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| | HB4545 Engrossed | | LRB102 22906 KTG 32059 b |
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| 1 | | AN ACT concerning public aid.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Public Aid Code is amended by |
| 5 | | adding Sections 5-30.12a and 5-45 as follows:
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| 6 | | (305 ILCS 5/5-30.12a new) |
| 7 | | Sec. 5-30.12a. Illinois Medicaid Program Advanced Cloud |
| 8 | | Technology. By October 1, 2023, the Department shall ensure |
| 9 | | that the Illinois Medicaid Program Advanced Cloud Technology |
| 10 | | system is updated daily with eligibility coverage information |
| 11 | | from the integrated eligibility system.
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| 12 | | (305 ILCS 5/5-45 new) |
| 13 | | Sec. 5-45. MCO post-payment audit; time period limitation. |
| 14 | | Notwithstanding any other provision of this Code, in order to |
| 15 | | recover an overpayment by recoupment or offset of future |
| 16 | | payments, a managed care organization's post-payment audit of |
| 17 | | any claim submitted by a provider must be completed no later |
| 18 | | than one year after the claim's payment date. The one-year |
| 19 | | time limit does not apply to claims that are (i) submitted |
| 20 | | fraudulently, (ii) known, or should have been known, by the |
| 21 | | provider to be a pattern of inappropriate billing according to |
| 22 | | standard provider billing practices, or (iii) subject to any |