Full Text of HB0489 96th General Assembly
HB0489eng 96TH GENERAL ASSEMBLY
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| AN ACT concerning deferred compensation.
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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 Pension Code is amended by changing | 5 |
| Section 24-102 and by adding Section 24-104.5 as follows:
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| (40 ILCS 5/24-102) (from Ch. 108 1/2, par. 24-102)
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| Sec. 24-102.
As used in this Article, "employee" means any | 8 |
| person,
including a person elected, appointed or under | 9 |
| contract, receiving
compensation from the State or a unit of | 10 |
| local government or school
district for personal services | 11 |
| rendered, including salaried persons. A health care provider | 12 |
| who elects to participate in the health care provider deferred | 13 |
| compensation plan established under Section 24-104.5 of this | 14 |
| Code shall, for purposes of that participation, be deemed an | 15 |
| "employee" as defined in this Section.
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| As used in this Article, "compensation" includes | 17 |
| compensation received
in a lump sum for accumulated unused | 18 |
| vacation, personal leave or sick leave.
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| In no event shall the total of the amount of deferred | 20 |
| compensation of an
employee set aside in relation to a | 21 |
| particular year under the Illinois
State Employees Deferred | 22 |
| Compensation Plan and the employee's
nondeferred compensation | 23 |
| for that year exceed the total annual salary or
compensation |
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| under the existing salary schedule or classification plan
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| applicable to such employee in such year; except that any | 3 |
| compensation
received in a lump sum for accumulated unused | 4 |
| vacation, personal leave or sick
leave shall not be included in | 5 |
| the calculation of such totals.
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| (Source: P.A. 84-878.)
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| (40 ILCS 5/24-104.5 new)
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| Sec. 24-104.5. Health care provider deferred compensation | 9 |
| plan. The State Board of Investment shall develop and establish | 10 |
| and the Department of Central Management Services shall | 11 |
| administer a deferred compensation plan for health care | 12 |
| providers under the same terms and conditions as the State | 13 |
| Employees Deferred Compensation Plan established under this | 14 |
| Article. | 15 |
| Moneys from this plan may not be commingled with moneys | 16 |
| from the State Employees Deferred Compensation Plan. | 17 |
| For the purposes of this Section, "health care provider" | 18 |
| means a dentist, physician, optometrist, pharmacist, or | 19 |
| podiatrist that participates and receives compensation as a | 20 |
| provider under the Illinois Public Aid Code, the Children's | 21 |
| Health Insurance Act, or the Covering ALL KIDS Health Insurance | 22 |
| Act.
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| Section 10. The Children's Health Insurance Program Act is | 24 |
| amended by adding Section 31 as follows: |
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| (215 ILCS 106/31 new)
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| Sec. 31. Health care provider deferred compensation plan. | 3 |
| Notwithstanding any other provision of law, a medical or health | 4 |
| care provider who participates under the Program may elect, in | 5 |
| lieu of receiving direct payment for goods or services provided | 6 |
| under the Program, to participate in the health care provider | 7 |
| deferred compensation plan adopted under Article 24 of the | 8 |
| Illinois Pension Code. A medical or health care provider who | 9 |
| elects to participate in the plan does not have a cause of | 10 |
| action against the State for any damages allegedly suffered by | 11 |
| the provider as a result of any delay by the State in crediting | 12 |
| the amount of any contribution to the provider's plan account. | 13 |
| Section 15. The Covering ALL KIDS Health Insurance Act is | 14 |
| amended by adding Section 41 as follows: | 15 |
| (215 ILCS 170/41 new)
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| Sec. 41. Health care provider deferred compensation plan. | 17 |
| Notwithstanding any other provision of law, a medical or health | 18 |
| care provider who participates under the Program may elect, in | 19 |
| lieu of receiving direct payment for goods or services provided | 20 |
| under the Program, to participate in the health care provider | 21 |
| deferred compensation plan adopted under Article 24 of the | 22 |
| Illinois Pension Code. A medical or health care provider who | 23 |
| elects to participate in the plan does not have a cause of |
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| action against the State for any damages allegedly suffered by | 2 |
| the provider as a result of any delay by the State in crediting | 3 |
| the amount of any contribution to the provider's plan account.
