (9)
11clinic services; (10) dental services, including prevention
12and treatment of periodontal disease and dental caries disease
13for pregnant individuals, provided by an individual licensed
14to practice dentistry or dental surgery; for purposes of this
15item (10), "dental services" means diagnostic, preventive, or
16corrective procedures provided by or under the supervision of
17a dentist in the practice of his or her profession; (11)
18physical therapy and related services; (12) prescribed drugs,
19dentures, and prosthetic devices; and eyeglasses prescribed by
20a physician skilled in the diseases of the eye, or by an
21optometrist, whichever the person may select; (13) other
22diagnostic, screening, preventive, and rehabilitative
23services, including to ensure that the individual's need for
24intervention or treatment of mental disorders or substance use
25disorders or co-occurring mental health and substance use
26disorders is determined using a uniform screening, assessment,

 

 

SB3741 Enrolled- 28 -LRB103 37781 RPS 67910 b

1and evaluation process inclusive of criteria, for children and
2adults; for purposes of this item (13), a uniform screening,
3assessment, and evaluation process refers to a process that
4includes an appropriate evaluation and, as warranted, a
5referral; "uniform" does not mean the use of a singular
6instrument, tool, or process that all must utilize; (14)
7transportation and such other expenses as may be necessary;
8(15) medical treatment of sexual assault survivors, as defined
9in Section 1a of the Sexual Assault Survivors Emergency
10Treatment Act, for injuries sustained as a result of the
11sexual assault, including examinations and laboratory tests to
12discover evidence which may be used in criminal proceedings
13arising from the sexual assault; (16) the diagnosis and
14treatment of sickle cell anemia; (16.5) services performed by
15a chiropractic physician licensed under the Medical Practice
16Act of 1987 and acting within the scope of his or her license,
17including, but not limited to, chiropractic manipulative
18treatment; and (17) any other medical care, and any other type
19of remedial care recognized under the laws of this State. The
20term "any other type of remedial care" shall include nursing
21care and nursing home service for persons who rely on
22treatment by spiritual means alone through prayer for healing.
23    Notwithstanding any other provision of this Section, a
24comprehensive tobacco use cessation program that includes
25purchasing prescription drugs or prescription medical devices
26approved by the Food and Drug Administration shall be covered

 

 

SB3741 Enrolled- 29 -LRB103 37781 RPS 67910 b

1under the medical assistance program under this Article for
2persons who are otherwise eligible for assistance under this
3Article.
4    Notwithstanding any other provision of this Code,
5reproductive health care that is otherwise legal in Illinois
6shall be covered under the medical assistance program for
7persons who are otherwise eligible for medical assistance
8under this Article.
9    Notwithstanding any other provision of this Section, all
10tobacco cessation medications approved by the United States
11Food and Drug Administration and all individual and group
12tobacco cessation counseling services and telephone-based
13counseling services and tobacco cessation medications provided
14through the Illinois Tobacco Quitline shall be covered under
15the medical assistance program for persons who are otherwise
16eligible for assistance under this Article. The Department
17shall comply with all federal requirements necessary to obtain
18federal financial participation, as specified in 42 CFR
19433.15(b)(7), for telephone-based counseling services provided
20through the Illinois Tobacco Quitline, including, but not
21limited to: (i) entering into a memorandum of understanding or
22interagency agreement with the Department of Public Health, as
23administrator of the Illinois Tobacco Quitline; and (ii)
24developing a cost allocation plan for Medicaid-allowable
25Illinois Tobacco Quitline services in accordance with 45 CFR
2695.507. The Department shall submit the memorandum of

 

 

SB3741 Enrolled- 30 -LRB103 37781 RPS 67910 b

1understanding or interagency agreement, the cost allocation
2plan, and all other necessary documentation to the Centers for
3Medicare and Medicaid Services for review and approval.
4Coverage under this paragraph shall be contingent upon federal
5approval.
6    Notwithstanding any other provision of this Code, the
7Illinois Department may not require, as a condition of payment
8for any laboratory test authorized under this Article, that a
9physician's handwritten signature appear on the laboratory
10test order form. The Illinois Department may, however, impose
11other appropriate requirements regarding laboratory test order
12documentation.
13    Upon receipt of federal approval of an amendment to the
14Illinois Title XIX State Plan for this purpose, the Department
15shall authorize the Chicago Public Schools (CPS) to procure a
16vendor or vendors to manufacture eyeglasses for individuals
17enrolled in a school within the CPS system. CPS shall ensure
18that its vendor or vendors are enrolled as providers in the
19medical assistance program and in any capitated Medicaid
20managed care entity (MCE) serving individuals enrolled in a
21school within the CPS system. Under any contract procured
22under this provision, the vendor or vendors must serve only
23individuals enrolled in a school within the CPS system. Claims
24for services provided by CPS's vendor or vendors to recipients
25of benefits in the medical assistance program under this Code,
26the Children's Health Insurance Program, or the Covering ALL

 

 

SB3741 Enrolled- 31 -LRB103 37781 RPS 67910 b

1KIDS Health Insurance Program shall be submitted to the
2Department or the MCE in which the individual is enrolled for
3payment and shall be reimbursed at the Department's or the
4MCE's established rates or rate methodologies for eyeglasses.
5    On and after July 1, 2012, the Department of Healthcare
6and Family Services may provide the following services to
7persons eligible for assistance under this Article who are
8participating in education, training or employment programs
9operated by the Department of Human Services as successor to
10the Department of Public Aid:
11        (1) dental services provided by or under the
12    supervision of a dentist; and
13        (2) eyeglasses prescribed by a physician skilled in
14    the diseases of the eye, or by an optometrist, whichever
15    the person may select.
16    On and after July 1, 2018, the Department of Healthcare
17and Family Services shall provide dental services to any adult
18who is otherwise eligible for assistance under the medical
19assistance program. As used in this paragraph, "dental
20services" means diagnostic, preventative, restorative, or
21corrective procedures, including procedures and services for
22the prevention and treatment of periodontal disease and dental
23caries disease, provided by an individual who is licensed to
24practice dentistry or dental surgery or who is under the
25supervision of a dentist in the practice of his or her
26profession.

