House Sponsors: ZICKUS-PUGH-LEITCH-SCHOENBERG-FLOWERS. Senate Sponsors: DONAHUE-PARKER-CLAYBORNE-TROTTER-DEL VALLE Short description: HMO-PUBLIC AID CD-COMM NTWORKS Synopsis of Bill as introduced: Amends the Medicaid Article of the Public Aid Code. Makes a stylistic change in a Section concerning purpose of the Medicaid program. FISCAL NOTE, H-AM 1 (Dpt. Public Aid) No fiscal impact anticipated. HOUSE AMENDMENT NO. 1. Deletes reference to: 305 ILCS 5/5-1 Adds reference to: 215 ILCS 125/2-1 from Ch. 111 1/2, par. 1403 305 ILCS 5/5-11 from Ch. 23, par. 5-11 305 ILCS 5/15-2 from Ch. 23, par. 15-2 305 ILCS 5/15-3 from Ch. 23, par. 15-3 305 ILCS 5/15-5 from Ch. 23, par. 15-5 Deletes everything. Amends the HMO Act and the Public Aid Code. Provides for certification of managed care community networks (which do not include HMOs) by the Department of Public Aid. Authorizes contracts between those networks and the Department for health care services for individuals participating in Department programs. Authorizes a county provider to contract with the Department to provide services as a managed care community network. Effective immediately. SENATE AMENDMENT NO. 1. Deletes authority for the Department of Insurance to use emergency rulemaking to implement provisions concerning exemption of managed care community networks certified by the Department of Public Aid from application of the Health Maintenance Organization Act. Imposes certain requirements on a managed care community network that contracts with the Department of Public Aid to furnish health care services to or arrange those services for enrollees participating in programs administered by the Department, including: (1) allow providers to provide services on a fee-for-service basis to Department clients not enrolled in the entity; (2) provide client education services; (3) allow enrollees to choose the site for services and the panel of health care providers; (4) not discriminate in enrollment or disenrollment practices based on health status; (5) provide a quality assurance and utilization review program; (6) issue ID cards; (7) ensure that primary care physicians and pharmacies meet standards established by the Department; (8) provide a procedure for handling complaints; (9) maintain records; and (10) provide that its pharmacy formulary be no more restrictive than the Department's pharmaceutical program. Last action on Bill: PUBLIC ACT.............................. 90-0618 Last action date: 98-07-10 Location: House Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 1 SENATE - 1 END OF INQUIRY Full Text Bill Status