Synopsis As Introduced Amends the Illinois Public Aid Code. Provides that, to ensure full access to the benefits set forth in provisions regarding the Healthy Kids Program, on and after January 1, 2022, the Department of Healthcare and Family Services shall ensure that provider and hospital reimbursements for immunization as required under the provisions are no lower than the Medicare reimbursement rate. Amends the Immunization Data Registry Act. Provides that health care providers, physician's designees, or pharmacist's designees shall (rather than may) provide immunization data to be entered into the immunization data registry. Removes language providing that the immunization data need not be provided if the patient or the patient's parent or guardian, if the patient is less than 18 years of age, has completed and filed with the provider, physician's designee, or pharmacist's designee a written immunization data exemption form. Provides that the written information and the immunization data exemption forms must include information that the health care provider shall (rather than may) report immunization data to the Department of Public Health to be entered into the immunization data registry. Effective January 1, 2022.
House Floor Amendment No. 2 In provisions amending the Illinois Public Aid Code, provides that the Department of Healthcare and Family Services shall ensure that provider and hospital reimbursements for immunization are no lower than 70% of the regional maximum administration fee as established by the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services (rather than the Medicare reimbursement rate).
Fiscal Note, House Floor Amendment No. 2 (Dept. of Healthcare & Family Services)
Based on limited data availability, the annual impact of using 70% of Medicare rates for vaccine services for Medicaid participants under age 21 is estimated at $5.7 million, with $0. 9 million for FFS claims and about $4.8 million impact to the MCO capitation rates. The FY 2022 impact for providing six months of services at the new rates would be about $2. 9 million. There would be substantial administrative costs to change the pricing methodology to the provider level and for storage and programming changes to the claims processing and provider enrollment systems. Planning and implementation may take up to 12 months to complete, which would exceed the time available with the January 1, 2022 effective date.