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IL HB2814

Bill

Status

Introduced

2/14/2019

Primary Sponsor

Camille Lilly

Click for details

Origin

House of Representatives

101st General Assembly

AI Summary

  • 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.

  • 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.

  • 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.

  • 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.

  • 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

Committee Referrals

Rules3/29/2019
Medicaid3/6/2019
Human Services2/26/2019
Rules2/14/2019

Full Bill Text

No bill text available