SB0788 99TH GENERAL ASSEMBLY

LRB099 05889 KTG 25937 b

99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB0788

Introduced 2/5/2015, by Sen. Heather A. Steans

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-30.2 new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop and implement an algorithm that is based on quality scores and other operational proficiency criteria developed, defined, and adopted by the Department, by rule, to automatically assign Medicaid enrollees served under the Family Health Plan and the Integrated Care Program and those Medicaid enrollees eligible for medical assistance pursuant to the Patient Protection and Affordable Care Act into managed care entities, including Accountable Care Entities, Care Coordination Entities, Children with Special Needs Care Coordination Entities, Managed Care Community Networks, and Managed Care Organizations. Provides that the algorithm developed and implemented shall favor assignment into managed care entities with the highest quality scores and levels of compliance with the operational proficiency criteria established.

FISCAL NOTE ACT MAY APPLY

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 Illinois Public Aid Code is amended by adding Section 5-30.2 as follows:

(305 ILCS 5/5-30.2 new)

Sec. 5-30.2. Managed care; automatic assignment. The Department shall develop and implement an algorithm that is based on quality scores and other operational proficiency criteria developed, defined, and adopted by the Department, by rule, to automatically assign Medicaid enrollees served under the Family Health Plan and the Integrated Care Program and those Medicaid enrollees eligible for medical assistance pursuant to the Patient Protection and Affordable Care Act (P.L. 111-148) into managed care entities, including Accountable Care Entities, Care Coordination Entities, Children with Special Needs Care Coordination Entities, Managed Care Community Networks, and Managed Care Organizations. The algorithm developed and implemented shall favor assignment into managed care entities with the highest quality scores and levels of compliance with the operational proficiency criteria established.