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| Section 20. The Illinois Public Aid Code is amended by | 5 |
| changing Section 5-5 as follows: | 6 |
| (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
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| Sec. 5-5. Medical services. The Illinois Department, by | 8 |
| rule, shall
determine the quantity and quality of and the rate | 9 |
| of reimbursement for the
medical assistance for which
payment | 10 |
| will be authorized, and the medical services to be provided,
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| which may include all or part of the following: (1) inpatient | 12 |
| hospital
services; (2) outpatient hospital services; (3) other | 13 |
| laboratory and
X-ray services; (4) skilled nursing home | 14 |
| services; (5) physicians'
services whether furnished in the | 15 |
| office, the patient's home, a
hospital, a skilled nursing home, | 16 |
| or elsewhere; (6) medical care, or any
other type of remedial | 17 |
| care furnished by licensed practitioners; (7)
home health care | 18 |
| services; (8) private duty nursing service; (9) clinic
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| services; (10) dental services, including prevention and | 20 |
| treatment of periodontal disease and dental caries disease for | 21 |
| pregnant women; (11) physical therapy and related
services; | 22 |
| (12) prescribed drugs, dentures, and prosthetic devices; and
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| eyeglasses prescribed by a physician skilled in the diseases of | 24 |
| the eye,
or by an optometrist, whichever the person may select; |
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| (13) other
diagnostic, screening, preventive, and | 2 |
| rehabilitative services; (14)
transportation and such other | 3 |
| expenses as may be necessary; (15) medical
treatment of sexual | 4 |
| assault survivors, as defined in
Section 1a of the Sexual | 5 |
| Assault Survivors Emergency Treatment Act, for
injuries | 6 |
| sustained as a result of the sexual assault, including
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| examinations and laboratory tests to discover evidence which | 8 |
| may be used in
criminal proceedings arising from the sexual | 9 |
| assault; (16) the
diagnosis and treatment of sickle cell | 10 |
| anemia; and (17)
any other medical care, and any other type of | 11 |
| remedial care recognized
under the laws of this State, but not | 12 |
| including abortions, or induced
miscarriages or premature | 13 |
| births, unless, in the opinion of a physician,
such procedures | 14 |
| are necessary for the preservation of the life of the
woman | 15 |
| seeking such treatment, or except an induced premature birth
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| intended to produce a live viable child and such procedure is | 17 |
| necessary
for the health of the mother or her unborn child. The | 18 |
| Illinois Department,
by rule, shall prohibit any physician from | 19 |
| providing medical assistance
to anyone eligible therefor under | 20 |
| this Code where such physician has been
found guilty of | 21 |
| performing an abortion procedure in a wilful and wanton
manner | 22 |
| upon a woman who was not pregnant at the time such abortion
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| procedure was performed. The term "any other type of remedial | 24 |
| care" shall
include nursing care and nursing home service for | 25 |
| persons who rely on
treatment by spiritual means alone through | 26 |
| prayer for healing.
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| Notwithstanding any other provision of this Section, a | 2 |
| comprehensive
tobacco use cessation program that includes | 3 |
| purchasing prescription drugs or
prescription medical devices | 4 |
| approved by the Food and Drug administration shall
be covered | 5 |
| under the medical assistance
program under this Article for | 6 |
| persons who are otherwise eligible for
assistance under this | 7 |
| Article.
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| Notwithstanding any other provision of this Code, the | 9 |
| Illinois
Department may not require, as a condition of payment | 10 |
| for any laboratory
test authorized under this Article, that a | 11 |
| physician's handwritten signature
appear on the laboratory | 12 |
| test order form. The Illinois Department may,
however, impose | 13 |
| other appropriate requirements regarding laboratory test
order | 14 |
| documentation.
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| The Department of Healthcare and Family Services shall | 16 |
| provide the following services to
persons
eligible for | 17 |
| assistance under this Article who are participating in
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| education, training or employment programs operated by the | 19 |
| Department of Human
Services as successor to the Department of | 20 |
| Public Aid:
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| (1) dental services, which shall include but not be | 22 |
| limited to
prosthodontics; and
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| (2) eyeglasses prescribed by a physician skilled in the | 24 |
| diseases of the
eye, or by an optometrist, whichever the | 25 |
| person may select.
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| The Illinois Department, by rule, may distinguish and |
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| classify the
medical services to be provided only in accordance | 2 |
| with the classes of
persons designated in Section 5-2.
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| The Department of Healthcare and Family Services must | 4 |
| provide coverage and reimbursement for amino acid-based | 5 |
| elemental formulas, regardless of delivery method, for the | 6 |
| diagnosis and treatment of (i) eosinophilic disorders and (ii) | 7 |
| short bowel syndrome when the prescribing physician has issued | 8 |
| a written order stating that the amino acid-based elemental | 9 |
| formula is medically necessary.
