Illinois General Assembly - Bill Status for HB5560

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that in the event that a hospital is not a contracted provider with a Medicaid managed care payor, and an enrollee of that Medicaid managed care payor requires care at that non-contracted facility, the Medicaid managed care payor shall be required to pay the non-contracted facility no less than the equivalent of what the State payment rate would be for the same non-elective services, including all policy adjustments and outlier payments. Provides that hospital triage services required under the federal Emergency Medical Treatment and Labor Act for enrollees presenting in the emergency room shall be considered a non-elective service as the provider is required by law to provide such services; and that the Medicaid managed care payor shall not be required to pay a State equivalent rate for any service deemed elective but may instead negotiate an agreement for such elective services with the non-contracted provider or redirect the enrollee within its contracted provider network. Effective immediately.

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