|
| | SB0637 Engrossed | | LRB101 04381 KTG 49389 b |
|
|
| 1 | | AN ACT concerning public aid.
|
| 2 | | Be it enacted by the People of the State of Illinois, |
| 3 | | represented in the General Assembly:
|
| 4 | | Section 5. The Illinois Public Aid Code is amended by |
| 5 | | adding Section 5-36 as follows:
|
| 6 | | (305 ILCS 5/5-36 new) |
| 7 | | Sec. 5-36. Custom prosthetic and orthotic devices. |
| 8 | | (a) Coverage for custom prosthetic and orthotic devices |
| 9 | | under the fee-for-service medical assistance program and under |
| 10 | | any Medicaid managed care plan shall be no less favorable than |
| 11 | | the terms and conditions that apply to substantially all |
| 12 | | medical and surgical benefits provided under the |
| 13 | | fee-for-service medical assistance program or the Medicaid |
| 14 | | managed care plan. |
| 15 | | (b) The Department shall set a rate of reimbursement under |
| 16 | | the fee-for-service medical assistance program for custom |
| 17 | | prosthetic and orthotic devices at a rate no less than the |
| 18 | | Medicare rate for the year minus 6%. |
| 19 | | (c) The Department must ensure that all Medicaid managed |
| 20 | | care plans comply with network adequacy requirements for custom |
| 21 | | prosthetic and orthotic device services. |
| 22 | | (d) The Department and contracted managed care |
| 23 | | organizations must comply with the Orthotics, Prosthetics, and |