Full Text of HB6213 99th General Assembly
HB6213enr 99TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning public aid.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-30.1 and by adding Section 5-30.3 as | 6 | | follows: | 7 | | (305 ILCS 5/5-30.1) | 8 | | Sec. 5-30.1. Managed care protections. | 9 | | (a) As used in this Section: | 10 | | "Managed care organization" or "MCO" means any entity which | 11 | | contracts with the Department to provide services where payment | 12 | | for medical services is made on a capitated basis. | 13 | | "Emergency services" include: | 14 | | (1) emergency services, as defined by Section 10 of the | 15 | | Managed Care Reform and Patient Rights Act; | 16 | | (2) emergency medical screening examinations, as | 17 | | defined by Section 10 of the Managed Care Reform and | 18 | | Patient Rights Act; | 19 | | (3) post-stabilization medical services, as defined by | 20 | | Section 10 of the Managed Care Reform and Patient Rights | 21 | | Act; and | 22 | | (4) emergency medical conditions, as defined by
| 23 | | Section 10 of the Managed Care Reform and Patient Rights
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| 1 | | Act. | 2 | | (b) As provided by Section 5-16.12, managed care | 3 | | organizations are subject to the provisions of the Managed Care | 4 | | Reform and Patient Rights Act. | 5 | | (c) An MCO shall pay any provider of emergency services | 6 | | that does not have in effect a contract with the contracted | 7 | | Medicaid MCO. The default rate of reimbursement shall be the | 8 | | rate paid under Illinois Medicaid fee-for-service program | 9 | | methodology, including all policy adjusters, including but not | 10 | | limited to Medicaid High Volume Adjustments, Medicaid | 11 | | Percentage Adjustments, Outpatient High Volume Adjustments, | 12 | | and all outlier add-on adjustments to the extent such | 13 | | adjustments are incorporated in the development of the | 14 | | applicable MCO capitated rates. | 15 | | (d) An MCO shall pay for all post-stabilization services as | 16 | | a covered service in any of the following situations: | 17 | | (1) the MCO authorized such services; | 18 | | (2) such services were administered to maintain the | 19 | | enrollee's stabilized condition within one hour after a | 20 | | request to the MCO for authorization of further | 21 | | post-stabilization services; | 22 | | (3) the MCO did not respond to a request to authorize | 23 | | such services within one hour; | 24 | | (4) the MCO could not be contacted; or | 25 | | (5) the MCO and the treating provider, if the treating | 26 | | provider is a non-affiliated provider, could not reach an |
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| 1 | | agreement concerning the enrollee's care and an affiliated | 2 | | provider was unavailable for a consultation, in which case | 3 | | the MCO
must pay for such services rendered by the treating | 4 | | non-affiliated provider until an affiliated provider was | 5 | | reached and either concurred with the treating | 6 | | non-affiliated provider's plan of care or assumed | 7 | | responsibility for the enrollee's care. Such payment shall | 8 | | be made at the default rate of reimbursement paid under | 9 | | Illinois Medicaid fee-for-service program methodology, | 10 | | including all policy adjusters, including but not limited | 11 | | to Medicaid High Volume Adjustments, Medicaid Percentage | 12 | | Adjustments, Outpatient High Volume Adjustments and all | 13 | | outlier add-on adjustments to the extent that such | 14 | | adjustments are incorporated in the development of the | 15 | | applicable MCO capitated rates. | 16 | | (e) The following requirements apply to MCOs in determining | 17 | | payment for all emergency services: | 18 | | (1) MCOs shall not impose any requirements for prior | 19 | | approval of emergency services. | 20 | | (2) The MCO shall cover emergency services provided to | 21 | | enrollees who are temporarily away from their residence and | 22 | | outside the contracting area to the extent that the | 23 | | enrollees would be entitled to the emergency services if | 24 | | they still were within the contracting area. | 25 | | (3) The MCO shall have no obligation to cover medical | 26 | | services provided on an emergency basis that are not |