 

 

SB3741 Enrolled- 32 -LRB103 37781 RPS 67910 b

1    On and after July 1, 2018, targeted dental services, as
2set forth in Exhibit D of the Consent Decree entered by the
3United States District Court for the Northern District of
4Illinois, Eastern Division, in the matter of Memisovski v.
5Maram, Case No. 92 C 1982, that are provided to adults under
6the medical assistance program shall be established at no less
7than the rates set forth in the "New Rate" column in Exhibit D
8of the Consent Decree for targeted dental services that are
9provided to persons under the age of 18 under the medical
10assistance program.
11    Notwithstanding any other provision of this Code and
12subject to federal approval, the Department may adopt rules to
13allow a dentist who is volunteering his or her service at no
14cost to render dental services through an enrolled
15not-for-profit health clinic without the dentist personally
16enrolling as a participating provider in the medical
17assistance program. A not-for-profit health clinic shall
18include a public health clinic or Federally Qualified Health
19Center or other enrolled provider, as determined by the
20Department, through which dental services covered under this
21Section are performed. The Department shall establish a
22process for payment of claims for reimbursement for covered
23dental services rendered under this provision.
24    On and after January 1, 2022, the Department of Healthcare
25and Family Services shall administer and regulate a
26school-based dental program that allows for the out-of-office

 

 

SB3741 Enrolled- 33 -LRB103 37781 RPS 67910 b

1delivery of preventative dental services in a school setting
2to children under 19 years of age. The Department shall
3establish, by rule, guidelines for participation by providers
4and set requirements for follow-up referral care based on the
5requirements established in the Dental Office Reference Manual
6published by the Department that establishes the requirements
7for dentists participating in the All Kids Dental School
8Program. Every effort shall be made by the Department when
9developing the program requirements to consider the different
10geographic differences of both urban and rural areas of the
11State for initial treatment and necessary follow-up care. No
12provider shall be charged a fee by any unit of local government
13to participate in the school-based dental program administered
14by the Department. Nothing in this paragraph shall be
15construed to limit or preempt a home rule unit's or school
16district's authority to establish, change, or administer a
17school-based dental program in addition to, or independent of,
18the school-based dental program administered by the
19Department.
20    The Illinois Department, by rule, may distinguish and
21classify the medical services to be provided only in
22accordance with the classes of persons designated in Section
235-2.
24    The Department of Healthcare and Family Services must
25provide coverage and reimbursement for amino acid-based
26elemental formulas, regardless of delivery method, for the

 

 

SB3741 Enrolled- 34 -LRB103 37781 RPS 67910 b

1diagnosis and treatment of (i) eosinophilic disorders and (ii)
2short bowel syndrome when the prescribing physician has issued
3a written order stating that the amino acid-based elemental
4formula is medically necessary.
5    The Illinois Department shall authorize the provision of,
6and shall authorize payment for, screening by low-dose
7mammography for the presence of occult breast cancer for
8individuals 35 years of age or older who are eligible for
9medical assistance under this Article, as follows:
10        (A) A baseline mammogram for individuals 35 to 39
11    years of age.
12        (B) An annual mammogram for individuals 40 years of
13    age or older.
14        (C) A mammogram at the age and intervals considered
15    medically necessary by the individual's health care
16    provider for individuals under 40 years of age and having
17    a family history of breast cancer, prior personal history
18    of breast cancer, positive genetic testing, or other risk
19    factors.
20        (D) A comprehensive ultrasound screening and MRI of an
21    entire breast or breasts if a mammogram demonstrates
22    heterogeneous or dense breast tissue or when medically
23    necessary as determined by a physician licensed to
24    practice medicine in all of its branches.
25        (E) A screening MRI when medically necessary, as
26    determined by a physician licensed to practice medicine in

 

 

SB3741 Enrolled- 35 -LRB103 37781 RPS 67910 b

1    all of its branches.
2        (F) A diagnostic mammogram when medically necessary,
3    as determined by a physician licensed to practice medicine
4    in all its branches, advanced practice registered nurse,
5    or physician assistant.
6    The Department shall not impose a deductible, coinsurance,
7copayment, or any other cost-sharing requirement on the
8coverage provided under this paragraph; except that this
9sentence does not apply to coverage of diagnostic mammograms
10to the extent such coverage would disqualify a high-deductible
11health plan from eligibility for a health savings account
12pursuant to Section 223 of the Internal Revenue Code (26
13U.S.C. 223).
14    All screenings shall include a physical breast exam,
15instruction on self-examination and information regarding the
16frequency of self-examination and its value as a preventative
17tool.
18     For purposes of this Section:
19    "Diagnostic mammogram" means a mammogram obtained using
20diagnostic mammography.
21    "Diagnostic mammography" means a method of screening that
22is designed to evaluate an abnormality in a breast, including
23an abnormality seen or suspected on a screening mammogram or a
24subjective or objective abnormality otherwise detected in the
25breast.
26    "Low-dose mammography" means the x-ray examination of the

 

 

