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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 Section 5-2.01 as follows: | ||||||
6 | (305 ILCS 5/5-2.01 new) | ||||||
7 | Sec. 5-2.01. Medicaid accountability through transparency | ||||||
8 | program. | ||||||
9 | (a) Internet-based transparency program. The Director of | ||||||
10 | the Department of Healthcare and Family Services shall be | ||||||
11 | authorized to implement a program under which the Director | ||||||
12 | shall make available through the Department's public Internet | ||||||
13 | website information on medical claims reimbursed under the | ||||||
14 | State's medical assistance program insofar as such information | ||||||
15 | has been de-identified in accordance with regulations | ||||||
16 | promulgated pursuant to the Illinois Health Insurance | ||||||
17 | Portability and Accountability Act. In implementing the | ||||||
18 | program, the Director shall ensure the following: | ||||||
19 | (1) The information made so available shall be in a | ||||||
20 | format that is easily accessible, useable, and | ||||||
21 | understandable to the public, including individuals | ||||||
22 | interested in improving the quality of care provided to | ||||||
23 | individuals eligible for items and services under this |
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1 | Article, researchers, health care providers, and | ||||||
2 | individuals interested in reducing the prevalence of waste | ||||||
3 | and fraud under this Article. | ||||||
4 | (2) The information made so available shall be as | ||||||
5 | current as deemed practical by the Director and shall be | ||||||
6 | updated at least once per calendar quarter. | ||||||
7 | (3) The information made so available shall be | ||||||
8 | aggregated to a level to ensure patient confidentiality, | ||||||
9 | but shall, to the extent feasible, allow for posting of | ||||||
10 | information by provider or vendor name and county, number | ||||||
11 | of individuals served, total patient visits, payment for | ||||||
12 | bills submitted, average cost for bills submitted, | ||||||
13 | adjustments to payments, and total amounts paid. | ||||||
14 | (4) The Director periodically solicits comments from a | ||||||
15 | sampling of individuals who access the information through | ||||||
16 | the program on how to best improve the utility of the | ||||||
17 | program. | ||||||
18 | (b) Use of contractor. For purposes of implementing the | ||||||
19 | program under subsection (a) of this Section and ensuring the | ||||||
20 | information made available through the program is periodically | ||||||
21 | updated, the Director may select and enter into a contract with | ||||||
22 | a public or private entity meeting the criteria and | ||||||
23 | qualifications the Director determines appropriate. | ||||||
24 | (c) Annual Reports. Not later than 12 months after the | ||||||
25 | effective date of this amendatory Act of the 96th General | ||||||
26 | Assembly and annually thereafter, the Director shall submit to |
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1 | the General Assembly a report on the status of the program | ||||||
2 | authorized under subsection (a). The report shall include | ||||||
3 | details including, but not limited to, the estimated or actual | ||||||
4 | costs of developing and maintaining the reporting system, the | ||||||
5 | actual or potential benefit or adverse consequences associated | ||||||
6 | with the system, and, if applicable, the extent to which | ||||||
7 | information made available through the program is accessed and | ||||||
8 | the extent to which comments received under paragraph (4) of | ||||||
9 | subsection (a) of this Section were used to improve the utility | ||||||
10 | of the program.
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11 | Section 99. Effective date. This Act takes effect upon | ||||||
12 | becoming law. |