HB5258 104TH GENERAL ASSEMBLY

LRB104 20212 KTG 33663 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5258

Introduced 2/10/2026, by Rep. Camille Y. Lilly

SYNOPSIS AS INTRODUCED:

30 ILCS 105/5.945
305 ILCS 75/185-5
305 ILCS 75/185-15
305 ILCS 75/185-20 rep.
305 ILCS 75/185-25 rep.

Amends the Medicaid Technical Assistance Act. Requires the Medicaid Technical Assistance Center to collaborate with public and private partners throughout the State to identify, establish, and maintain best practices necessary for health providers to ensure their capacity to participate in the Illinois Medical Assistance Program (rather than ensure their capacity to participate in HealthChoice Illinois or YouthCare). Requires the Medicaid Technical Assistance Center to promote equitable delivery systems, remaining committed to the principle that all Medicaid recipients have accessible and equitable physical and mental health care services. Removes provisions concerning the Medicaid Technical Assistance Center's administration of network adequacy reports, and instead requires the Medicaid Technical Assistance Center to administer a network requirement plan. Provides that by using reports and data provided by the Department of Healthcare and Family Service's External Quality Review Organization on network adequacy, provider service deserts, and health care disparities by race and ethnicity, the Medicaid Technical Assistance Center shall propose for Department review and approval an annual plan for recruiting providers to participate in the Illinois Medical Assistance Program and report on outcomes of its recruitment efforts to the Department for continuous improvement. Repeals a provision requiring the Department to maximize federal financial participation for any moneys appropriated to the Department for the Medicaid Technical Assistance Center and to deposit all federal financial participation funds into the Medicaid Technical Assistance Center Fund. Repeals a provision creating the Medicaid Technical Assistance Center Fund. Amends the State Finance Act. Provides for the dissolution of the Medicaid Technical Assistance Center Fund on July 1, 2026, or as soon thereafter as practical, after the transfer of all remaining funds into the Healthcare Provider Relief Fund. Effective July 1, 2026.

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 State Finance Act is amended by changing Section 5.945 as follows:

(30 ILCS 105/5.945)

Sec. 5.945. The Medicaid Technical Assistance Center Fund. Notwithstanding any other provision of law, in addition to any other transfers that may be provided by law, on July 1, 2026, or as soon thereafter as practical, the State Comptroller shall direct, and the State Treasurer shall transfer the remaining balance from the Medicaid Technical Assistance Center Fund into the Healthcare Provider Relief Fund. Upon completion of the transfers, the Medicaid Technical Assistance Center Fund is dissolved, and any future deposits due to that Fund and any outstanding obligations or liabilities of that Fund pass to the Healthcare Provider Relief Fund.

(Source: P.A. 102-4, Article 185, Section 185-90, eff. 4-27-21; 102-813, eff. 5-13-22.)

Section 10. The Medicaid Technical Assistance Act is amended by changing Sections 185-5 and 185-15 as follows:

(305 ILCS 75/185-5)

Sec. 185-5. Definitions. As used in this Act:

"Behavioral health providers" includes providers of mental health, substance use disorder, developmental disabilities, and autism services for purposes of this Act, but does not change any other legal, programmatic, diagnostic, or clinical provisions defining or relating to coverage of such services. means mental health and substance use disorder providers.

"Department" means the Department of Healthcare and Family Services.

"Health care providers" means individuals and organizations who provide physical, mental, substance use disorder, or services supporting social determinant of health services.

"Health equity" means providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

"Network adequacy" means a Medicaid beneficiaries' ability to access all necessary provider types within time and distance standards as defined in the Managed Care Organization model contract.

"Service deserts" means geographic areas of the State with no or limited Medicaid providers that accept Medicaid.

"Social determinants of health" means any conditions that impact an individual's health, including, but not limited to, access to healthy food, safety, education, and housing stability.

"Stakeholders" means, but are not limited to, health care providers, advocacy organizations, managed care organizations, Medicaid beneficiaries, and State and city partners.

(Source: P.A. 102-4, eff. 4-27-21.)

(305 ILCS 75/185-15)

Sec. 185-15. Collaboration. The Medicaid Technical Assistance Center shall collaborate with public and private partners throughout the State to identify, establish, and maintain best practices necessary for health providers to ensure their capacity to participate in the Illinois Medical Assistance Program. The Medicaid Technical Assistance Center shall promote equitable delivery systems, remaining committed to the principle that all Medicaid recipients have accessible and equitable physical and mental health care services HealthChoice Illinois or YouthCare. The Medicaid Technical Assistance Center shall administer the following:

(1) Outreach and engagement: The Medicaid Technical Assistance Center shall undertake efforts to identify and engage community-based providers offering services to customers funded by the Department, including, but not limited to, behavioral health services and or services addressing the social determinants of health, especially those predominantly serving communities of color or those operating within or near service deserts, for the purpose of offering training and technical assistance to them through the Medicaid Technical Assistance Center. Outreach and engagement services may be subcontracted.

(2) Trainings: The Medicaid Technical Assistance Center shall create and administer ongoing trainings for health care providers. Trainings may be subcontracted. The Medicaid Technical Assistance Center shall provide in-person and web-based trainings. In-person training shall be conducted throughout the State. All trainings must be free of charge. The Medicaid Technical Assistance Center shall administer post-training surveys and incorporate feedback. Training content and delivery must be reflective of Illinois providers' varying levels of readiness, resources, and client populations.

(3) Web-based resources: The Medicaid Technical Assistance Center shall maintain an independent, easy to navigate, and up-to-date website that includes, but is not limited to: recorded training archives, a training calendar, provider resources and tools, up-to-date explanations of Department and managed care organization guidance, a running database of frequently asked questions and contact information for key staff members of the Department, managed care organizations, and the Medicaid Technical Assistance Center.

(4) Learning collaboratives: The Medicaid Technical Assistance Center shall host regional learning collaboratives that will supplement the Medicaid Technical Assistance Center training curriculum to bring together groups of stakeholders to share issues and best practices, and to escalate issues. Leadership of the Department and managed care organizations shall attend learning collaboratives on a quarterly basis.

(5) Network recruitment plan: Using reports and data provided by the Department's External Quality Review Organization on adequacy reports: The Medicaid Technical Assistance Center shall publicly release a report on Medicaid provider network adequacy, within the first 3 years of implementation and annually thereafter. The reports shall identify provider service deserts, and health care disparities by race and ethnicity, the Medicaid Technical Assistance Center shall propose for Department review and approval an annual plan for recruiting providers to participate in the Illinois Medical Assistance Program and report on outcomes of its recruitment efforts to the Department for continuous improvement. Recruitment plans shall prioritize efforts to bolster access in provider service deserts and in communities experiencing health care disparities by race and ethnicity, with a special focus on behavioral health services and services that address social determinants of health.

(6) Equitable delivery system: The Medicaid Technical Assistance Center is committed to the principle that all Medicaid recipients have accessible and equitable physical and mental health care services. All providers served through the Medicaid Technical Assistance Center shall deliver services notwithstanding the patient's race, color, gender, gender identity, age, ancestry, marital status, military status, religion, national origin, disability status, sexual orientation, order of protection status, as defined under Section 1-103 of the Illinois Human Rights Act, or immigration status.

(Source: P.A. 102-4, eff. 4-27-21.)

(305 ILCS 75/185-20 rep.)

(305 ILCS 75/185-25 rep.)

Section 15. The Medicaid Technical Assistance Act is amended by repealing Sections 185-20 and 185-25.

Section 99. Effective date. This Act takes effect July 1, 2026.