SB3741 Enrolled- 36 -LRB103 37781 RPS 67910 b

1breast using equipment dedicated specifically for mammography,
2including the x-ray tube, filter, compression device, and
3image receptor, with an average radiation exposure delivery of
4less than one rad per breast for 2 views of an average size
5breast. The term also includes digital mammography and
6includes breast tomosynthesis.
7    "Breast tomosynthesis" means a radiologic procedure that
8involves the acquisition of projection images over the
9stationary breast to produce cross-sectional digital
10three-dimensional images of the breast.
11    If, at any time, the Secretary of the United States
12Department of Health and Human Services, or its successor
13agency, promulgates rules or regulations to be published in
14the Federal Register or publishes a comment in the Federal
15Register or issues an opinion, guidance, or other action that
16would require the State, pursuant to any provision of the
17Patient Protection and Affordable Care Act (Public Law
18111-148), including, but not limited to, 42 U.S.C.
1918031(d)(3)(B) or any successor provision, to defray the cost
20of any coverage for breast tomosynthesis outlined in this
21paragraph, then the requirement that an insurer cover breast
22tomosynthesis is inoperative other than any such coverage
23authorized under Section 1902 of the Social Security Act, 42
24U.S.C. 1396a, and the State shall not assume any obligation
25for the cost of coverage for breast tomosynthesis set forth in
26this paragraph.

 

 

SB3741 Enrolled- 37 -LRB103 37781 RPS 67910 b

1    On and after January 1, 2016, the Department shall ensure
2that all networks of care for adult clients of the Department
3include access to at least one breast imaging Center of
4Imaging Excellence as certified by the American College of
5Radiology.
6    On and after January 1, 2012, providers participating in a
7quality improvement program approved by the Department shall
8be reimbursed for screening and diagnostic mammography at the
9same rate as the Medicare program's rates, including the
10increased reimbursement for digital mammography and, after
11January 1, 2023 (the effective date of Public Act 102-1018),
12breast tomosynthesis.
13    The Department shall convene an expert panel including
14representatives of hospitals, free-standing mammography
15facilities, and doctors, including radiologists, to establish
16quality standards for mammography.
17    On and after January 1, 2017, providers participating in a
18breast cancer treatment quality improvement program approved
19by the Department shall be reimbursed for breast cancer
20treatment at a rate that is no lower than 95% of the Medicare
21program's rates for the data elements included in the breast
22cancer treatment quality program.
23    The Department shall convene an expert panel, including
24representatives of hospitals, free-standing breast cancer
25treatment centers, breast cancer quality organizations, and
26doctors, including breast surgeons, reconstructive breast

 

 

SB3741 Enrolled- 38 -LRB103 37781 RPS 67910 b

1surgeons, oncologists, and primary care providers to establish
2quality standards for breast cancer treatment.
3    Subject to federal approval, the Department shall
4establish a rate methodology for mammography at federally
5qualified health centers and other encounter-rate clinics.
6These clinics or centers may also collaborate with other
7hospital-based mammography facilities. By January 1, 2016, the
8Department shall report to the General Assembly on the status
9of the provision set forth in this paragraph.
10    The Department shall establish a methodology to remind
11individuals who are age-appropriate for screening mammography,
12but who have not received a mammogram within the previous 18
13months, of the importance and benefit of screening
14mammography. The Department shall work with experts in breast
15cancer outreach and patient navigation to optimize these
16reminders and shall establish a methodology for evaluating
17their effectiveness and modifying the methodology based on the
18evaluation.
19    The Department shall establish a performance goal for
20primary care providers with respect to their female patients
21over age 40 receiving an annual mammogram. This performance
22goal shall be used to provide additional reimbursement in the
23form of a quality performance bonus to primary care providers
24who meet that goal.
25    The Department shall devise a means of case-managing or
26patient navigation for beneficiaries diagnosed with breast

 

 

SB3741 Enrolled- 39 -LRB103 37781 RPS 67910 b

1cancer. This program shall initially operate as a pilot
2program in areas of the State with the highest incidence of
3mortality related to breast cancer. At least one pilot program
4site shall be in the metropolitan Chicago area and at least one
5site shall be outside the metropolitan Chicago area. On or
6after July 1, 2016, the pilot program shall be expanded to
7include one site in western Illinois, one site in southern
8Illinois, one site in central Illinois, and 4 sites within
9metropolitan Chicago. An evaluation of the pilot program shall
10be carried out measuring health outcomes and cost of care for
11those served by the pilot program compared to similarly
12situated patients who are not served by the pilot program.
13    The Department shall require all networks of care to
14develop a means either internally or by contract with experts
15in navigation and community outreach to navigate cancer
16patients to comprehensive care in a timely fashion. The
17Department shall require all networks of care to include
18access for patients diagnosed with cancer to at least one
19academic commission on cancer-accredited cancer program as an
20in-network covered benefit.
21    The Department shall provide coverage and reimbursement
22for a human papillomavirus (HPV) vaccine that is approved for
23marketing by the federal Food and Drug Administration for all
24persons between the ages of 9 and 45. Subject to federal
25approval, the Department shall provide coverage and
26reimbursement for a human papillomavirus (HPV) vaccine for

 

 

