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HB5241 Engrossed |
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LRB096 16158 KTG 31409 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by |
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| adding Section 5-2.01 as follows: |
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| (305 ILCS 5/5-2.01 new) |
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| Sec. 5-2.01. Medicaid accountability through transparency |
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| program. |
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| (a) Internet-based transparency program. The Director of |
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| the Department of Healthcare and Family Services shall be |
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| authorized to implement a program under which the Director |
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| shall make available through the Department's public Internet |
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| website information on medical claims reimbursed under the |
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| State's medical assistance program insofar as such information |
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| has been de-identified in accordance with regulations |
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| promulgated pursuant to the Illinois Health Insurance |
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| Portability and Accountability Act. In implementing the |
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| program, the Director shall ensure the following: |
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| (1) The information made so available shall be in a |
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| format that is easily accessible, useable, and |
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| understandable to the public, including individuals |
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| interested in improving the quality of care provided to |
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| individuals eligible for items and services under this |
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HB5241 Engrossed |
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LRB096 16158 KTG 31409 b |
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| Article, researchers, health care providers, and |
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| individuals interested in reducing the prevalence of waste |
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| and fraud under this Article. |
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| (2) The information made so available shall be as |
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| current as deemed practical by the Director and shall be |
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| updated at least once per calendar quarter. |
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| (3) The information made so available shall be |
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| aggregated to a level to ensure patient confidentiality, |
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| but shall, to the extent feasible, allow for posting of |
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| information by provider or vendor name and county, number |
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| of individuals served, total patient visits, payment for |
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| bills submitted, average cost for bills submitted, |
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| adjustments to payments, and total amounts paid. |
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| (4) The Director periodically solicits comments from a |
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| sampling of individuals who access the information through |
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| the program on how to best improve the utility of the |
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| program. |
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| (b) Use of contractor. For purposes of implementing the |
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| program under subsection (a) of this Section and ensuring the |
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| information made available through the program is periodically |
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| updated, the Director may select and enter into a contract with |
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| a public or private entity meeting the criteria and |
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| qualifications the Director determines appropriate. |
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| (c) Annual Reports. Not later than 12 months after the |
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| effective date of this amendatory Act of the 96th General |
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| Assembly and annually thereafter, the Director shall submit to |
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HB5241 Engrossed |
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LRB096 16158 KTG 31409 b |
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| the General Assembly a report on the status of the program |
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| authorized under subsection (a). The report shall include |
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| details including, but not limited to, the estimated or actual |
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| costs of developing and maintaining the reporting system, the |
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| actual or potential benefit or adverse consequences associated |
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| with the system, and, if applicable, the extent to which |
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| information made available through the program is accessed and |
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| the extent to which comments received under paragraph (4) of |
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| subsection (a) of this Section were used to improve the utility |
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| of the program.
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| Section 99. Effective date. This Act takes effect upon |
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| becoming law. |