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| The Illinois Department shall authorize the provision of, | 11 |
| and shall
authorize payment for, screening by low-dose | 12 |
| mammography for the presence of
occult breast cancer for women | 13 |
| 35 years of age or older who are eligible
for medical | 14 |
| assistance under this Article, as follows: a baseline
mammogram | 15 |
| for women 35 to 39 years of age and an
annual mammogram for | 16 |
| women 40 years of age or older. All screenings
shall
include a | 17 |
| physical breast exam, instruction on self-examination and
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| information regarding the frequency of self-examination and | 19 |
| its value as a
preventative tool. As used in this Section, | 20 |
| "low-dose mammography" means
the x-ray examination of the | 21 |
| breast using equipment dedicated specifically
for mammography, | 22 |
| including the x-ray tube, filter, compression device,
image | 23 |
| receptor, and cassettes, with an average radiation exposure | 24 |
| delivery
of less than one rad mid-breast, with 2 views for each | 25 |
| breast.
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| Any medical or health care provider shall immediately |
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| recommend, to
any pregnant woman who is being provided prenatal | 2 |
| services and is suspected
of drug abuse or is addicted as | 3 |
| defined in the Alcoholism and Other Drug Abuse
and Dependency | 4 |
| Act, referral to a local substance abuse treatment provider
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| licensed by the Department of Human Services or to a licensed
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| hospital which provides substance abuse treatment services. | 7 |
| The Department of Healthcare and Family Services
shall assure | 8 |
| coverage for the cost of treatment of the drug abuse or
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| addiction for pregnant recipients in accordance with the | 10 |
| Illinois Medicaid
Program in conjunction with the Department of | 11 |
| Human Services.
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| All medical providers providing medical assistance to | 13 |
| pregnant women
under this Code shall receive information from | 14 |
| the Department on the
availability of services under the Drug | 15 |
| Free Families with a Future or any
comparable program providing | 16 |
| case management services for addicted women,
including | 17 |
| information on appropriate referrals for other social services
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| that may be needed by addicted women in addition to treatment | 19 |
| for addiction.
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| The Illinois Department, in cooperation with the | 21 |
| Departments of Human
Services (as successor to the Department | 22 |
| of Alcoholism and Substance
Abuse) and Public Health, through a | 23 |
| public awareness campaign, may
provide information concerning | 24 |
| treatment for alcoholism and drug abuse and
addiction, prenatal | 25 |
| health care, and other pertinent programs directed at
reducing | 26 |
| the number of drug-affected infants born to recipients of |
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| medical
assistance.
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| Neither the Department of Healthcare and Family Services | 3 |
| nor the Department of Human
Services shall sanction the | 4 |
| recipient solely on the basis of
her substance abuse.
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| The Illinois Department shall establish such regulations | 6 |
| governing
the dispensing of health services under this Article | 7 |
| as it shall deem
appropriate. The Department
should
seek the | 8 |
| advice of formal professional advisory committees appointed by
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| the Director of the Illinois Department for the purpose of | 10 |
| providing regular
advice on policy and administrative matters, | 11 |
| information dissemination and
educational activities for | 12 |
| medical and health care providers, and
consistency in | 13 |
| procedures to the Illinois Department.
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| Notwithstanding any other provision of law, a medical or | 15 |
| health care provider under the medical assistance program may | 16 |
| elect, in lieu of receiving direct payment for goods or | 17 |
| services provided under that program, to participate in the | 18 |
| health care provider deferred compensation plan adopted under | 19 |
| Article 24 of the Illinois Pension Code. A medical or health | 20 |
| care provider who elects to participate in the plan does not | 21 |
| have a cause of action against the State for any damages | 22 |
| allegedly suffered by the provider as a result of any delay by | 23 |
| the State in crediting the amount of any contribution to the | 24 |
| provider's plan account. | 25 |
| The Illinois Department may develop and contract with | 26 |
| Partnerships of
medical providers to arrange medical services |
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| for persons eligible under
Section 5-2 of this Code. | 2 |
| Implementation of this Section may be by
demonstration projects | 3 |
| in certain geographic areas. The Partnership shall
be | 4 |
| represented by a sponsor organization. The Department, by rule, | 5 |
| shall
develop qualifications for sponsors of Partnerships. | 6 |
| Nothing in this
Section shall be construed to require that the | 7 |
| sponsor organization be a
medical organization.
