HB5909 Summary

• Amends care coordination requirements in the Children's Health Insurance Program Act, Covering ALL KIDS Health Insurance Act, and Illinois Public Aid Code to move the enrollment deadline from January 1, 2015 to January 1, 2014.

• Requires at least 50% of recipients eligible for comprehensive medical benefits across all state medical assistance programs to be enrolled in care coordination programs using integrated delivery systems.

• Defines care coordination to include integrated delivery systems responsible for primary care, referrals, diagnostic and treatment services, behavioral health, hospital services, dental services, and rehabilitation/long-term care.

• Requires payment based on performance metrics including health care outcomes, evidence-based practices, comprehensive medical homes, electronic medical records, and either capitated or other risk-based payment arrangements.

• Mandates the Department report to the General Assembly annually from April 2012 through April 2016 on care coordination implementation progress and federal payment limitation issues affecting coordinated care expansion.