Senate Sponsors: SYVERSON-DEL VALLE-SMITH-TROTTER-GARCIA, OBAMA, BERMAN AND HALVORSON. House Sponsors: LEITCH-CURRIE-SCHAKOWSKY Short description: DPA-MEDICAID-PURPOSE-TECHNICAL Synopsis of Bill as introduced: Amends the Medical Assistance Article of the Illinois Public Aid Code. Makes a stylistic change in provisions regarding the purpose of the Article. SENATE AMENDMENT NO. 1. Deletes reference to: 305 ILCS 5/5-1 Adds reference to: 305 ILCS 5/5-16.3 Deletes everything. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the 24 hour per day emergency service telephone number provided to clients of the managed health care entity providing services under the Department of Public Aid's integrated health care program shall be staffed by registered nurses, rather than licensed practical nurses or registered nurses. Effective immediately. FISCAL NOTE (Dept. of Public Aid) There is no fiscal impact on this Dept. STATE MANDATES FISCAL NOTE (DCCA) SB 320 fails to preempt home rule authority. HOME RULE NOTE SB 320 does not preempt home rule authority. HOUSE AMENDMENT NO. 2. (House recedes November 14, 1997) Adds reference to: 305 ILCS 5/5-16.8 new 305 ILCS 5/5-16.10 new 305 ILCS 5/12-13.1 Deletes everything and reinserts language identical to the engrossed bill, adding other provisions. Further amends the Public Aid Code. In the "Medicaid" Article, makes the following changes with respect to the integrated health care program: (1) authorizes the Department of Public Aid to consider a managed health care entity's accreditation in selecting program participants; (2) requires managed health care entities to provide orientation; (3) requires contractors to make a good faith effort to have program enrollees evaluated; (4) requires that no payment be made to a physician or other provider for withholding covered services because of the cost of the services; (5) requires that a Managed Care Roundtable be established; (6) authorizes the Department to impose penalties or sanctions for violations; and (7) requires the Auditor General to conduct an annual performance audit of the program. Requires managed care organizations to provide programs for provider and client education. Authorizes the Inspector General within the Department to establish a special administrative subdivision to monitor the integrated health care program and to receive and investigate complaints. Provides that if a managed health care entity is accredited by a national organization, the Department of Public Aid may give preference to that managed health care entity in selecting participants for the program. Requires that the medical director of a managed health care entity be a physician. Provides that a managed health care entity may not engage in door-to-door and cer- tain other marketing activities. Requires that the Department of Pub- lic Aid approve an entity's marketing plan. Authorizes the Department of Public Aid Inspector General to investigate entities' marketing practices. Effective immediately. HOUSE AMENDMENT NO. 3. (House recedes November 14, 1997) Adds reference to: 405 ILCS 5/5-120 new Amends the Mental Health and Developmental Disabilities Code. Provides that the Department of Mental Health and Developmental Disabilities may enter into agreements with not-for-profit organizations to conduct pilot projects to provide case management, screening services, and monitoring services for persons with developmental disabilities. HOUSE AMENDMENT NO. 4. (House recedes November 14, 1997) Further amends the managed health care for recipients provisions of the Illinois Public Aid Code. In provisions authorizing the development of a demonstration program to accelerate and facilitate the development of integrated health care and maintain and sustain the high quality of education and residency programs coordinated and associated with local area hospitals for managed care community networks owned, operated, or governed by State-funded medical schools, removes restriction that the program be limited to contracting areas outside counties with populations in excess of 3,000,000 and counties adjacent to those counties. HOUSE AMENDMENT NO. 5. (House recedes November 14, 1997) Adds reference to: 305 ILCS 5/5-16.11 new Further amends the Illinois Public Aid Code. Provides that the pharmacy formulary used by any managed care entity and its contract providers providing services under this Code shall be no more restrictive than the Illinois Department's pharmaceutical program on and after July 26, 1994. HOUSE AMENDMENT NO. 6. (House recedes November 14, 1997) Adds reference to: 305 ILCS 5/5-16.12 new In provisions regarding managed health care for recipients and in provisions regarding cooperative arrangements, contracts with other State agencies, health care and rehabilitation organizations, and fiscal intermediaries, adds a requirement that the Department of Public Aid shall ensure in its contracts with pre-paid health plans that a College of Medicine operated by the University of Illinois shall have continued access to patients under these contracts and that the Department shall develop rules and contracts to implement these provisions. CONFERENCE COMMITTEE REPORT NO. 1. Recommends that the House recede from H-ams 2, 3, 4, 5, and 6. Recommends that the bill be further amended as follows: Deletes reference to: 305 ILCS 5/5-16.3 Adds reference to: 305 ILCS 5/12-4.34 new 305 ILCS 5/12-4.32 rep. Deletes everything. Amends the Illinois Public Aid Code. Authorizes the Department of Human Services to provide, subject to appropriation, naturalization services to legal immigrants and nutrition services to certain noncitizens who are not eligible for the federal food stamp program due to their noncitizen status. Provides that the payment levels and eligibility conditions shall be determined by rule and authorizes the Department to lower payment levels or take other actions during the fiscal year to ensure that payments do not exceed the amounts appropriated for this purpose. Repeals these provisions on August 31, 1998. Repeals provision of the Public Aid Code authorizing the Department of Human Services to provide payments to certain individuals who are terminated from the federal Supplemental Security Income program due to their noncitizen status. Effective immediately. Last action on Bill: PUBLIC ACT.............................. 90-0564 Last action date: 97-12-22 Location: Senate Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 5 SENATE - 1 END OF INQUIRY Full Text Bill Status