SB0637 EngrossedLRB101 04381 KTG 49389 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 5-36 as follows:
 
6    (305 ILCS 5/5-36 new)
7    Sec. 5-36. Custom prosthetic and orthotic devices.
8    (a) Coverage for custom prosthetic and orthotic devices
9under the fee-for-service medical assistance program and under
10any Medicaid managed care plan shall be no less favorable than
11the terms and conditions that apply to substantially all
12medical and surgical benefits provided under the
13fee-for-service medical assistance program or the Medicaid
14managed care plan.
15    (b) The Department shall set a rate of reimbursement under
16the fee-for-service medical assistance program for custom
17prosthetic and orthotic devices at a rate no less than the
18Medicare rate for the year minus 6%.
19    (c) The Department must ensure that all Medicaid managed
20care plans comply with network adequacy requirements for custom
21prosthetic and orthotic device services.
22    (d) The Department and contracted managed care
23organizations must comply with the Orthotics, Prosthetics, and

 

 

SB0637 Engrossed- 2 -LRB101 04381 KTG 49389 b

1Pedorthics Practice Act when making payments for custom
2orthotic and custom prosthetic devices.