Illinois General Assembly - Bill Status for HB5433
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 Bill Status of HB5433  100th General Assembly


Short Description:  MEDICAID-MCO-PAYOUT RATIOS

House Sponsors
Rep. Fred Crespo - Emanuel Chris Welch

Last Action
DateChamber Action
  1/8/2019HouseSession Sine Die

Statutes Amended In Order of Appearance
305 ILCS 5/5-30


Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to calculate the payout ratios reported by managed care organizations no less frequently than annually and to post these calculations on its website. Provides that the minimum payout ratio shall be 85% and that a managed care organization not meeting the 85% threshold must refund to the State, for each coverage year, an amount equal to the difference between the calculated payout ratio and 85% multiplied by coverage year revenue for that managed care organization. Defines "payment ratio". Requires the Department to exclusively use paid claims data submitted by managed care organizations in establishing managed care capitation rates. Provides that managed care organizations shall not be reimbursed by the State for any costs associated with health insurance fees.

Actions 
DateChamber Action
  2/16/2018HouseFiled with the Clerk by Rep. Fred Crespo
  2/16/2018HouseFirst Reading
  2/16/2018HouseReferred to Rules Committee
  3/5/2018HouseAssigned to Appropriations-Human Services Committee
  4/11/2018HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Fred Crespo
  4/11/2018HouseHouse Committee Amendment No. 1 Referred to Rules Committee
  4/13/2018HouseRule 19(a) / Re-referred to Rules Committee
  4/18/2018HouseAdded Chief Co-Sponsor Rep. Emanuel Chris Welch
  1/8/2019HouseSession Sine Die

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