SB1724 Summary

• MCOs must participate in the Non-Emergency Transportation Services Prior Approval Program (NETSPAP) beginning 90 days after enactment and submit all unpaid non-emergency transportation claims since January 1, 2012 for adjudication without regard to filing deadlines.

• Non-emergency ambulance service providers have 150 days after enactment to submit documentation for prior claims, and MCOs must pay all NETSPAP-approved claims within 30 days without further provider action.

• MCOs must not unreasonably refuse to contract with ground ambulance and medi-car service providers, must not unreasonably restrict access to these services, and must ensure Medicaid recipients are not liable for these expenses consistent with federal law and Illinois Insurance Code provisions.

• Costs for NETSPAP claim review are the sole responsibility of the MCO, and any claim denials may be appealed through the process established in Section 5-4.2.

• The Act takes effect immediately upon becoming law.