SB3741 Enrolled- 40 -LRB103 37781 RPS 67910 b

1persons of the age of 46 and above who have been diagnosed with
2cervical dysplasia with a high risk of recurrence or
3progression. The Department shall disallow any
4preauthorization requirements for the administration of the
5human papillomavirus (HPV) vaccine.
6    On or after July 1, 2022, individuals who are otherwise
7eligible for medical assistance under this Article shall
8receive coverage for perinatal depression screenings for the
912-month period beginning on the last day of their pregnancy.
10Medical assistance coverage under this paragraph shall be
11conditioned on the use of a screening instrument approved by
12the Department.
13    Any medical or health care provider shall immediately
14recommend, to any pregnant individual who is being provided
15prenatal services and is suspected of having a substance use
16disorder as defined in the Substance Use Disorder Act,
17referral to a local substance use disorder treatment program
18licensed by the Department of Human Services or to a licensed
19hospital which provides substance abuse treatment services.
20The Department of Healthcare and Family Services shall assure
21coverage for the cost of treatment of the drug abuse or
22addiction for pregnant recipients in accordance with the
23Illinois Medicaid Program in conjunction with the Department
24of Human Services.
25    All medical providers providing medical assistance to
26pregnant individuals under this Code shall receive information

 

 

SB3741 Enrolled- 41 -LRB103 37781 RPS 67910 b

1from the Department on the availability of services under any
2program providing case management services for addicted
3individuals, including information on appropriate referrals
4for other social services that may be needed by addicted
5individuals in addition to treatment for addiction.
6    The Illinois Department, in cooperation with the
7Departments of Human Services (as successor to the Department
8of Alcoholism and Substance Abuse) and Public Health, through
9a public awareness campaign, may provide information
10concerning treatment for alcoholism and drug abuse and
11addiction, prenatal health care, and other pertinent programs
12directed at reducing the number of drug-affected infants born
13to recipients of medical assistance.
14    Neither the Department of Healthcare and Family Services
15nor the Department of Human Services shall sanction the
16recipient solely on the basis of the recipient's substance
17abuse.
18    The Illinois Department shall establish such regulations
19governing the dispensing of health services under this Article
20as it shall deem appropriate. The Department should seek the
21advice of formal professional advisory committees appointed by
22the Director of the Illinois Department for the purpose of
23providing regular advice on policy and administrative matters,
24information dissemination and educational activities for
25medical and health care providers, and consistency in
26procedures to the Illinois Department.

 

 

SB3741 Enrolled- 42 -LRB103 37781 RPS 67910 b

1    The Illinois Department may develop and contract with
2Partnerships of medical providers to arrange medical services
3for persons eligible under Section 5-2 of this Code.
4Implementation of this Section may be by demonstration
5projects in certain geographic areas. The Partnership shall be
6represented by a sponsor organization. The Department, by
7rule, shall develop qualifications for sponsors of
8Partnerships. Nothing in this Section shall be construed to
9require that the sponsor organization be a medical
10organization.
11    The sponsor must negotiate formal written contracts with
12medical providers for physician services, inpatient and
13outpatient hospital care, home health services, treatment for
14alcoholism and substance abuse, and other services determined
15necessary by the Illinois Department by rule for delivery by
16Partnerships. Physician services must include prenatal and
17obstetrical care. The Illinois Department shall reimburse
18medical services delivered by Partnership providers to clients
19in target areas according to provisions of this Article and
20the Illinois Health Finance Reform Act, except that:
21        (1) Physicians participating in a Partnership and
22    providing certain services, which shall be determined by
23    the Illinois Department, to persons in areas covered by
24    the Partnership may receive an additional surcharge for
25    such services.
26        (2) The Department may elect to consider and negotiate

 

 

SB3741 Enrolled- 43 -LRB103 37781 RPS 67910 b

1    financial incentives to encourage the development of
2    Partnerships and the efficient delivery of medical care.
3        (3) Persons receiving medical services through
4    Partnerships may receive medical and case management
5    services above the level usually offered through the
6    medical assistance program.
7    Medical providers shall be required to meet certain
8qualifications to participate in Partnerships to ensure the
9delivery of high quality medical services. These
10qualifications shall be determined by rule of the Illinois
11Department and may be higher than qualifications for
12participation in the medical assistance program. Partnership
13sponsors may prescribe reasonable additional qualifications
14for participation by medical providers, only with the prior
15written approval of the Illinois Department.
16    Nothing in this Section shall limit the free choice of
17practitioners, hospitals, and other providers of medical
18services by clients. In order to ensure patient freedom of
19choice, the Illinois Department shall immediately promulgate
20all rules and take all other necessary actions so that
21provided services may be accessed from therapeutically
22certified optometrists to the full extent of the Illinois
23Optometric Practice Act of 1987 without discriminating between
24service providers.
25    The Department shall apply for a waiver from the United
26States Health Care Financing Administration to allow for the

 

 

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1implementation of Partnerships under this Section.
2    The Illinois Department shall require health care
3providers to maintain records that document the medical care
4and services provided to recipients of Medical Assistance
5under this Article. Such records must be retained for a period
6of not less than 6 years from the date of service or as
7provided by applicable State law, whichever period is longer,
8except that if an audit is initiated within the required
9retention period then the records must be retained until the
10audit is completed and every exception is resolved. The
11Illinois Department shall require health care providers to
12make available, when authorized by the patient, in writing,
13the medical records in a timely fashion to other health care
14providers who are treating or serving persons eligible for
15Medical Assistance under this Article. All dispensers of
16medical services shall be required to maintain and retain
17business and professional records sufficient to fully and
18accurately document the nature, scope, details and receipt of
19the health care provided to persons eligible for medical
20assistance under this Code, in accordance with regulations
21promulgated by the Illinois Department. The rules and
22regulations shall require that proof of the receipt of
23prescription drugs, dentures, prosthetic devices and
24eyeglasses by eligible persons under this Section accompany
25each claim for reimbursement submitted by the dispenser of
26such medical services. No such claims for reimbursement shall

 

 