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| 1 | | covered services under the contract. | 2 | | (4) The MCO shall not condition coverage for emergency | 3 | | services on the treating provider notifying the MCO of the | 4 | | enrollee's screening and treatment within 10 days after | 5 | | presentation for emergency services. | 6 | | (5) The determination of the attending emergency | 7 | | physician, or the provider actually treating the enrollee, | 8 | | of whether an enrollee is sufficiently stabilized for | 9 | | discharge or transfer to another facility, shall be binding | 10 | | on the MCO. The MCO shall cover emergency services for all | 11 | | enrollees whether the emergency services are provided by an | 12 | | affiliated or non-affiliated provider. | 13 | | (6) The MCO's financial responsibility for | 14 | | post-stabilization care services it has not pre-approved | 15 | | ends when: | 16 | | (A) a plan physician with privileges at the | 17 | | treating hospital assumes responsibility for the | 18 | | enrollee's care; | 19 | | (B) a plan physician assumes responsibility for | 20 | | the enrollee's care through transfer; | 21 | | (C) a contracting entity representative and the | 22 | | treating physician reach an agreement concerning the | 23 | | enrollee's care; or | 24 | | (D) the enrollee is discharged. | 25 | | (f) Network adequacy. | 26 | | (1) The Department shall: |
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| 1 | | (A) ensure that an adequate provider network is in | 2 | | place, taking into consideration health professional | 3 | | shortage areas and medically underserved areas; | 4 | | (B) publicly release an explanation of its process | 5 | | for analyzing network adequacy; | 6 | | (C) periodically ensure that an MCO continues to | 7 | | have an adequate network in place; and | 8 | | (D) require MCOs, including Medicaid Managed Care | 9 | | Entities as defined in Section 5-30.2, to meet provider | 10 | | directory requirements under Section 5-30.3. require | 11 | | MCOs to maintain an updated and public list of network | 12 | | providers. | 13 | | (g) Timely payment of claims. | 14 | | (1) The MCO shall pay a claim within 30 days of | 15 | | receiving a claim that contains all the essential | 16 | | information needed to adjudicate the claim. | 17 | | (2) The MCO shall notify the billing party of its | 18 | | inability to adjudicate a claim within 30 days of receiving | 19 | | that claim. | 20 | | (3) The MCO shall pay a penalty that is at least equal | 21 | | to the penalty imposed under the Illinois Insurance Code | 22 | | for any claims not timely paid. | 23 | | (4) The Department may establish a process for MCOs to | 24 | | expedite payments to providers based on criteria | 25 | | established by the Department. | 26 | | (h) The Department shall not expand mandatory MCO |
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| 1 | | enrollment into new counties beyond those counties already | 2 | | designated by the Department as of June 1, 2014 for the | 3 | | individuals whose eligibility for medical assistance is not the | 4 | | seniors or people with disabilities population until the | 5 | | Department provides an opportunity for accountable care | 6 | | entities and MCOs to participate in such newly designated | 7 | | counties. | 8 | | (i) The requirements of this Section apply to contracts | 9 | | with accountable care entities and MCOs entered into, amended, | 10 | | or renewed after the effective date of this amendatory Act of | 11 | | the 98th General Assembly.