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| The sponsor must negotiate formal written contracts with | 9 |
| medical
providers for physician services, inpatient and | 10 |
| outpatient hospital care,
home health services, treatment for | 11 |
| alcoholism and substance abuse, and
other services determined | 12 |
| necessary by the Illinois Department by rule for
delivery by | 13 |
| Partnerships. Physician services must include prenatal and
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| obstetrical care. The Illinois Department shall reimburse | 15 |
| medical services
delivered by Partnership providers to clients | 16 |
| in target areas according to
provisions of this Article and the | 17 |
| Illinois Health Finance Reform Act,
except that:
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| (1) Physicians participating in a Partnership and | 19 |
| providing certain
services, which shall be determined by | 20 |
| the Illinois Department, to persons
in areas covered by the | 21 |
| Partnership may receive an additional surcharge
for such | 22 |
| services.
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| (2) The Department may elect to consider and negotiate | 24 |
| financial
incentives to encourage the development of | 25 |
| Partnerships and the efficient
delivery of medical care.
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| (3) Persons receiving medical services through |
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| Partnerships may receive
medical and case management | 2 |
| services above the level usually offered
through the | 3 |
| medical assistance program.
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| Medical providers shall be required to meet certain | 5 |
| qualifications to
participate in Partnerships to ensure the | 6 |
| delivery of high quality medical
services. These | 7 |
| qualifications shall be determined by rule of the Illinois
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| Department and may be higher than qualifications for | 9 |
| participation in the
medical assistance program. Partnership | 10 |
| sponsors may prescribe reasonable
additional qualifications | 11 |
| for participation by medical providers, only with
the prior | 12 |
| written approval of the Illinois Department.
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| Nothing in this Section shall limit the free choice of | 14 |
| practitioners,
hospitals, and other providers of medical | 15 |
| services by clients.
In order to ensure patient freedom of | 16 |
| choice, the Illinois Department shall
immediately promulgate | 17 |
| all rules and take all other necessary actions so that
provided | 18 |
| services may be accessed from therapeutically certified | 19 |
| optometrists
to the full extent of the Illinois Optometric | 20 |
| Practice Act of 1987 without
discriminating between service | 21 |
| providers.
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| The Department shall apply for a waiver from the United | 23 |
| States Health
Care Financing Administration to allow for the | 24 |
| implementation of
Partnerships under this Section.
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| The Illinois Department shall require health care | 26 |
| providers to maintain
records that document the medical care |
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| and services provided to recipients
of Medical Assistance under | 2 |
| this Article. The Illinois Department shall
require health care | 3 |
| providers to make available, when authorized by the
patient, in | 4 |
| writing, the medical records in a timely fashion to other
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| health care providers who are treating or serving persons | 6 |
| eligible for
Medical Assistance under this Article. All | 7 |
| dispensers of medical services
shall be required to maintain | 8 |
| and retain business and professional records
sufficient to | 9 |
| fully and accurately document the nature, scope, details and
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| receipt of the health care provided to persons eligible for | 11 |
| medical
assistance under this Code, in accordance with | 12 |
| regulations promulgated by
the Illinois Department. The rules | 13 |
| and regulations shall require that proof
of the receipt of | 14 |
| prescription drugs, dentures, prosthetic devices and
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| eyeglasses by eligible persons under this Section accompany | 16 |
| each claim
for reimbursement submitted by the dispenser of such | 17 |
| medical services.
No such claims for reimbursement shall be | 18 |
| approved for payment by the Illinois
Department without such | 19 |
| proof of receipt, unless the Illinois Department
shall have put | 20 |
| into effect and shall be operating a system of post-payment
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| audit and review which shall, on a sampling basis, be deemed | 22 |
| adequate by
the Illinois Department to assure that such drugs, | 23 |
| dentures, prosthetic
devices and eyeglasses for which payment | 24 |
| is being made are actually being
received by eligible | 25 |
| recipients. Within 90 days after the effective date of
this | 26 |
| amendatory Act of 1984, the Illinois Department shall establish |
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| a
current list of acquisition costs for all prosthetic devices | 2 |
| and any
other items recognized as medical equipment and | 3 |
| supplies reimbursable under
this Article and shall update such | 4 |
| list on a quarterly basis, except that
the acquisition costs of | 5 |
| all prescription drugs shall be updated no
less frequently than | 6 |
| every 30 days as required by Section 5-5.12.
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| The rules and regulations of the Illinois Department shall | 8 |
| require
that a written statement including the required opinion | 9 |
| of a physician
shall accompany any claim for reimbursement for | 10 |
| abortions, or induced
miscarriages or premature births. This | 11 |
| statement shall indicate what
procedures were used in providing | 12 |
| such medical services.