SB3741 Enrolled- 45 -LRB103 37781 RPS 67910 b

1be approved for payment by the Illinois Department without
2such proof of receipt, unless the Illinois Department shall
3have put into effect and shall be operating a system of
4post-payment audit and review which shall, on a sampling
5basis, be deemed adequate by the Illinois Department to assure
6that such drugs, dentures, prosthetic devices and eyeglasses
7for which payment is being made are actually being received by
8eligible recipients. Within 90 days after September 16, 1984
9(the effective date of Public Act 83-1439), the Illinois
10Department shall establish a current list of acquisition costs
11for all prosthetic devices and any other items recognized as
12medical equipment and supplies reimbursable under this Article
13and shall update such list on a quarterly basis, except that
14the acquisition costs of all prescription drugs shall be
15updated no less frequently than every 30 days as required by
16Section 5-5.12.
17    Notwithstanding any other law to the contrary, the
18Illinois Department shall, within 365 days after July 22, 2013
19(the effective date of Public Act 98-104), establish
20procedures to permit skilled care facilities licensed under
21the Nursing Home Care Act to submit monthly billing claims for
22reimbursement purposes. Following development of these
23procedures, the Department shall, by July 1, 2016, test the
24viability of the new system and implement any necessary
25operational or structural changes to its information
26technology platforms in order to allow for the direct

 

 

SB3741 Enrolled- 46 -LRB103 37781 RPS 67910 b

1acceptance and payment of nursing home claims.
2    Notwithstanding any other law to the contrary, the
3Illinois Department shall, within 365 days after August 15,
42014 (the effective date of Public Act 98-963), establish
5procedures to permit ID/DD facilities licensed under the ID/DD
6Community Care Act and MC/DD facilities licensed under the
7MC/DD Act to submit monthly billing claims for reimbursement
8purposes. Following development of these procedures, the
9Department shall have an additional 365 days to test the
10viability of the new system and to ensure that any necessary
11operational or structural changes to its information
12technology platforms are implemented.
13    The Illinois Department shall require all dispensers of
14medical services, other than an individual practitioner or
15group of practitioners, desiring to participate in the Medical
16Assistance program established under this Article to disclose
17all financial, beneficial, ownership, equity, surety or other
18interests in any and all firms, corporations, partnerships,
19associations, business enterprises, joint ventures, agencies,
20institutions or other legal entities providing any form of
21health care services in this State under this Article.
22    The Illinois Department may require that all dispensers of
23medical services desiring to participate in the medical
24assistance program established under this Article disclose,
25under such terms and conditions as the Illinois Department may
26by rule establish, all inquiries from clients and attorneys

 

 

SB3741 Enrolled- 47 -LRB103 37781 RPS 67910 b

1regarding medical bills paid by the Illinois Department, which
2inquiries could indicate potential existence of claims or
3liens for the Illinois Department.
4    Enrollment of a vendor shall be subject to a provisional
5period and shall be conditional for one year. During the
6period of conditional enrollment, the Department may terminate
7the vendor's eligibility to participate in, or may disenroll
8the vendor from, the medical assistance program without cause.
9Unless otherwise specified, such termination of eligibility or
10disenrollment is not subject to the Department's hearing
11process. However, a disenrolled vendor may reapply without
12penalty.
13    The Department has the discretion to limit the conditional
14enrollment period for vendors based upon the category of risk
15of the vendor.
16    Prior to enrollment and during the conditional enrollment
17period in the medical assistance program, all vendors shall be
18subject to enhanced oversight, screening, and review based on
19the risk of fraud, waste, and abuse that is posed by the
20category of risk of the vendor. The Illinois Department shall
21establish the procedures for oversight, screening, and review,
22which may include, but need not be limited to: criminal and
23financial background checks; fingerprinting; license,
24certification, and authorization verifications; unscheduled or
25unannounced site visits; database checks; prepayment audit
26reviews; audits; payment caps; payment suspensions; and other

 

 

SB3741 Enrolled- 48 -LRB103 37781 RPS 67910 b

1screening as required by federal or State law.
2    The Department shall define or specify the following: (i)
3by provider notice, the "category of risk of the vendor" for
4each type of vendor, which shall take into account the level of
5screening applicable to a particular category of vendor under
6federal law and regulations; (ii) by rule or provider notice,
7the maximum length of the conditional enrollment period for
8each category of risk of the vendor; and (iii) by rule, the
9hearing rights, if any, afforded to a vendor in each category
10of risk of the vendor that is terminated or disenrolled during
11the conditional enrollment period.
12    To be eligible for payment consideration, a vendor's
13payment claim or bill, either as an initial claim or as a
14resubmitted claim following prior rejection, must be received
15by the Illinois Department, or its fiscal intermediary, no
16later than 180 days after the latest date on the claim on which
17medical goods or services were provided, with the following
18exceptions:
19        (1) In the case of a provider whose enrollment is in
20    process by the Illinois Department, the 180-day period
21    shall not begin until the date on the written notice from
22    the Illinois Department that the provider enrollment is
23    complete.
24        (2) In the case of errors attributable to the Illinois
25    Department or any of its claims processing intermediaries
26    which result in an inability to receive, process, or

 

 

