Illinois General Assembly - Full Text of HB5403
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Full Text of HB5403  102nd General Assembly

HB5403 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5403

 

Introduced 1/31/2022, by Rep. Deanne M. Mazzochi

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-46 new

    Amends the Medicaid Assistance Article of the Illinois Public Aid Code. Contains legislative findings concerning the necessity of implementing the Illinois Behavioral Health Transformation Section 1115 demonstration approved May 7, 2018 by the federal Centers for Medicare and Medicaid Services to ensure a truly integrated physical and behavioral health system, centered on Medicaid members, their families, and their communities. Provides that no later than 60 days after the Department of Healthcare and Family Services receives federal approval of any waiver application it submitted to the federal Centers for Medicare and Medicaid Services to effectuate the purposes of the medical assistance program, the Department shall adopt rules to implement the approved waiver. Requires the Department to adopt, within 60 days after the effective date of the amendatory Act, rules to implement the Illinois Behavioral Health Transformation Section 1115 demonstration. Provides that upon expiration of the 60-day rulemaking period, providers of behavioral health services, including providers and facilities that are operated by a county, municipality, township, or unit of local government, shall be eligible for reimbursement from the Department of Human Services for services that are a part of an approved treatment regimen and provided under the Illinois Behavioral Health Transformation Section 1115 demonstration. Provides that eligibility for services provided under the Illinois Behavioral Health Transformation Section 1115 demonstration shall cover up to one year of treatment or until self-sufficiency can be demonstrated. Effective immediately.


LRB102 25973 KTG 35372 b

 

 

A BILL FOR

 

HB5403LRB102 25973 KTG 35372 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 10. The Illinois Public Aid Code is amended by
5adding Section 5-46 as follows:
 
6    (305 ILCS 5/5-46 new)
7    Sec. 5-46. Approved federal waivers; Department rules for
8implementation.
9    (a) Legislative findings. Illinois is one of the largest
10funders of health and human services in the country. With
11$32,000,000,000 spent across its health and human services
12agencies, amounting to more than 40% of its total budget, the
13State is deeply invested in the health and well-being of its
14residents and Medicaid members. It is urgent that Illinois
15puts a focus on prevention by paying for value and outcomes.
16Building a behavioral health strategy will address the opioid
17pandemic, reduce violent crime and violent encounters with the
18police, and have a large financial payoff as Medicaid members
19with behavioral health needs represent approximately
20one-quarter of the total Illinois Medicaid members.
21    In May of 2018, a Behavioral Health Transformation Section
221115 demonstration was approved by the federal Centers for
23Medicare and Medicaid Services. The waiver demonstration

 

 

HB5403- 2 -LRB102 25973 KTG 35372 b

1proposed 6 main goals:
2        (1) Rebalance the behavioral health ecosystem,
3    reducing overreliance on institutional care and shifting
4    to community-based care.
5        (2) Promote integrated delivery of behavioral and
6    physical health care for behavioral health members with
7    high needs.
8        (3) Promote integration of behavioral health and
9    primary care for behavioral health members with lower
10    needs.
11        (4) Support development of robust and sustainable
12    behavioral health services that provide both core and
13    preventative care to ensure that behavioral health members
14    receive the full complement of high-quality treatment they
15    need.
16        (5) Invest in support services to address the larger
17    needs of behavioral health members, such as housing and
18    employment services.
19        (6) Create an enabling environment to more behavioral
20    health providers toward outcomes and value-based payments.
21    The General Assembly finds that the implementation of the
22approved waiver is necessary for a truly integrated physical
23and behavioral health system, centered on behavioral health
24members, their families, and their communities.
25    (b) No later than 60 days after the Department receives
26federal approval of any waiver application it submitted to the

 

 

HB5403- 3 -LRB102 25973 KTG 35372 b

1federal Centers for Medicare and Medicaid Services to
2effectuate the purposes of this Article, the Department shall
3adopt rules to implement the approved waiver.
4    (c) Within 60 days after the effective date of this
5amendatory Act of the 102nd General Assembly, the Department
6must adopt rules to implement the Illinois Behavioral Health
7Transformation Section 1115 demonstration approved May 7, 2018
8by the federal Centers for Medicare and Medicaid Services.
9Upon expiration of the 60-day rulemaking period, licensed
10providers of behavioral health services, including providers
11and facilities that are operated by a county, municipality,
12township, or unit of local government, shall be eligible for
13reimbursement from the Department of Human Services for
14services that are a part of an approved treatment regimen and
15provided under the Illinois Behavioral Health Transformation
16Section 1115 demonstration. Eligibility for services provided
17under the Illinois Behavioral Health Transformation Section
181115 demonstration shall cover up to one year of treatment or
19until self-sufficiency can be demonstrated.
 
20    Section 99. Effective date. This Act takes effect upon
21becoming law.