Illinois General Assembly - Full Text of SB3659
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Full Text of SB3659  102nd General Assembly

SB3659 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB3659

 

Introduced 1/21/2022, by Sen. Cristina Castro

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-18.5

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that midwifery services shall be covered under the medical assistance program, subject to appropriation, for persons who are otherwise eligible for medical assistance under the Code. Requires the Department of Healthcare and Family Services to consult with midwives on formulating rules concerning reimbursement rates for midwifery services. Provides that reimbursement rates for certain related services shall be increased by 6% for dates of service on and after January 1, 2023. Effective immediately.


LRB102 25729 KTG 35038 b

 

 

A BILL FOR

 

SB3659LRB102 25729 KTG 35038 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-18.5 as follows:
 
6    (305 ILCS 5/5-18.5)
7    Sec. 5-18.5. Perinatal doula and evidence-based home
8visiting services.
9    (a) As used in this Section:
10    "Home visiting" means a voluntary, evidence-based strategy
11used to support pregnant people, infants, and young children
12and their caregivers to promote infant, child, and maternal
13health, to foster educational development and school
14readiness, and to help prevent child abuse and neglect. Home
15visitors are trained professionals whose visits and activities
16focus on promoting strong parent-child attachment to foster
17healthy child development.
18    "Perinatal doula" means a trained provider who provides
19regular, voluntary physical, emotional, and educational
20support, but not medical or midwife care, to pregnant and
21birthing persons before, during, and after childbirth,
22otherwise known as the perinatal period.
23    "Perinatal doula training" means any doula training that

 

 

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1focuses on providing support throughout the prenatal, labor
2and delivery, or postpartum period, and reflects the type of
3doula care that the doula seeks to provide.
4    (b) Notwithstanding any other provision of this Article,
5perinatal doula services and evidence-based home visiting
6services shall be covered under the medical assistance
7program, subject to appropriation, for persons who are
8otherwise eligible for medical assistance under this Article.
9Perinatal doula services include regular visits beginning in
10the prenatal period and continuing into the postnatal period,
11inclusive of continuous support during labor and delivery,
12that support healthy pregnancies and positive birth outcomes.
13Perinatal doula services may be embedded in an existing
14program, such as evidence-based home visiting. Perinatal doula
15services provided during the prenatal period may be provided
16weekly, services provided during the labor and delivery period
17may be provided for the entire duration of labor and the time
18immediately following birth, and services provided during the
19postpartum period may be provided up to 12 months postpartum.
20    (b-5) Notwithstanding any other provision of this Article,
21midwifery services shall be covered under the medical
22assistance program, subject to appropriation, for persons who
23are otherwise eligible for medical assistance under this
24Article. The Department shall consult with midwives on
25formulating rules concerning reimbursement rates for midwifery
26services. The reimbursement rates for the following related

 

 

SB3659- 3 -LRB102 25729 KTG 35038 b

1services shall be increased by 6% for dates of service on and
2after January 1, 2023:
3        59409 Vaginal Delivery Only.
4        59410 Obstetrical Care; Vaginal Delivery Only
5    Including Postpartum Care.
6        59514 Cesarean Delivery Only.
7        59515 Cesarean Delivery Postpartum.
8        59612 Vaginal Delivery Only, After Previous Cesarean
9    Delivery.
10        59614 Vaginal Delivery After Previous Cesarean
11    Section, Including Postpartum Care.
12        59620 Cesarean Section Delivery After Attempted
13    Vaginal Delivery After Previous Cesarean Section.
14        59622 Cesarean Section After Attempted Vaginal
15    Delivery Intravenous/Cesarean Section/Including
16    Postpartum Care.
17        99201 Evaluation and Management Office/Other Health
18    Visit New Patient.
19        99202 Evaluation and Management Office/Other Health
20    Visit New Patient.
21        99203 Office or Other Outpatient Visit for the
22    Evaluation and Management of a New Patient.
23        99204 Office or Other Outpatient Visit for the
24    Evaluation and Management of a New Patient.
25        99205 Office or Other Outpatient Visit for the
26    Evaluation and Management of a New Patient.

 

 

SB3659- 4 -LRB102 25729 KTG 35038 b

1        99211 Face-to-Face Encounter With a Patient Consisting
2    of Elements of Both Evaluation.
3        99212 Office or Other Outpatient Visit for the
4    Evaluation and Management of an Established Patient.
5        99213 Office or Other Outpatient Visit for the
6    Evaluation and Management of an Established Patient.
7        99214 Office or Other Outpatient Visit for the
8    Evaluation and Management of an Established Patient.
9        99215 Office or Other Outpatient Visit for the
10    Evaluation and Management of an Established Patient.
11        99381 Initial Comprehensive Preventive Medicine
12    Evaluation and Management of an Individual Including an
13    Age and Gender Appropriate History.
14        99382 Initial Comprehensive Preventive Medicine
15    Evaluation and Management of an Individual Including an
16    Age and Gender Appropriate History, Examination,
17    Counseling/Anticipatory Guidance/Risk Factor Reduction
18    Interventions.
19        99383 Initial Comprehensive Preventive Medicine
20    Evaluation and Management of an Individual Including an
21    Age and Gender Appropriate History.
22        99384 New Patient Preventive Medicine Services.
23        99385 Initial Comprehensive Preventive Medicine
24    Evaluation and Management of an Individual Including an
25    Age and Gender Appropriate History, Examination,
26    Counseling/Anticipatory Guidance/Risk Factor Reduction

 

 

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1    Interventions.
2        99386 Initial Comprehensive Preventive Medicine
3    Evaluation and Management of an Individual Including an
4    Age and Gender Appropriate History, Examination.
5        99387 New Patient Preventive Medicine Services.
6        99391 Periodic Comprehensive Preventive Medicine
7    Reevaluation and Management of an Individual Including an
8    Age and Gender Appropriate History.
9        99392 Periodic Reevaluation Healthy Child.
10        99393 Periodic Reevaluation Healthy Child.
11        99394 Periodic Reevaluation Healthy Adolescent.
12        99395 Periodic Reevaluation/Management 18-39 Years.
13        99396 Periodic Reevaluation/Management 40-64 Years.
14        99397 Periodic Reevaluation/Management 65 Years and
15    Greater.
16    (c) The Department of Healthcare and Family Services shall
17adopt rules to administer this Section. In this rulemaking,
18the Department shall consider the expertise of and consult
19with doula program experts, doula training providers,
20practicing doulas, and home visiting experts, along with State
21agencies implementing perinatal doula services and relevant
22bodies under the Illinois Early Learning Council. This body of
23experts shall inform the Department on the credentials
24necessary for perinatal doula and home visiting services to be
25eligible for Medicaid reimbursement and the rate of
26reimbursement for home visiting and perinatal doula services

 

 

SB3659- 6 -LRB102 25729 KTG 35038 b

1in the prenatal, labor and delivery, and postpartum periods.
2Every 2 years, the Department shall assess the rates of
3reimbursement for perinatal doula and home visiting services
4and adjust rates accordingly.
5    (d) The Department shall seek such State plan amendments
6or waivers as may be necessary to implement this Section and
7shall secure federal financial participation for expenditures
8made by the Department in accordance with this Section.
9(Source: P.A. 102-4, eff. 4-27-21.)
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.