SB3741 Enrolled- 49 -LRB103 37781 RPS 67910 b

1    adjudicate a claim, the 180-day period shall not begin
2    until the provider has been notified of the error.
3        (3) In the case of a provider for whom the Illinois
4    Department initiates the monthly billing process.
5        (4) In the case of a provider operated by a unit of
6    local government with a population exceeding 3,000,000
7    when local government funds finance federal participation
8    for claims payments.
9    For claims for services rendered during a period for which
10a recipient received retroactive eligibility, claims must be
11filed within 180 days after the Department determines the
12applicant is eligible. For claims for which the Illinois
13Department is not the primary payer, claims must be submitted
14to the Illinois Department within 180 days after the final
15adjudication by the primary payer.
16    In the case of long term care facilities, within 120
17calendar days of receipt by the facility of required
18prescreening information, new admissions with associated
19admission documents shall be submitted through the Medical
20Electronic Data Interchange (MEDI) or the Recipient
21Eligibility Verification (REV) System or shall be submitted
22directly to the Department of Human Services using required
23admission forms. Effective September 1, 2014, admission
24documents, including all prescreening information, must be
25submitted through MEDI or REV. Confirmation numbers assigned
26to an accepted transaction shall be retained by a facility to

 

 

SB3741 Enrolled- 50 -LRB103 37781 RPS 67910 b

1verify timely submittal. Once an admission transaction has
2been completed, all resubmitted claims following prior
3rejection are subject to receipt no later than 180 days after
4the admission transaction has been completed.
5    Claims that are not submitted and received in compliance
6with the foregoing requirements shall not be eligible for
7payment under the medical assistance program, and the State
8shall have no liability for payment of those claims.
9    To the extent consistent with applicable information and
10privacy, security, and disclosure laws, State and federal
11agencies and departments shall provide the Illinois Department
12access to confidential and other information and data
13necessary to perform eligibility and payment verifications and
14other Illinois Department functions. This includes, but is not
15limited to: information pertaining to licensure;
16certification; earnings; immigration status; citizenship; wage
17reporting; unearned and earned income; pension income;
18employment; supplemental security income; social security
19numbers; National Provider Identifier (NPI) numbers; the
20National Practitioner Data Bank (NPDB); program and agency
21exclusions; taxpayer identification numbers; tax delinquency;
22corporate information; and death records.
23    The Illinois Department shall enter into agreements with
24State agencies and departments, and is authorized to enter
25into agreements with federal agencies and departments, under
26which such agencies and departments shall share data necessary

 

 

SB3741 Enrolled- 51 -LRB103 37781 RPS 67910 b

1for medical assistance program integrity functions and
2oversight. The Illinois Department shall develop, in
3cooperation with other State departments and agencies, and in
4compliance with applicable federal laws and regulations,
5appropriate and effective methods to share such data. At a
6minimum, and to the extent necessary to provide data sharing,
7the Illinois Department shall enter into agreements with State
8agencies and departments, and is authorized to enter into
9agreements with federal agencies and departments, including,
10but not limited to: the Secretary of State; the Department of
11Revenue; the Department of Public Health; the Department of
12Human Services; and the Department of Financial and
13Professional Regulation.
14    Beginning in fiscal year 2013, the Illinois Department
15shall set forth a request for information to identify the
16benefits of a pre-payment, post-adjudication, and post-edit
17claims system with the goals of streamlining claims processing
18and provider reimbursement, reducing the number of pending or
19rejected claims, and helping to ensure a more transparent
20adjudication process through the utilization of: (i) provider
21data verification and provider screening technology; and (ii)
22clinical code editing; and (iii) pre-pay, pre-adjudicated, or
23post-adjudicated predictive modeling with an integrated case
24management system with link analysis. Such a request for
25information shall not be considered as a request for proposal
26or as an obligation on the part of the Illinois Department to

 

 

SB3741 Enrolled- 52 -LRB103 37781 RPS 67910 b

1take any action or acquire any products or services.
2    The Illinois Department shall establish policies,
3procedures, standards and criteria by rule for the
4acquisition, repair and replacement of orthotic and prosthetic
5devices and durable medical equipment. Such rules shall
6provide, but not be limited to, the following services: (1)
7immediate repair or replacement of such devices by recipients;
8and (2) rental, lease, purchase or lease-purchase of durable
9medical equipment in a cost-effective manner, taking into
10consideration the recipient's medical prognosis, the extent of
11the recipient's needs, and the requirements and costs for
12maintaining such equipment. Subject to prior approval, such
13rules shall enable a recipient to temporarily acquire and use
14alternative or substitute devices or equipment pending repairs
15or replacements of any device or equipment previously
16authorized for such recipient by the Department.
17Notwithstanding any provision of Section 5-5f to the contrary,
18the Department may, by rule, exempt certain replacement
19wheelchair parts from prior approval and, for wheelchairs,
20wheelchair parts, wheelchair accessories, and related seating
21and positioning items, determine the wholesale price by
22methods other than actual acquisition costs.
23    The Department shall require, by rule, all providers of
24durable medical equipment to be accredited by an accreditation
25organization approved by the federal Centers for Medicare and
26Medicaid Services and recognized by the Department in order to

 

 

SB3741 Enrolled- 53 -LRB103 37781 RPS 67910 b

1bill the Department for providing durable medical equipment to
2recipients. No later than 15 months after the effective date
3of the rule adopted pursuant to this paragraph, all providers
4must meet the accreditation requirement.
5    In order to promote environmental responsibility, meet the
6needs of recipients and enrollees, and achieve significant
7cost savings, the Department, or a managed care organization
8under contract with the Department, may provide recipients or
9managed care enrollees who have a prescription or Certificate
10of Medical Necessity access to refurbished durable medical
11equipment under this Section (excluding prosthetic and
12orthotic devices as defined in the Orthotics, Prosthetics, and
13Pedorthics Practice Act and complex rehabilitation technology
14products and associated services) through the State's
15assistive technology program's reutilization program, using
16staff with the Assistive Technology Professional (ATP)
17Certification if the refurbished durable medical equipment:
18(i) is available; (ii) is less expensive, including shipping
19costs, than new durable medical equipment of the same type;
20(iii) is able to withstand at least 3 years of use; (iv) is
21cleaned, disinfected, sterilized, and safe in accordance with
22federal Food and Drug Administration regulations and guidance
23governing the reprocessing of medical devices in health care
24settings; and (v) equally meets the needs of the recipient or
25enrollee. The reutilization program shall confirm that the
26recipient or enrollee is not already in receipt of the same or

