HB3450 103RD GENERAL ASSEMBLY

LRB103 26160 KTG 52518 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3450

Introduced 2/17/2023, by Rep. Sonya M. Harper

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-47 new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to establish a 2-year pilot program to provide medically supportive food to medical assistance recipients through one or more food prescription programs operated by a participating managed care health plan with the goal of eliminating health disparities, improving health outcomes, and reducing rates of food and nutrition insecurity. Provides that under the pilot program, the Department shall provide medically supportive food coupons to medical assistance recipients who have a food prescription, issued by a licensed physician or health care provider under a participating managed care health plan, for medically supportive food as part of any treatment regimen for type 2 diabetes or prediabetes; hypertension; high-risk pregnancy; or some other specified condition. Provides that coupon holders may redeem their coupons at any participating food retailer and that farmers markets located in "food deserts" and grocery stores that accept Supplemental Nutrition Assistance Program benefits may participate in the pilot program as designated retailers that accept medically supportive food program coupons. Contains provisions concerning utilization controls, reporting requirements, and Department rules. Effective immediately.

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 5-47 as follows:

(305 ILCS 5/5-47 new)

Sec. 5-47. Food prescription pilot program.

(a) Findings and legislative intent.

(1) It is the intent of the General Assembly to eliminate racial and ethnic health disparities, increase positive health outcomes, and reduce rates of food and nutrition insecurity for medical assistance recipients by establishing a 2-year food prescription pilot program. The objective of this pilot program is to encourage managed care health plans contracted with the Department to create "Food as Medicine" programs to address the obesity and diabetes epidemic. The pilot program shall provide food prescriptions to eligible medical assistance recipients who are enrolled in a managed care health plan and are medically considered at rising-risk because they have one or more specified chronic health conditions and are experiencing food insecurity, but they do not require extensive care coordination. A food prescription shall consist of medically supportive food used for the prevention, reversal, or treatment of chronic health conditions, and may be paired with behavioral, cooking, or nutrition education, coaching, and counseling.

(2) The General Assembly finds that racial and ethnic health disparities have been exacerbated by the COVID-19 pandemic. The federal Centers for Disease Control and Prevention overwhelmingly reports that most of those hospitalized or who die from COVID-19 have an underlying health condition. Chronic health conditions disproportionately impact communities of color, making them particularly vulnerable for adverse health outcomes from severe COVID-19, including hospitalization and death. By preventing, treating, and reversing their underlying chronic health conditions, medical assistance recipients, and especially members of populations who experience health disparities, may be less vulnerable not only to COVID-19, but other chronic illnesses. Moreover, it is the intent of the General Assembly to reduce racial health disparities and generate long-term cost savings to the health care system as a result of the implementation of the 2-year food prescription pilot program.

(b) Definitions. As used in this Section:

"Eligible medical assistance recipient" means an individual who is eligible to participate in the pilot program and is enrolled in a participating managed care health plan.

"Food prescription" means a specific dosage of medically supportive food, which is prescribed by a managed care health plan, that is based on evidence-based practices that demonstrate the prevention, treatment, or reversal of specific chronic health conditions.

"Managed care health plan" means a managed care health plan or managed care organization contracted with the Department that operates a food prescription program in accordance with this Section.

"Medically supportive food" means any nutrient-rich whole food, including any fruit, vegetable, legume, nut, seed, whole grain, seafood, and lean animal protein, used for the prevention, treatment, or reversal of a specific chronic health condition.

"Pilot program" means the 2-year pilot program established in this Section.

(c) The Department shall establish a 2-year pilot program to provide medically supportive food to medical assistance recipients through one or more food prescription programs operated by a participating managed care health plan with the goal of eliminating health disparities, improving health outcomes, and reducing rates of food and nutrition insecurity. Under the pilot program, the Department shall provide medically supportive food coupons to medical assistance recipients who have a food prescription, issued by a licensed physician or health care provider under a managed care health plan, for medically supportive food as part of any treatment regimen for one of the following chronic health conditions:

(1) Depression or anxiety.

(2) Type 2 diabetes or prediabetes.

(3) Hypertension, which is also referred to as high blood pressure.

(4) Nonalcoholic fatty liver disease.

(5) Overweight, obesity, or severe obesity, as measured by a person's body mass index (BMI). For purposes of this paragraph, "overweight" means a person's BMI is between 25 kg/m2 and 30 kg/m2. "Obesity" means a person's BMI is 30 kg/m2 or higher, but under 40 kg/m2, and "severe obesity" means that a person's BMI is 40 kg/m2 or higher.

(6) Dyslipidemia, hypertriglyceridemia, or low high-density lipoprotein cholesterol.

(7) High-risk pregnancy, including gestational diabetes.

Coupon holders may redeem their coupons at any participating food retailer. Farmers markets located in "food deserts" and grocery stores that accept Supplemental Nutrition Assistance Program benefits may participate in the pilot program as designated retailers that accept medically supportive food program coupons. The Department may provide incentives to solicit food retailers to participate in the program and may adopt any rules necessary to implement the program.

(d) The Department, in consultation with stakeholders, may establish utilization controls, with respect to the limitation on food prescriptions, including how these food prescriptions may be restricted as to a set number within a specified timeframe. In developing these utilization controls under the pilot program, the Department and managed care health plans shall consider the nutritional needs, food security, and health status of a medical assistance recipient.

(e) Upon the completion of the pilot program, and to the extent it can be determined, the Department shall evaluate the impact of the pilot program, including, but not limited to, relevant health outcome and health disparities data, and the pilot program's impact on quality and performance improvement metrics, medication adherence, medical appointment attendance, and member satisfaction scores. The Department shall prepare these findings, including its recommendation on expanding the pilot program on a statewide-basis or for an extended period of time, into a finalized report, and shall submit this report to the General Assembly by January 1, 2026, or within 12 months after the end of the pilot program, whichever is sooner.

(f) The Department may adopt any rules necessary to implement this Section.

Section 99. Effective date. This Act takes effect upon becoming law.