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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | ||||||
5 | adding Sections 1-13 as follows: | ||||||
6 | (305 ILCS 5/1-13 new) | ||||||
7 | Sec. 1-13. Program and reimbursement changes under the | ||||||
8 | medical assistance program. | ||||||
9 | (a) It is the purpose of this Section to improve planning | ||||||
10 | and consistency for implementation of program and | ||||||
11 | reimbursement changes under the medical assistance program. It | ||||||
12 | is critical that there is an adequate planning timeline in | ||||||
13 | order to structure changes in a way that meets the needs of | ||||||
14 | program enrollees and allow proper time to educate and consult | ||||||
15 | with impacted providers. Streamlining the dates upon which | ||||||
16 | program and reimbursement changes take effect promotes | ||||||
17 | strategic planning by the State to ensure all programs and | ||||||
18 | policies are aligned to meet the goals of the medical | ||||||
19 | assistance program. In addition, allowing time to | ||||||
20 | operationalize changes and collaborate with providers | ||||||
21 | significantly reduces provider confusion and abrasion. | ||||||
22 | (b) Effective January 1, 2024, for any program coverage | ||||||
23 | benefit change or reimbursement methodology change enacted by |
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1 | the General Assembly or implemented through administrative | ||||||
2 | rule by the Department after the effective date of this | ||||||
3 | amendatory Act of the 103rd General Assembly, there shall be a | ||||||
4 | 6-month implementation period resulting in an effective date | ||||||
5 | which is not sooner than 6 months following the effective date | ||||||
6 | of the new change by law or administrative rule, except that | ||||||
7 | the change shall either have an effective date of January 1 or | ||||||
8 | July 1, whichever occurs first after the end of the 6-month | ||||||
9 | implementation period. The Department and all affected | ||||||
10 | Medicaid managed care organizations shall publish the | ||||||
11 | applicable effective date of implementation for any such | ||||||
12 | benefit or reimbursement methodology change on their publicly | ||||||
13 | accessible website no less than 120 days prior to the | ||||||
14 | effective date of implementation. The requirements of this | ||||||
15 | Section do not apply to scheduled periodic rate updates, | ||||||
16 | updates required by federal regulation, or required updates | ||||||
17 | published by the federal Centers for Medicare and Medicaid | ||||||
18 | Services. Scheduled and periodic rate updates shall be | ||||||
19 | published on the Department's publicly accessible website no | ||||||
20 | less than 30 days prior to the effective date of such rate | ||||||
21 | updates.
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