| 12 | | (Source: P.A. 98-651, eff. 6-16-14.) | 13 | | (305 ILCS 5/5-30.3 new) | 14 | | Sec. 5-30.3. Empowering meaningful patient choice in | 15 | | Medicaid Managed Care. | 16 | | (a) Definitions. As used in this Section: | 17 | | "Client enrollment services broker" means a vendor the | 18 | | Department contracts with to carry out activities related to | 19 | | Medicaid recipients' enrollment, disenrollment, and renewal | 20 | | with Medicaid Managed Care Entities. | 21 | | "Composite domains" means the synthesized categories | 22 | | reflecting the standardized quality performance measures | 23 | | included in the consumer quality comparison tool. At a minimum, | 24 | | these composite domains shall display Medicaid Managed Care | 25 | | Entities' individual Plan performance on standardized quality, |
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| 1 | | timeliness, and access measures. | 2 | | "Consumer quality comparison tool" means an online and | 3 | | paper tool developed by the Department with input from | 4 | | interested stakeholders reflecting the performance of Medicaid | 5 | | Managed Care Entity Plans on standardized quality performance | 6 | | measures. This tool shall be designed in a consumer-friendly | 7 | | and easily understandable format. | 8 | | "Covered services" means those health care services to | 9 | | which a covered person is entitled to under the terms of the | 10 | | Medicaid Managed Care Entity Plan. | 11 | | "Facilities" includes, but is not limited to, federally | 12 | | qualified health centers, skilled nursing facilities, and | 13 | | rehabilitation centers. | 14 | | "Hospitals" includes, but is not limited to, acute care, | 15 | | rehabilitation, children's, and cancer hospitals. | 16 | | "Integrated provider directory" means a searchable | 17 | | database bringing together network data from multiple Medicaid | 18 | | Managed Care Entities that is available through client | 19 | | enrollment services. | 20 | | "Medicaid eligibility redetermination" means the process | 21 | | by which the eligibility of a Medicaid recipient is reviewed by | 22 | | the Department to determine if the recipient's medical benefits | 23 | | will continue, be modified, or terminated. | 24 | | "Medicaid Managed Care Entity" has the same meaning as | 25 | | defined in Section 5-30.2 of this Code. | 26 | | (b) Provider directory transparency. |
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| 1 | | (1) Each Medicaid Managed Care Entity shall: | 2 | | (A) Make available on the entity's website a | 3 | | provider directory in a machine readable file and | 4 | | format. | 5 | | (B) Make provider directories publicly accessible | 6 | | without the necessity of providing a password, a | 7 | | username, or personally identifiable information. | 8 | | (C) Comply with all federal and State statutes and | 9 | | regulations, including 42 CFR 438.10, pertaining to | 10 | | provider directories within Medicaid Managed Care. | 11 | | (D) Request, at least annually, provider office | 12 | | hours for each of the following provider types: | 13 | | (i) Health care professionals, including | 14 | | dental and vision providers. | 15 | | (ii) Hospitals. | 16 | | (iii) Facilities, other than hospitals. | 17 | | (iv) Pharmacies, other than hospitals. | 18 | | (v) Durable medical equipment suppliers, other | 19 | | than hospitals. | 20 | | Medicaid Managed Care Entities shall publish the | 21 | | provider office hours in the provider directory upon | 22 | | receipt. | 23 | | (E) Confirm with the Medicaid Managed Care | 24 | | Entity's contracted providers who have not submitted | 25 | | claims within the past 6 months that the contracted | 26 | | providers intend to remain in the network and correct |
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| 1 | | any incorrect provider directory information as | 2 | | necessary. | 3 | | (F) Ensure that in situations in which a Medicaid | 4 | | Managed Care Entity Plan enrollee receives covered | 5 | | services from a non-participating provider due to a | 6 | | material misrepresentation in a Medicaid Managed Care | 7 | | Entity's online electronic provider directory, the | 8 | | Medicaid Managed Care Entity Plan enrollee shall not be | 9 | | held responsible for any costs resulting from that | 10 | | material misrepresentation. | 11 | | (G) Conspicuously display an e-mail address and a | 12 | | toll-free telephone number to which any individual may | 13 | | report any inaccuracy in the provider directory. If the | 14 | | Medicaid Managed Care Entity receives a report from any | 15 | | person who specifically identifies provider directory | 16 | | information as inaccurate, the Medicaid Managed Care | 17 | | Entity shall investigate the report and correct any | 18 | | inaccurate information displayed in the electronic | 19 | | directory. | 20 | | (2) The Department shall: | 21 | | (A) Regularly monitor Medicaid Managed Care | 22 | | Entities to ensure that they are compliant with the | 23 | | requirements under paragraph (1) of subsection (b). | 24 | | (B) Require that the client enrollment services | 25 | | broker use the Medicaid provider number for all | 26 | | providers with a Medicaid Provider number to populate |
