HB2802 Summary

• Amends the Illinois Public Aid Code to modify medical services covered under the state's medical assistance program, including inpatient/outpatient hospital services, physician services, dental services, prescribed drugs, and other diagnostic and preventive services.

• Requires the Department of Healthcare and Family Services to provide coverage for amino acid-based elemental formulas for treating eosinophilic disorders and short bowel syndrome when medically necessary as prescribed by a physician.

• Authorizes low-dose mammography screening for women age 35 and older eligible for medical assistance, including baseline mammograms for ages 35-39 and annual mammograms for age 40 and older, with ultrasound screening available when mammograms show dense breast tissue.

• Establishes procedures for nursing home prescreening, including increasing determination of need (DON) scores from 29 to 37 for long-term care applicants effective July 1, 2012, and requiring long-term care providers to have access to eligibility scores for individuals seeking or receiving services by October 1, 2013.

• Implements vendor enrollment oversight measures including provisional enrollment periods, enhanced screening and background checks, and establishes a 180-day deadline for medical providers to submit claims for payment under the medical assistance program.