Public Act 93-0518

SB64 Enrolled                        LRB093 02166 DRJ 02173 b

    AN ACT in relation to 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 5-24 as follows:

    (305 ILCS 5/5-24 new)
    Sec. 5-24.  Disease management programs and services  for
chronic conditions; pilot project.
    (a)  In  this  Section,  "disease management programs and
services" means services administered to patients in order to
improve  their  overall  health  and  to   prevent   clinical
exacerbations   and   complications,   using  cost-effective,
evidence-based    practice     guidelines     and     patient
self-management  strategies.  Disease management programs and
services include all of the following:
         (1)  A population identification process.
         (2)  Evidence-based  or   consensus-based   clinical
    practice guidelines, risk identification, and matching of
    interventions with clinical need.
         (3)  Patient self-management and disease education.
         (4)  Process  and  outcomes measurement, evaluation,
    management, and reporting.
    (b)  Subject to appropriations, the Department of  Public
Aid  may undertake a pilot project to study patient outcomes,
for patients with chronic diseases, associated with  the  use
of  disease  management  programs  and  services  for chronic
condition management. "Chronic diseases" include, but are not
limited to, diabetes, congestive heart failure,  and  chronic
obstructive pulmonary disease.
    (c)  The  disease  management programs and services pilot
project shall  examine  whether  chronic  disease  management
programs  and  services  for  patients  with specific chronic
conditions do any or all of the following:
         (1)  Improve the patient's overall health in a  more
    expeditious manner.
         (2)  Lower  costs  in  other  aspects of the medical
    assistance program, such as hospital admissions, days  in
    skilled  nursing  homes,  emergency  room visits, or more
    frequent physician office visits.
    (d)  In carrying out the pilot project, the Department of
Public Aid shall examine all relevant  scientific  literature
and  shall  consult with health care practitioners including,
but  not  limited  to,   physicians,   surgeons,   registered
pharmacists, and registered nurses.
    (e)  The  Department  of  Public  Aid  shall consult with
medical  experts,  disease  advocacy  groups,  and   academic
institutions  to  develop  criteria to be used in selecting a
vendor for the pilot project.
    (f)  The Department of Public  Aid  may  adopt  rules  to
implement this Section.
    (g)  This   Section   is  repealed  10  years  after  the
effective date of this amendatory Act  of  the  93rd  General
Assembly.

Effective Date: 1/1/2004