 

 

SB3741 Enrolled- 54 -LRB103 37781 RPS 67910 b

1similar equipment from another service provider, and that the
2refurbished durable medical equipment equally meets the needs
3of the recipient or enrollee. Nothing in this paragraph shall
4be construed to limit recipient or enrollee choice to obtain
5new durable medical equipment or place any additional prior
6authorization conditions on enrollees of managed care
7organizations.
8    The Department shall execute, relative to the nursing home
9prescreening project, written inter-agency agreements with the
10Department of Human Services and the Department on Aging, to
11effect the following: (i) intake procedures and common
12eligibility criteria for those persons who are receiving
13non-institutional services; and (ii) the establishment and
14development of non-institutional services in areas of the
15State where they are not currently available or are
16undeveloped; and (iii) notwithstanding any other provision of
17law, subject to federal approval, on and after July 1, 2012, an
18increase in the determination of need (DON) scores from 29 to
1937 for applicants for institutional and home and
20community-based long term care; if and only if federal
21approval is not granted, the Department may, in conjunction
22with other affected agencies, implement utilization controls
23or changes in benefit packages to effectuate a similar savings
24amount for this population; and (iv) no later than July 1,
252013, minimum level of care eligibility criteria for
26institutional and home and community-based long term care; and

 

 

SB3741 Enrolled- 55 -LRB103 37781 RPS 67910 b

1(v) no later than October 1, 2013, establish procedures to
2permit long term care providers access to eligibility scores
3for individuals with an admission date who are seeking or
4receiving services from the long term care provider. In order
5to select the minimum level of care eligibility criteria, the
6Governor shall establish a workgroup that includes affected
7agency representatives and stakeholders representing the
8institutional and home and community-based long term care
9interests. This Section shall not restrict the Department from
10implementing lower level of care eligibility criteria for
11community-based services in circumstances where federal
12approval has been granted.
13    The Illinois Department shall develop and operate, in
14cooperation with other State Departments and agencies and in
15compliance with applicable federal laws and regulations,
16appropriate and effective systems of health care evaluation
17and programs for monitoring of utilization of health care
18services and facilities, as it affects persons eligible for
19medical assistance under this Code.
20    The Illinois Department shall report annually to the
21General Assembly, no later than the second Friday in April of
221979 and each year thereafter, in regard to:
23        (a) actual statistics and trends in utilization of
24    medical services by public aid recipients;
25        (b) actual statistics and trends in the provision of
26    the various medical services by medical vendors;

 

 

SB3741 Enrolled- 56 -LRB103 37781 RPS 67910 b

1        (c) current rate structures and proposed changes in
2    those rate structures for the various medical vendors; and
3        (d) efforts at utilization review and control by the
4    Illinois Department.
5    The period covered by each report shall be the 3 years
6ending on the June 30 prior to the report. The report shall
7include suggested legislation for consideration by the General
8Assembly. The requirement for reporting to the General
9Assembly shall be satisfied by filing copies of the report as
10required by Section 3.1 of the General Assembly Organization
11Act, and filing such additional copies with the State
12Government Report Distribution Center for the General Assembly
13as is required under paragraph (t) of Section 7 of the State
14Library Act.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21    On and after July 1, 2012, the Department shall reduce any
22rate of reimbursement for services or other payments or alter
23any methodologies authorized by this Code to reduce any rate
24of reimbursement for services or other payments in accordance
25with Section 5-5e.
26    Because kidney transplantation can be an appropriate,

 

 

SB3741 Enrolled- 57 -LRB103 37781 RPS 67910 b

1cost-effective alternative to renal dialysis when medically
2necessary and notwithstanding the provisions of Section 1-11
3of this Code, beginning October 1, 2014, the Department shall
4cover kidney transplantation for noncitizens with end-stage
5renal disease who are not eligible for comprehensive medical
6benefits, who meet the residency requirements of Section 5-3
7of this Code, and who would otherwise meet the financial
8requirements of the appropriate class of eligible persons
9under Section 5-2 of this Code. To qualify for coverage of
10kidney transplantation, such person must be receiving
11emergency renal dialysis services covered by the Department.
12Providers under this Section shall be prior approved and
13certified by the Department to perform kidney transplantation
14and the services under this Section shall be limited to
15services associated with kidney transplantation.
16    Notwithstanding any other provision of this Code to the
17contrary, on or after July 1, 2015, all FDA approved forms of
18medication assisted treatment prescribed for the treatment of
19alcohol dependence or treatment of opioid dependence shall be
20covered under both fee-for-service fee for service and managed
21care medical assistance programs for persons who are otherwise
22eligible for medical assistance under this Article and shall
23not be subject to any (1) utilization control, other than
24those established under the American Society of Addiction
25Medicine patient placement criteria, (2) prior authorization
26mandate, or (3) lifetime restriction limit mandate, or (4)

 

 

