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IL SB1733
Bill
AI Summary
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Creates the Complex Needs Patient Act to establish separate recognition within Illinois Medicaid for individually configured complex rehabilitation technology (CRT) products and services for patients with significant physical or functional needs.
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Defines "complex needs patients" as individuals with diagnoses or conditions resulting in significant physical or functional needs, including spinal cord injury, traumatic brain injury, cerebral palsy, muscular dystrophy, and multiple sclerosis.
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Requires the Department of Healthcare and Family Services to establish supplier standards, create new billing codes, and develop pricing policies maintaining reimbursement at no less than 100% of Medicare fee schedule minus 6%, or Manufacturer's Suggested Retail Price minus 10% for non-Medicare items.
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Mandates that complex needs patients receiving CRT be evaluated by both a qualified health care professional (physical therapist, occupational therapist, etc.) and a qualified complex rehabilitation technology professional certified as an Assistive Technology Professional (ATP).
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Exempts complex rehabilitation technology billing codes from competitive bidding programs and modifies prior approval requirements for wheelchair repairs, with expedited approval for repairs involving batteries or those making wheelchairs inoperable.
Legislative Description
COMPLEX NEEDS PATIENT ACT
Last Action
Session Sine Die
1/13/2015