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IL HB2814
Bill
Status
2/14/2019
Primary Sponsor
Camille Lilly
Click for details
AI Summary
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Requires MCOs to pay any contracted provider for medically necessary services rendered on the date of service, regardless of whether the provider appears on the MCO's published roster of available providers.
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Mandates MCOs update provider rosters within 7 days of entering into a contract and ensure rosters are readily accessible to all medical assistance enrollees for provider selection.
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Changes MCO expedited payment requirements from discretionary to mandatory, with minimum standards including paying expedited providers on schedules at least as frequent as the Department's fee-for-service expedited provider schedule.
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Establishes that hospitals must receive placement of discharged patients in alternative facilities within 24 hours of notification, or the MCO must pay the hospital's daily inpatient rate plus applicable add-ons.
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Provides 90 business days correction period for providers to resubmit non-electronic format claims after rejection notification, with prohibition on payment denial for failure to meet timely submission requirements unless claim submitted after 180 days from latest service date.
Legislative Description
MEDICAID-MANAGED CARE PAYMENTS
Last Action
Added Co-Sponsor Rep. Karina Villa
3/29/2019