HB5742 96TH GENERAL ASSEMBLY

LRB096 19758 KTG 35191 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB5742

Introduced 2/9/2010, by Rep. David E. Miller

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-27 new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, in cooperation with the Department of Human Services, to establish the Dental Improvement Pilot Program to fund the provision of dental services in areas designated as medically underserved. Provides that within these medically underserved areas, there shall be a pilot program in the northern, central, and southern region of the state. Provides that the Departments shall fund the provision of all dental services provided under the program using a rate structure that is cost-based and encounter-based, and that in order for a dentist to qualify for a reimbursement of delivered services, the dentist must provide services in an area that has been designated as medically underserved and the recipient of such services must qualify for medical assistance under the Medicaid program. Further provides that implementation of the program is contingent upon federal approval and that the Department of Healthcare and Family Services shall take appropriate action to seek approval by January 15, 2011. Requires the Department to report back the 1st year's findings of an evaluation of both quality and quantitative factors associated with improving access and reimbursement for these demonstration programs no more than 60 days after the 1st year of implementation. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by adding Section 5-27 as follows:

(305 ILCS 5/5-27 new)

Sec. 5-27. Dental services in medically underserved areas. The Department, in cooperation with the Department of Human Services, shall establish the Dental Improvement Pilot Program to fund the provision of dental services in areas designated as medically underserved. Within these medically underserved areas, there shall be a pilot program in the following locations: (i) one in the northern region of the state; (ii) one in the central region of the state; and (iii) one in the southern region of the state. The dentist or clinic, or both, must serve a payor mix that is 40% or greater Medicaid dependent. The Departments shall fund the provision of all dental services provided under the program using a rate structure that is cost-based and encounter-based. In order for a dentist to qualify for a reimbursement of delivered services, the dentist must provide services in an area that has been designated as medically underserved and the recipient of such services must qualify for medical assistance under this Article. Implementation of the program is contingent upon federal approval. The Department shall take appropriate action to seek approval by January 15, 2011. No more than 60 days after the 1st year of implementation, the Department shall report back the 1st year's findings of an evaluation of both quality and quantitative factors associated with improving access and reimbursement for these demonstration programs.

Section 99. Effective date. This Act takes effect upon becoming law.