Bill Status of HB4545  102nd General Assembly


Short Description:  MEDICAID-MANAGED CARE

House Sponsors
Rep. Jackie Haas, Norine K. Hammond, Chris Bos and Angelica Guerrero-Cuellar

Senate Sponsors
(Sen. Dave Syverson)

Last Action
DateChamber Action
  3/16/2022SenateReferred to Assignments

Statutes Amended In Order of Appearance
305 ILCS 5/5-30.12a new
305 ILCS 5/5-45 new


Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to explore, by July 1, 2023, the availability of and, if reasonably available, procure technology that: (i) allows the Department's Medical Electronic Data Interchange (MEDI) system to update recipient eligibility and coverage information for providers in real time; and (ii) allows the Department to transmit updated recipient eligibility and coverage information to managed care organizations under contract with the Department to ensure the information contained in the MEDI system corresponds with the information maintained by managed care organizations in their web-based provider portals. Provides that notwithstanding any provision of this Code to the contrary, in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than 2 years after the claim's payment date. Provides that the 2-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond 2 years. Effective immediately.

House Floor Amendment No. 1
Replaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by October 1, 2023 the Department of Healthcare and Family Services shall ensure the Illinois Medicaid Program Advanced Cloud Technology system is updated daily with eligibility coverage information from the integrated eligibility system. Provides that notwithstanding any other provision of the Code, in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than one year after the claim's payment date. Provides that the one-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond one year. Effective immediately.

Actions 
DateChamber Action
  1/13/2022HouseFiled with the Clerk by Rep. Jackie Haas
  1/21/2022HouseFirst Reading
  1/21/2022HouseReferred to Rules Committee
  2/1/2022HouseAssigned to Human Services Committee
  2/16/2022HouseDo Pass / Short Debate Human Services Committee; 015-000-000
  2/16/2022HouseAdded Co-Sponsor Rep. Norine K. Hammond
  2/17/2022HousePlaced on Calendar 2nd Reading - Short Debate
  3/1/2022HouseHouse Floor Amendment No. 1 Filed with Clerk by Rep. Jackie Haas
  3/1/2022HouseHouse Floor Amendment No. 1 Referred to Rules Committee
  3/2/2022HouseHouse Floor Amendment No. 1 Rules Refers to Human Services Committee
  3/2/2022HouseSecond Reading - Short Debate
  3/2/2022HouseHeld on Calendar Order of Second Reading - Short Debate
  3/3/2022HouseHouse Floor Amendment No. 1 Recommends Be Adopted Human Services Committee; 014-000-000
  3/4/2022HouseHouse Floor Amendment No. 1 Adopted
  3/4/2022HousePlaced on Calendar Order of 3rd Reading - Short Debate
  3/4/2022HouseThird Reading - Short Debate - Passed 103-001-000
  3/4/2022HouseAdded Co-Sponsor Rep. Chris Bos
  3/7/2022HouseAdded Co-Sponsor Rep. Angelica Guerrero-Cuellar
  3/7/2022SenateArrive in Senate
  3/7/2022SenatePlaced on Calendar Order of First Reading March 8, 2022
  3/16/2022SenateChief Senate Sponsor Sen. Dave Syverson
  3/16/2022SenateFirst Reading
  3/16/2022SenateReferred to Assignments