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| The Illinois Department shall require all dispensers of | 14 |
| medical
services, other than an individual practitioner or | 15 |
| group of practitioners,
desiring to participate in the Medical | 16 |
| Assistance program
established under this Article to disclose | 17 |
| all financial, beneficial,
ownership, equity, surety or other | 18 |
| interests in any and all firms,
corporations, partnerships, | 19 |
| associations, business enterprises, joint
ventures, agencies, | 20 |
| institutions or other legal entities providing any
form of | 21 |
| health care services in this State under this Article.
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| The Illinois Department may require that all dispensers of | 23 |
| medical
services desiring to participate in the medical | 24 |
| assistance program
established under this Article disclose, | 25 |
| under such terms and conditions as
the Illinois Department may | 26 |
| by rule establish, all inquiries from clients
and attorneys |
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| regarding medical bills paid by the Illinois Department, which
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| inquiries could indicate potential existence of claims or liens | 3 |
| for the
Illinois Department.
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| Enrollment of a vendor that provides non-emergency medical | 5 |
| transportation,
defined by the Department by rule,
shall be
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| conditional for 180 days. During that time, the Department of | 7 |
| Healthcare and Family Services may
terminate the vendor's | 8 |
| eligibility to participate in the medical assistance
program | 9 |
| without cause. That termination of eligibility is not subject | 10 |
| to the
Department's hearing process.
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| The Illinois Department shall establish policies, | 12 |
| procedures,
standards and criteria by rule for the acquisition, | 13 |
| repair and replacement
of orthotic and prosthetic devices and | 14 |
| durable medical equipment. Such
rules shall provide, but not be | 15 |
| limited to, the following services: (1)
immediate repair or | 16 |
| replacement of such devices by recipients without
medical | 17 |
| authorization; and (2) rental, lease, purchase or | 18 |
| lease-purchase of
durable medical equipment in a | 19 |
| cost-effective manner, taking into
consideration the | 20 |
| recipient's medical prognosis, the extent of the
recipient's | 21 |
| needs, and the requirements and costs for maintaining such
| 22 |
| equipment. Such rules shall enable a recipient to temporarily | 23 |
| acquire and
use alternative or substitute devices or equipment | 24 |
| pending repairs or
replacements of any device or equipment | 25 |
| previously authorized for such
recipient by the Department.
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| The Department shall execute, relative to the nursing home |
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| prescreening
project, written inter-agency agreements with the | 2 |
| Department of Human
Services and the Department on Aging, to | 3 |
| effect the following: (i) intake
procedures and common | 4 |
| eligibility criteria for those persons who are receiving
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| non-institutional services; and (ii) the establishment and | 6 |
| development of
non-institutional services in areas of the State | 7 |
| where they are not currently
available or are undeveloped.
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| The Illinois Department shall develop and operate, in | 9 |
| cooperation
with other State Departments and agencies and in | 10 |
| compliance with
applicable federal laws and regulations, | 11 |
| appropriate and effective
systems of health care evaluation and | 12 |
| programs for monitoring of
utilization of health care services | 13 |
| and facilities, as it affects
persons eligible for medical | 14 |
| assistance under this Code.
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| The Illinois Department shall report annually to the | 16 |
| General Assembly,
no later than the second Friday in April of | 17 |
| 1979 and each year
thereafter, in regard to:
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| (a) actual statistics and trends in utilization of | 19 |
| medical services by
public aid recipients;
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| (b) actual statistics and trends in the provision of | 21 |
| the various medical
services by medical vendors;
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| (c) current rate structures and proposed changes in | 23 |
| those rate structures
for the various medical vendors; and
| 24 |
| (d) efforts at utilization review and control by the | 25 |
| Illinois Department.
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| The period covered by each report shall be the 3 years |
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| ending on the June
30 prior to the report. The report shall | 2 |
| include suggested legislation
for consideration by the General | 3 |
| Assembly. The filing of one copy of the
report with the | 4 |
| Speaker, one copy with the Minority Leader and one copy
with | 5 |
| the Clerk of the House of Representatives, one copy with the | 6 |
| President,
one copy with the Minority Leader and one copy with | 7 |
| the Secretary of the
Senate, one copy with the Legislative | 8 |
| Research Unit, and such additional
copies
with the State | 9 |
| Government Report Distribution Center for the General
Assembly | 10 |
| as is required under paragraph (t) of Section 7 of the State
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| Library Act shall be deemed sufficient to comply with this | 12 |
| Section.
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| (Source: P.A. 95-331, eff. 8-21-07; 95-520, eff. 8-28-07.)
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| Section 99. Effective date. This Act takes effect January | 15 |
| 1, 2010.
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