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90_HB0980
305 ILCS 5/5-5.04 new
Amends the Medicaid Article of the Illinois Public Aid
Code. Provides that the Illinois Department of Public Aid
shall develop an automated system for providing
reimbursements to providers of service under the Medicaid
program, subject to funds availability. The Department
shall assist service providers to make their systems
compatible with the automated system which must be able to
link the Department electronically with providers by which
each provider will make claims when the system is
operational. The Department shall charge a fee in an amount
necessary to cover the costs of manually processing the
claims to providers not making their claims electronically.
The Department shall pay claims made electronically not later
than the 30th day after the date the claim is made and shall
adopt rules and make policy changes as necessary to improve
the efficiency and capabilities of the system. The
Department shall implement the nursing facilities
reimbursement component by January 1, 1999, determine
deadlines for using the system for other Medicaid components,
and reduce staff and purchases as savings from implementing
the system are realized.
LRB9000953SMdv
LRB9000953SMdv
1 AN ACT to amend the Illinois Public Aid Code by adding
2 Section 5-5.04.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Public Aid Code is amended by
6 adding Section 5-5.04 as follows:
7 (305 ILCS 5/5-5.04 new)
8 Sec. 5-5.04. The Department shall acquire and develop an
9 automated system for providing reimbursements to providers of
10 service under the Illinois Medicaid program, subject to the
11 availability of funds appropriated for that purpose.
12 The Department shall apply for all available federal
13 funds to help pay for the automated system. To the extent
14 possible, the Department shall assist providers of service to
15 make systems compatible with the automated system selected by
16 the Department.
17 The automated patient care and reimbursement system must
18 use a form designed by the United States Health Care
19 Financing Administration for nursing home use.
20 The automated reimbursement system must be able to link
21 the Department electronically with providers making claims
22 for reimbursement. When the system is operational, each
23 provider shall make claims electronically. The Department
24 shall charge a fee to providers that do not make their claims
25 for reimbursement electronically. The Department shall set
26 the fee in an amount necessary to cover the costs of manually
27 processing the claims. The Department shall pay provider
28 reimbursement claims under the Illinois Medicaid program that
29 are made electronically not later than the 30th day after the
30 date the claim is made.
31 The Department shall adopt rules and make policy changes
-2- LRB9000953SMdv
1 as necessary to improve the efficiency of the reimbursement
2 process and to maximize the automated reimbursement system's
3 capabilities.
4 The Department shall implement the nursing facilities
5 reimbursement component of the automated reimbursement system
6 not later than January 1, 1999. The Department shall
7 evaluate and determine deadlines for using the system for
8 other components of the Illinois Medicaid program. The
9 Department shall reduce staff and purchases as savings and
10 efficiency from implementing the automated reimbursement
11 system are realized.