Illinois General Assembly - Full Text of HB4545
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Full Text of HB4545  102nd General Assembly

HB4545eng 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB4545 EngrossedLRB102 22906 KTG 32059 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5adding Sections 5-30.12a and 5-45 as follows:
 
6    (305 ILCS 5/5-30.12a new)
7    Sec. 5-30.12a. Illinois Medicaid Program Advanced Cloud
8Technology. By October 1, 2023, the Department shall ensure
9that the Illinois Medicaid Program Advanced Cloud Technology
10system is updated daily with eligibility coverage information
11from the integrated eligibility system.
 
12    (305 ILCS 5/5-45 new)
13    Sec. 5-45. MCO post-payment audit; time period limitation.
14Notwithstanding any other provision of this Code, in order to
15recover an overpayment by recoupment or offset of future
16payments, a managed care organization's post-payment audit of
17any claim submitted by a provider must be completed no later
18than one year after the claim's payment date. The one-year
19time limit does not apply to claims that are (i) submitted
20fraudulently, (ii) known, or should have been known, by the
21provider to be a pattern of inappropriate billing according to
22standard provider billing practices, or (iii) subject to any

 

 

HB4545 Engrossed- 2 -LRB102 22906 KTG 32059 b

1federal law or regulation that permits post-payment audits
2beyond one year.
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.