HB3031 97TH GENERAL ASSEMBLY

LRB097 06464 KTG 46546 b

97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB3031

Introduced 2/23/2011, by Rep. Jim Durkin

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-16.6a new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall require third-party providers that administer any portion of the medical assistance program to conduct, on a random sampling basis, an annual analysis of the enrollees under their authority. Requires all requests for proposals and associated third-party provider contracts issued by the Department to include a statement notifying third-party providers of this requirement. Effective immediately.

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 5-16.6a as follows:

(305 ILCS 5/5-16.6a new)

Sec. 5-16.6a. Provider contracts; enrollee analysis. Beginning on the effective date of this amendatory Act of the 97th General Assembly, the Department shall require third-party providers that administer any portion of the medical assistance program to conduct, on a random sampling basis, an annual analysis of the enrollees under their authority. The analysis shall include a review for potential fraudulent actions or improvements to address wasteful spending. All requests for proposals and associated third-party provider contracts issued by the Department shall include a statement providing that an annual analysis conducted pursuant to this Section is required under the contract.

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