SB1498 96TH GENERAL ASSEMBLY

LRB096 08425 DRJ 18538 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB1498

Introduced 2/18/2009, by Sen. Mattie Hunter

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.27 new

Amends the Illinois Public Aid Code. Provides that beginning July 1, 2010, reimbursement for child and adult psychiatric services provided by a physician must not be lower than 90% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. Provides that beginning July 1, 2010, reimbursement for child and adult psychiatric services provided by a licensed health care professional under the Medicaid Community Mental Health Services Program must not be lower than 90% of Medicare reimbursement in accordance with Medicare payment localities for Illinois. Provides that all adjustments shall be made without lowering any rates then in effect that may be higher than the level required by these provisions. Provides that by July 2, 2010, reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies. 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 5-5.27 as follows:

(305 ILCS 5/5-5.27 new)

Sec. 5-5.27. Psychiatric services rates.

(a) Notwithstanding any other provision of this Article, beginning July 1, 2010, reimbursement for child and adult psychiatric services provided by a physician must not be lower than 90% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. All adjustments shall be made without lowering any rates then in effect that may be higher than the level required by this Section. By July 2, 2010, reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies.

(b) Notwithstanding any other provision of this Article, beginning July 1, 2010, reimbursement for child and adult psychiatric services provided by a licensed health care professional under the Medicaid Community Mental Health Services Program under 59 Ill. Adm. Code 132 must not be lower than 90% of Medicare reimbursement in accordance with Medicare payment localities for Illinois. All adjustments shall be made without lowering any rates then in effect that may be higher than the level required by this Section. By July 2, 2010, reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies.

(c) For purposes of this Section:

"Licensed health care professional" includes licensed clinicians, mental health professionals, qualified mental health professionals, and rehabilitative services associates as defined under the Medicaid Community Mental Health Services Program under 59 Ill. Adm. Code 132.25.

"Physician" means a physician as defined in Section 1-120 of the Mental Health and Developmental Disabilities Code.

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