IL SB0637

Amends the Illinois Public Aid Code to add Section 5-36 establishing coverage requirements for custom prosthetic and orthotic devices under Medicaid fee-for-service and managed care plans.

Requires coverage terms for custom prosthetic and orthotic devices to be no less favorable than terms applied to substantially all other medical and surgical benefits.

Sets the reimbursement rate for custom prosthetic and orthotic devices in the fee-for-service program at no less than the Medicare rate for the year minus 6%.

Mandates that all Medicaid managed care plans comply with network adequacy requirements for custom prosthetic and orthotic device services.

Requires the Department and managed care organizations to comply with the Orthotics, Prosthetics, and Pedorthics Practice Act when making payments for these devices.