SB3741 Enrolled- 58 -LRB103 37781 RPS 67910 b

1limitations on dosage.
2    On or after July 1, 2015, opioid antagonists prescribed
3for the treatment of an opioid overdose, including the
4medication product, administration devices, and any pharmacy
5fees or hospital fees related to the dispensing, distribution,
6and administration of the opioid antagonist, shall be covered
7under the medical assistance program for persons who are
8otherwise eligible for medical assistance under this Article.
9As used in this Section, "opioid antagonist" means a drug that
10binds to opioid receptors and blocks or inhibits the effect of
11opioids acting on those receptors, including, but not limited
12to, naloxone hydrochloride or any other similarly acting drug
13approved by the U.S. Food and Drug Administration. The
14Department shall not impose a copayment on the coverage
15provided for naloxone hydrochloride under the medical
16assistance program.
17    Upon federal approval, the Department shall provide
18coverage and reimbursement for all drugs that are approved for
19marketing by the federal Food and Drug Administration and that
20are recommended by the federal Public Health Service or the
21United States Centers for Disease Control and Prevention for
22pre-exposure prophylaxis and related pre-exposure prophylaxis
23services, including, but not limited to, HIV and sexually
24transmitted infection screening, treatment for sexually
25transmitted infections, medical monitoring, assorted labs, and
26counseling to reduce the likelihood of HIV infection among

 

 

SB3741 Enrolled- 59 -LRB103 37781 RPS 67910 b

1individuals who are not infected with HIV but who are at high
2risk of HIV infection.
3    A federally qualified health center, as defined in Section
41905(l)(2)(B) of the federal Social Security Act, shall be
5reimbursed by the Department in accordance with the federally
6qualified health center's encounter rate for services provided
7to medical assistance recipients that are performed by a
8dental hygienist, as defined under the Illinois Dental
9Practice Act, working under the general supervision of a
10dentist and employed by a federally qualified health center.
11    Within 90 days after October 8, 2021 (the effective date
12of Public Act 102-665), the Department shall seek federal
13approval of a State Plan amendment to expand coverage for
14family planning services that includes presumptive eligibility
15to individuals whose income is at or below 208% of the federal
16poverty level. Coverage under this Section shall be effective
17beginning no later than December 1, 2022.
18    Subject to approval by the federal Centers for Medicare
19and Medicaid Services of a Title XIX State Plan amendment
20electing the Program of All-Inclusive Care for the Elderly
21(PACE) as a State Medicaid option, as provided for by Subtitle
22I (commencing with Section 4801) of Title IV of the Balanced
23Budget Act of 1997 (Public Law 105-33) and Part 460
24(commencing with Section 460.2) of Subchapter E of Title 42 of
25the Code of Federal Regulations, PACE program services shall
26become a covered benefit of the medical assistance program,

 

 

SB3741 Enrolled- 60 -LRB103 37781 RPS 67910 b

1subject to criteria established in accordance with all
2applicable laws.
3    Notwithstanding any other provision of this Code,
4community-based pediatric palliative care from a trained
5interdisciplinary team shall be covered under the medical
6assistance program as provided in Section 15 of the Pediatric
7Palliative Care Act.
8    Notwithstanding any other provision of this Code, within
912 months after June 2, 2022 (the effective date of Public Act
10102-1037) and subject to federal approval, acupuncture
11services performed by an acupuncturist licensed under the
12Acupuncture Practice Act who is acting within the scope of his
13or her license shall be covered under the medical assistance
14program. The Department shall apply for any federal waiver or
15State Plan amendment, if required, to implement this
16paragraph. The Department may adopt any rules, including
17standards and criteria, necessary to implement this paragraph.
18    Notwithstanding any other provision of this Code, the
19medical assistance program shall, subject to appropriation and
20federal approval, reimburse hospitals for costs associated
21with a newborn screening test for the presence of
22metachromatic leukodystrophy, as required under the Newborn
23Metabolic Screening Act, at a rate not less than the fee
24charged by the Department of Public Health. The Department
25shall seek federal approval before the implementation of the
26newborn screening test fees by the Department of Public

 

 

SB3741 Enrolled- 61 -LRB103 37781 RPS 67910 b

1Health.
2    Notwithstanding any other provision of this Code,
3beginning on January 1, 2024, subject to federal approval,
4cognitive assessment and care planning services provided to a
5person who experiences signs or symptoms of cognitive
6impairment, as defined by the Diagnostic and Statistical
7Manual of Mental Disorders, Fifth Edition, shall be covered
8under the medical assistance program for persons who are
9otherwise eligible for medical assistance under this Article.
10    Notwithstanding any other provision of this Code,
11medically necessary reconstructive services that are intended
12to restore physical appearance shall be covered under the
13medical assistance program for persons who are otherwise
14eligible for medical assistance under this Article. As used in
15this paragraph, "reconstructive services" means treatments
16performed on structures of the body damaged by trauma to
17restore physical appearance.
18(Source: P.A. 102-43, Article 30, Section 30-5, eff. 7-6-21;
19102-43, Article 35, Section 35-5, eff. 7-6-21; 102-43, Article
2055, Section 55-5, eff. 7-6-21; 102-95, eff. 1-1-22; 102-123,
21eff. 1-1-22; 102-558, eff. 8-20-21; 102-598, eff. 1-1-22;
22102-655, eff. 1-1-22; 102-665, eff. 10-8-21; 102-813, eff.
235-13-22; 102-1018, eff. 1-1-23; 102-1037, eff. 6-2-22;
24102-1038, eff. 1-1-23; 103-102, Article 15, Section 15-5, eff.
251-1-24; 103-102, Article 95, Section 95-15, eff. 1-1-24;
26103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-368, eff.

 

 

SB3741 Enrolled- 62 -LRB103 37781 RPS 67910 b

11-1-24; revised 12-15-23.)
 
2    Section 99. Effective date. This Act takes effect upon
3becoming law.