Illinois General Assembly - Bill Status for SB3916
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 Bill Status of SB3916  102nd General Assembly


Short Description:  MEDICAID-MCO-CLAIMS PAYMENT

Senate Sponsors
Sen. Celina Villanueva

Last Action
DateChamber Action
  1/21/2022SenateReferred to Assignments

Statutes Amended In Order of Appearance
305 ILCS 5/5-30.1
305 ILCS 5/5A-12.7


Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires managed care organizations (MCOs) to pay a clean claim (rather than claim) within 30 days of receiving a claim. Defines "clean claim" as a claim that contains all the essential information needed to adjudicate the claim or a claim for which a managed care organization does not request within 30 days of receipt any additional information to adjudicate the claim. Contains provisions concerning MCO reports to providers on the receipt and payment of claims; MCO data collection requirements; providers' right to file suit to recover outstanding payments; quarterly audits of each MCO's requests for provider information to adjudicate claims; MCO claims processing and performance analysis; quarterly audits of MCOs payments to hospitals; the segregation of State-issued Medicaid funds received by MCOs for payments to providers; and other matters. Amends the Hospital Provider Funding Article of the Code. Requires the Department of Healthcare and Family Services to calculate, at least quarterly, all Hospital Assessment Program-related funds paid to each hospital, whether paid by the Department or an MCO, including the amounts integrated into rate increases and distributed as provided under the Code.

Actions 
DateChamber Action
  1/21/2022SenateFiled with Secretary by Sen. Celina Villanueva
  1/21/2022SenateFirst Reading
  1/21/2022SenateReferred to Assignments
  2/10/2022SenateRule 2-10 Committee Deadline Established As February 18, 2022

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