101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4139

 

Introduced 1/22/2020, by Rep. Deanne M. Mazzochi

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-30.15 new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that if a Medicaid enrollee of a managed care organization selects a plan based on the in-network status of (i) an existing primary care provider or (ii) up to 2 existing specialty care providers for an existing condition that is under active treatment, the managed care organization may not change the Medicaid enrollee's selected provider in (i) or (ii) for the remainder of the 12-month period following enrollment in the managed care health plan without permission by the Medicaid enrollee. Permits the Department of Healthcare and Family Services to adopt any rules necessary to administer the amendatory Act. Provides that nothing in the amendatory Act shall be construed to prohibit a Medicaid enrollee from changing his or her primary care provider as authorized by Department rules.


LRB101 13166 KTG 64065 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4139LRB101 13166 KTG 64065 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5adding Section 5-30.15 as follows:
 
6    (305 ILCS 5/5-30.15 new)
7    Sec. 5-30.15. Change in provider; managed care
8restrictions. If a Medicaid enrollee of a managed care
9organization selects a plan based on the in-network status of
10(i) an existing primary care provider or (ii) up to 2 existing
11specialty care providers for an existing condition that is
12under active treatment, the managed care organization may not
13change the Medicaid enrollee's selected provider in (i) or (ii)
14for the remainder of the 12-month period following enrollment
15in the managed care health plan without permission by the
16Medicaid enrollee. The Department may adopt any rules necessary
17to administer this Section. Nothing in this Section shall be
18construed to prohibit a Medicaid enrollee from changing his or
19her primary care provider as authorized by Department rules.