Full Text of HB1365 94th General Assembly
HB1365 94TH GENERAL ASSEMBLY
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94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006 HB1365
Introduced 02/09/05, by Rep. Dave Winters SYNOPSIS AS INTRODUCED: |
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305 ILCS 5/5-4.2 |
from Ch. 23, par. 5-4.2 |
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Amends the Illinois Public Aid Code. In provisions concerning ambulance service payments under the Medicaid program, provides that for ambulance services provided to a Medicaid recipient on or after January 1, 2006, the Department of Public Aid shall reimburse providers of medical transportation services provided to a disabled person by means of a medi-car, regardless of whether the person has a physical disability or a mental or cognitive disability. Provides that the Department or its authorized prior approval agent shall determine that a person is disabled and eligible for transportation by means of a medi-car if a physician licensed to practice medicine in all its branches certifies to the Department in writing that the person has a physical disability or a mental or cognitive disability.
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| FISCAL NOTE ACT MAY APPLY | |
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A BILL FOR
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HB1365 |
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LRB094 05553 DRJ 35602 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by | 5 |
| changing Section 5-4.2 as follows:
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| (305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)
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| Sec. 5-4.2. Ambulance services payments. For
ambulance
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| services provided to a recipient of aid under this Article on | 9 |
| or after
January 1, 1993, the Illinois Department shall | 10 |
| reimburse ambulance service
providers at rates calculated in | 11 |
| accordance with this Section. It is the intent
of the General | 12 |
| Assembly to provide adequate reimbursement for ambulance
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| services so as to ensure adequate access to services for | 14 |
| recipients of aid
under this Article and to provide appropriate | 15 |
| incentives to ambulance service
providers to provide services | 16 |
| in an efficient and cost-effective manner. Thus,
it is the | 17 |
| intent of the General Assembly that the Illinois Department | 18 |
| implement
a reimbursement system for ambulance services that, | 19 |
| to the extent practicable
and subject to the availability of | 20 |
| funds appropriated by the General Assembly
for this purpose, is | 21 |
| consistent with the payment principles of Medicare. To
ensure | 22 |
| uniformity between the payment principles of Medicare and | 23 |
| Medicaid, the
Illinois Department shall follow, to the extent | 24 |
| necessary and practicable and
subject to the availability of | 25 |
| funds appropriated by the General Assembly for
this purpose, | 26 |
| the statutes, laws, regulations, policies, procedures,
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| principles, definitions, guidelines, and manuals used to | 28 |
| determine the amounts
paid to ambulance service providers under | 29 |
| Title XVIII of the Social Security
Act (Medicare).
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| For ambulance services provided to a recipient of aid under | 31 |
| this Article
on or after January 1, 1996, the Illinois | 32 |
| Department shall reimburse ambulance
service providers based |
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HB1365 |
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LRB094 05553 DRJ 35602 b |
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| upon the actual distance traveled if a natural
disaster, | 2 |
| weather conditions, road repairs, or traffic congestion | 3 |
| necessitates
the use of a
route other than the most direct | 4 |
| route.
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| Notwithstanding any other provision of this Section, for | 6 |
| ambulance services provided to a recipient of aid under this | 7 |
| Article
on or after January 1, 2006, the Department of Public | 8 |
| Aid shall reimburse providers of medical transportation | 9 |
| services provided to a disabled person by means of a medi-car, | 10 |
| regardless of whether the person has a physical disability or a | 11 |
| mental or cognitive disability. For purposes of this paragraph, | 12 |
| the Department or its authorized prior approval agent shall | 13 |
| determine that a person is disabled and eligible for | 14 |
| transportation by means of a medi-car if a physician licensed | 15 |
| to practice medicine in all its branches certifies to the | 16 |
| Department in writing that the person has a physical disability | 17 |
| or a mental or cognitive disability.
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| For purposes of this Section, "ambulance services" | 19 |
| includes medical
transportation services provided by means of | 20 |
| an ambulance, medi-car, service
car, or
taxi.
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| This Section does not prohibit separate billing by | 22 |
| ambulance service
providers for oxygen furnished while | 23 |
| providing advanced life support
services.
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| (Source: P.A. 88-104; 89-43, eff. 1-1-96.)
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