HB5019ham002 95TH GENERAL ASSEMBLY

Rep. Esther Golar

Filed: 4/10/2008

09500HB5019ham002 LRB095 15142 RPM 49145 a

AMENDMENT TO HOUSE BILL 5019

AMENDMENT NO. ______. Amend House Bill 5019, AS AMENDED, by replacing everything after the enacting clause with the following:

"Section 5. The Children's Health Insurance Program Act is amended by adding Section 65 as follows:

(215 ILCS 106/65 new)

Sec. 65. Fee schedule. Beginning on January 1, 2009, reimbursement for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim for payment in accordance with Section 368a of the Illinois Insurance Code.

Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and the Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.

Section 10. The Covering ALL KIDS Health Insurance Act is amended by adding Section 52.5 as follows:

(215 ILCS 170/52.5 new)

Sec. 52.5. Fee schedule. Beginning on January 1, 2009, the physician fee schedule for the Covering ALL KIDS Insurance Program for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim for payment in accordance with Section 368a of the Illinois Insurance Code.

Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and the Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.

Section 15. The Illinois Public Aid Code is amended by adding Section 5-5.05 as follows:

(305 ILCS 5/5-5.05 new)

Sec. 5-5.05. Fee schedule. Notwithstanding any other provision of this Article, beginning on January 1, 2009, reimbursement for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim or payment in accordance with Section 368a of the Illinois Insurance Code.

Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and the Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.

Section 99. Effective date. This Act takes effect upon becoming law.".