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| 1 | | the provider information in the integrated provider | 2 | | directory. | 3 | | (C) Ensure that each Medicaid Managed Care Entity | 4 | | shall, at minimum, make the information in | 5 | | subparagraph (D) of paragraph (1) of subsection (b) | 6 | | available to the client enrollment services broker. | 7 | | (D) Ensure that the client enrollment services | 8 | | broker shall, at minimum, have the information in | 9 | | subparagraph (D) of paragraph (1) of subsection (b) | 10 | | available and searchable through the integrated | 11 | | provider directory on its website as soon as possible | 12 | | but no later than January 1, 2017. | 13 | | (E) Require the client enrollment services broker | 14 | | to conspicuously display near the integrated provider | 15 | | directory an email address and a toll-free telephone | 16 | | number provided by the Department to which any | 17 | | individual may report inaccuracies in the integrated | 18 | | provider directory. If the Department receives a | 19 | | report that identifies an inaccuracy in the integrated | 20 | | provider directory, the Department shall provide the | 21 | | information about the reported inaccuracy to the | 22 | | appropriate Medicaid Managed Care Entity within 3 | 23 | | business days after the reported inaccuracy is | 24 | | received. | 25 | | (c) Formulary transparency. | 26 | | (1) Medicaid Managed Care Entities shall publish on |
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| 1 | | their respective websites a formulary for each Medicaid | 2 | | Managed Care Entity Plan offered and make the formularies | 3 | | easily understandable and publicly accessible without the | 4 | | necessity of providing a password, a username, or | 5 | | personally identifiable information. | 6 | | (2) Medicaid Managed Care Entities shall provide | 7 | | printed formularies upon request. | 8 | | (3) Electronic and print formularies shall display: | 9 | | (A) the medications covered (both generic and name | 10 | | brand); | 11 | | (B) if the medication is preferred or not | 12 | | preferred, and what each term means; | 13 | | (C) what tier each medication is in and the meaning | 14 | | of each tier; | 15 | | (D) any utilization controls including, but not | 16 | | limited to, step therapy, prior approval, dosage | 17 | | limits, gender or age restrictions, quantity limits, | 18 | | or other policies that affect access to medications; | 19 | | (E) any required cost-sharing; | 20 | | (F) a glossary of key terms and explanation of | 21 | | utilization controls and cost-sharing requirements; | 22 | | (G) a key or legend for all utilization controls | 23 | | visible on every page in which specific medication | 24 | | coverage information is displayed; and | 25 | | (H) directions explaining the process or processes | 26 | | a consumer may follow to obtain more information if a |
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| 1 | | medication the consumer requires is not covered or | 2 | | listed in the formulary. | 3 | | (4) Each Medicaid Managed Care Entity shall display | 4 | | conspicuously with each electronic and printed medication | 5 | | formulary an e-mail address and a toll-free telephone | 6 | | number to which any individual may report any inaccuracy in | 7 | | the formulary. If the Medicaid Managed Care Entity receives | 8 | | a report that the formulary information is inaccurate, the | 9 | | Medicaid Managed Care Entity shall investigate the report | 10 | | and correct any inaccurate information displayed in the | 11 | | electronic formulary. | 12 | | (5) Each Medicaid Managed Care Entity shall include a | 13 | | disclosure in the electronic and requested print | 14 | | formularies that provides the date of publication, a | 15 | | statement that the formulary is up to date as of | 16 | | publication, and contact information for questions and | 17 | | requests to receive updated information. | 18 | | (6) The client enrollment services broker's website | 19 | | shall display prominently a website URL link to each | 20 | | Medicaid Managed Care Entity's Plan formulary. If a | 21 | | Medicaid enrollee calls the client enrollment services | 22 | | broker with questions regarding formularies, the client | 23 | | enrollment services broker shall offer a brief description | 24 | | of what a formulary is and shall refer the Medicaid | 25 | | enrollee to the appropriate Medicaid Managed Care Entity | 26 | | regarding his or her questions about a specific entity's |
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| 1 | | formulary. | 2 | | (d) Grievances and appeals. The Department shall display | 3 | | prominently on its website consumer-oriented information | 4 | | describing how a Medicaid enrollee can file a complaint or | 5 | | grievance, request a fair hearing for any adverse action taken | 6 | | by the Department or a Medicaid Managed Care Entity, and access | 7 | | free legal assistance or other assistance made available by the | 8 | | State for Medicaid enrollees to pursue an action. | 9 | | (e) Medicaid redetermination information.
