IL HB1654

Requires the Department of Healthcare and Family Services to calculate and publicly post managed care organization (MCO) payout ratios at least annually, with a minimum 85% threshold; MCOs falling below 85% must refund the difference to the State

Mandates that beginning in calendar year 2020, the Department must use only paid claims data from MCOs when establishing managed care capitation rates, and prohibits reimbursing MCOs for health insurance fee costs

Establishes hospital inpatient add-on enhancement payments effective July 1, 2019: $172 per day for general acute care hospitals with Medicaid inpatient utilization rates of 47% or higher, $200 per day for qualifying children's hospitals with rates of 59% or higher, and $600 per day for critical access hospitals

Requires managed care organizations to pay the same inpatient high-volume add-on enhancements to hospitals as the Department pays for fee-for-service patients