Sen. Antonio Muņoz
Filed: 3/26/2019
 
 

 

 

 
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1
AMENDMENT TO SENATE BILL 1575




2    AMENDMENT NO. ______. Amend Senate Bill 1575 by replacing 
3everything after the enacting clause with the following:

 
 
4    "Section 5. The Illinois Public Aid Code is amended  by 
5adding Section 5-36 as follows:
 
6    (305 ILCS 5/5-36 new)
7    Sec. 5-36. Custom prosthetic and orthotic devices.
8    (a) Coverage for custom prosthetic and orthotic devices 
9under the fee-for-service medical assistance program and under 
10any Medicaid managed care plan shall be no less favorable than 
11the terms and conditions that apply to substantially all 
12medical and surgical benefits provided under the 
13fee-for-service medical assistance program or the Medicaid 
14managed care plan. 
15    (b) The Department shall set a rate of reimbursement under 
16the fee-for-service medical assistance program for custom 
 
 
10100SB1575sam002- 2 -LRB101 09293 KTG 58435 a

1prosthetic and orthotic devices at a rate no less than the 
2Medicare rate for the year minus 6%. 
3    (c) Notwithstanding any other law or any other contract 
4terms and conditions, nothing in this Section shall be 
5construed to allow the Department or its contracted managed 
6care organizations to enter into sole source contracts for the 
7provision of custom prosthetic or orthotic devices to 
8recipients of medical assistance or Medicaid managed care 
9enrollees.
10    (d) The Department and contracted managed care 
11organizations must comply with the Orthotics, Prosthetics, and 
12Pedorthics Practice Act when making payments for custom 
13orthotic and custom prosthetic devices.".