The Department | 10 | | shall require the client enrollment services broker to display | 11 | | prominently on the client enrollment services broker's website | 12 | | a description of where a Medicaid enrollee can access | 13 | | information regarding the Medicaid redetermination process. | 14 | | (f) Medicaid care coordination information. The client | 15 | | enrollment services broker shall display prominently on its | 16 | | website, in an easily understandable format, consumer-oriented | 17 | | information regarding the role of care coordination services | 18 | | within Medicaid Managed Care. Such information shall include, | 19 | | but shall not be limited to: | 20 | | (1) a basic description of the role of care | 21 | | coordination services and examples of specific care | 22 | | coordination activities; and | 23 | | (2) how a Medicaid enrollee may request care | 24 | | coordination services from a Medicaid Managed Care Entity. | 25 | | (g) Consumer quality comparison tool. | 26 | | (1) The Department shall create a consumer quality |
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| 1 | | comparison tool to assist Medicaid enrollees with Medicaid | 2 | | Managed Care Entity Plan selection. This tool shall provide | 3 | | Medicaid Managed Care Entities' individual Plan | 4 | | performance on a set of standardized quality performance | 5 | | measures. The Department shall ensure that this tool shall | 6 | | be accessible in both a print and online format, with the | 7 | | online format allowing for individuals to access | 8 | | additional detailed Plan performance information. | 9 | | (2) At a minimum, a printed version of the consumer | 10 | | quality comparison tool shall be provided by the Department | 11 | | on an annual basis to Medicaid enrollees who are required | 12 | | by the Department to enroll in a Medicaid Managed Care | 13 | | Entity Plan during an enrollee's open enrollment period. | 14 | | The consumer quality comparison tool shall also meet all of | 15 | | the following criteria: | 16 | | (A) Display Medicaid Managed Care Entities' | 17 | | individual Plan performance on at least 4 composite | 18 | | domains that reflect Plan quality, timeliness, and | 19 | | access. The composite domains shall draw from the most | 20 | | current available performance data sets including, but | 21 | | not limited to: | 22 | | (i) Healthcare Effectiveness Data and | 23 | | Information Set (HEDIS) measures. | 24 | | (ii) Core Set of Children's Health Care | 25 | | Quality measures as required under the Children's | 26 | | Health Insurance Program Reauthorization Act |
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| 1 | | (CHIPRA). | 2 | | (iii) Adult Core Set measures. | 3 | | (iv) Consumer Assessment of Healthcare | 4 | | Providers and Systems (CAHPS) survey results. | 5 | | (v) Additional performance measures the | 6 | | Department deems appropriate to populate the | 7 | | composite domains. | 8 | | (B) Use a quality rating system developed by the | 9 | | Department to reflect Medicaid Managed Care Entities' | 10 | | individual Plan performance. The quality rating system | 11 | | for each composite domain shall reflect the Medicaid | 12 | | Managed Care Entities' individual Plan performance | 13 | | and, when possible, plan performance relative to | 14 | | national Medicaid percentiles. | 15 | | (C) Be customized to reflect the specific Medicaid | 16 | | Managed Care Entities' Plans available to the Medicaid | 17 | | enrollee based on his or her geographic location and | 18 | | Medicaid eligibility category. | 19 | | (D) Include contact information for the client | 20 | | enrollment services broker and contact information for | 21 | | Medicaid Managed Care Entities available to the | 22 | | Medicaid enrollee based on his or her geographic | 23 | | location and Medicaid eligibility category. | 24 | | (E) Include guiding questions designed to assist | 25 | | individuals selecting a Medicaid Managed Care Entity | 26 | | Plan. |
