Rep. Mary E. Flowers

Filed: 2/15/2022

 

 


 

 


 
10200HB5013ham001LRB102 25451 KTG 36474 a

1
AMENDMENT TO HOUSE BILL 5013

2    AMENDMENT NO. ______. Amend House Bill 5013 by replacing
3line 17 on page 3 through line 1 on page 4 with the following:
4    "(2) In order to maximize the accessibility of preventive
5prenatal and perinatal health care services, the Department of
6Healthcare and Family Services shall amend its managed care
7contracts such that an MCO must pay for preventive prenatal
8services, perinatal healthcare services, and postpartum
9services rendered by a non-affiliated provider, for which the
10health plan would pay if rendered by an affiliated provider,
11at no less than the rate paid under the Illinois Medicaid
12fee-for-service program methodology for such services,
13including all policy adjusters, including, but not limited to,
14Medicaid High Volume Adjustments, Medicaid Percentage
15Adjustments, Outpatient High Volume Adjustments, and all
16outlier add-on adjustments to the extent such adjustments are
17incorporated in the development of the applicable MCO
18capitated rates, unless a different rate was agreed upon by

 

 

10200HB5013ham001- 2 -LRB102 25451 KTG 36474 a

1the health plan and the non-affiliated provider.".