IL HB5013

Amends the Birth Center Licensing Act to add "licensed certified professional midwife" as a defined term and allows them to serve as clinical directors and attend births at licensed birth centers alongside physicians and certified nurse midwives.

Expands the definition of "preventive prenatal and perinatal health care services" under the Illinois Public Aid Code to explicitly include diagnostic labs, imaging, RhoGAM injections, 17P injections, inpatient and outpatient labor and delivery services, and services related to pregnancy and the 12 months following childbirth or fetal loss.

Requires managed care organizations to reimburse non-affiliated providers for preventive prenatal, perinatal, and postpartum services at the Illinois Medicaid fee-for-service rate, including all applicable policy adjusters, unless a different rate was agreed upon.

Exempts MCOs from the reimbursement requirement for non-affiliated providers in limited circumstances, including when a perinatal hospital rejected a good faith contract offer or when the MCO terminated a provider for specified causes (discharge planning failures, fraud, waste, abuse, or ethics violations).