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| 1 | | (3) At a minimum, the online version of the consumer | 2 | | quality comparison tool shall meet all of the following | 3 | | criteria: | 4 | | (A) Display Medicaid Managed Care Entities' | 5 | | individual Plan performance for the same composite | 6 | | domains selected by the Department in the printed | 7 | | version of the consumer quality comparison tool. The | 8 | | Department may display additional composite domains in | 9 | | the online version of the consumer quality comparison | 10 | | tool as appropriate. | 11 | | (B) Display Medicaid Managed Care Entities' | 12 | | individual Plan performance on each of the | 13 | | standardized performance measures that contribute to | 14 | | each composite domain displayed on the online version | 15 | | of the consumer quality comparison tool. | 16 | | (C) Use a quality rating system developed by the | 17 | | Department to reflect Medicaid Managed Care Entities' | 18 | | individual Plan performance. The quality rating system | 19 | | for each composite domain shall reflect the Medicaid | 20 | | Managed Care Entities' individual Plan performance | 21 | | and, when possible, plan performance relative to | 22 | | national Medicaid percentiles. | 23 | | (D) Include the specific Medicaid Managed Care | 24 | | Entity Plans available to the Medicaid enrollee based | 25 | | on his or her geographic location and Medicaid | 26 | | eligibility category. |
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| 1 | | (E) Include a sort function to view Medicaid | 2 | | Managed Care Entities' individual Plan performance by | 3 | | quality rating and by standardized quality performance | 4 | | measures. | 5 | | (F) Include contact information for the client | 6 | | enrollment services broker and for each Medicaid | 7 | | Managed Care Entity. | 8 | | (G) Include guiding questions designed to assist | 9 | | individuals in selecting a Medicaid Managed Care | 10 | | Entity Plan. | 11 | | (H) Prominently display current notice of quality | 12 | | performance sanctions against Medicaid Managed Care | 13 | | Entities. Notice of the sanctions shall remain present | 14 | | on the online version of the consumer quality | 15 | | comparison tool until the sanctions are lifted. | 16 | | (4) The online version of the consumer quality | 17 | | comparison tool shall be displayed prominently on the | 18 | | client enrollment services broker's website. | 19 | | (5) In the development of the consumer quality | 20 | | comparison tool, the Department shall establish and | 21 | | publicize a formal process to collect and consider written | 22 | | and oral feedback from consumers, advocates, and | 23 | | stakeholders on aspects of the consumer quality comparison | 24 | | tool, including, but not limited to, the following: | 25 | | (A) The standardized data sets and surveys, | 26 | | specific performance measures, and composite domains |
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| 1 | | represented in the consumer quality comparison tool. | 2 | | (B) The format and presentation of the consumer | 3 | | quality comparison tool. | 4 | | (C) The methods undertaken by the Department to | 5 | | notify Medicaid enrollees of the availability of the | 6 | | consumer quality comparison tool. | 7 | | (6) The Department shall review and update as | 8 | | appropriate the composite domains and performance measures | 9 | | represented in the print and online versions of the | 10 | | consumer quality comparison tool at least once every 3 | 11 | | years. During the Department's review process, the | 12 | | Department shall solicit engagement in the public feedback | 13 | | process described in paragraph (5). | 14 | | (7) The Department shall ensure that the consumer | 15 | | quality comparison tool is available for consumer use as | 16 | | soon as possible but no later than January 1, 2018. | 17 | | (h)
The Department may adopt rules and take any other | 18 | | appropriate action necessary to implement its responsibilities | 19 | | under this Section.
| 20 | | Section 99. Effective date. This Act takes effect upon | 21 | | becoming law. |
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