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Rep. Mary E. Flowers
Filed: 2/15/2022
| | 10200HB5013ham001 | | LRB102 25451 KTG 36474 a |
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| 1 | | AMENDMENT TO HOUSE BILL 5013
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| 2 | | AMENDMENT NO. ______. Amend House Bill 5013 by replacing |
| 3 | | line 17 on page 3 through line 1 on page 4 with the following:
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| 4 | | "(2) In order to maximize the accessibility of preventive |
| 5 | | prenatal and perinatal health care services, the Department of |
| 6 | | Healthcare and Family Services shall amend its managed care |
| 7 | | contracts such that an MCO must pay for preventive prenatal |
| 8 | | services, perinatal healthcare services, and postpartum |
| 9 | | services rendered by a non-affiliated provider, for which the |
| 10 | | health plan would pay if rendered by an affiliated provider, |
| 11 | | at no less than the rate paid under the Illinois Medicaid |
| 12 | | fee-for-service program methodology for such services, |
| 13 | | including all policy adjusters, including, but not limited to, |
| 14 | | Medicaid High Volume Adjustments, Medicaid Percentage |
| 15 | | Adjustments, Outpatient High Volume Adjustments, and all |
| 16 | | outlier add-on adjustments to the extent such adjustments are |
| 17 | | incorporated in the development of the applicable MCO |
| 18 | | capitated rates, unless a different rate was agreed upon by |