IL HB2944

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

Non-emergency ambulance service providers must submit documentation of prior claims no later than 150 days after the effective date, and MCOs must pay all NETSPAP-approved claims within 30 days.

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

Costs incurred by NETSPAP contractors for claim review shall be the sole responsibility of the MCO, and denials of reimbursement may be appealed through the established process.

The Act takes effect immediately upon becoming law.