SB3522 103RD GENERAL ASSEMBLY

LRB103 38878 KTG 69015 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3522

Introduced 2/9/2024, by Sen. Karina Villa

SYNOPSIS AS INTRODUCED:

5 ILCS 100/5-45.55 new
305 ILCS 5/5-5.05h new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning on January 1, 2025, rates for psychiatric evaluations performed by community mental health centers and substance use disorder treatment providers and practitioners as set forth on the Department of Healthcare and Family Services' Practitioner Fee Schedule shall be increased to $237.57. Provides that beginning on January 1, 2025, rates for medication monitoring performed by community mental health centers and substance use disorder treatment providers and practitioners as set forth on the Department's Practitioner Fee Schedule shall be increased to $140.77 per quarter hour. Provides that no existing or future reimbursement rates or add-ons shall be reduced or changed to address these rate increases. Provides that no later than October 1, 2024, the Department shall submit any necessary application to the federal Centers for Medicare and Medicaid Services for a waiver or State Plan amendment to implement the requirements of the amendatory Act. Provides that beginning in State Fiscal Year 2025, and every State fiscal year thereafter, reimbursement rates for those community-based mental health and substance use disorder services shall be adjusted upward by an amount equal to the Consumer Price Index-U from the previous year, not to exceed 5% in any State fiscal year. Effective immediately.

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. The Illinois Administrative Procedure Act is amended by adding Section 5-45.55 as follows:

(5 ILCS 100/5-45.55 new)

Sec. 5-45.55. Emergency rulemaking; reimbursement rates for psychiatric evaluations and medication monitoring. To provide for the expeditious and timely implementation of Section 5-5.05h of the Illinois Public Aid Code, emergency rules implementing Section 5-5.05h of the Illinois Public Aid Code may be adopted in accordance with Section 5-45 by the Department of Healthcare and Family Services. The adoption of emergency rules authorized by Section 5-45 and this Section is deemed to be necessary for the public interest, safety, and welfare.

This Section is repealed one year after the effective date of this amendatory Act of the 103rd General Assembly.

Section 5. The Illinois Public Aid Code is amended by adding Section 5-5.05h as follows:

(305 ILCS 5/5-5.05h new)

Sec. 5-5.05h. Reimbursement rates for psychiatric evaluations and medication monitoring.

(a) Beginning on January 1, 2025, rates for psychiatric evaluations performed by community mental health centers and substance use disorder treatment providers and practitioners as set forth on the Department's Practitioner Fee Schedule shall be increased to $237.57. Beginning on January 1, 2025, rates for medication monitoring performed by community mental health centers and substance use disorder treatment providers and practitioners as set forth on the Department's Practitioner Fee Schedule shall be increased to $140.77 per quarter hour.

(b) No existing or future reimbursement rates or add-ons shall be reduced or changed to address the rate increases proposed under this Section. No later than October 1, 2024, the Department shall submit any necessary application to the federal Centers for Medicare and Medicaid Services for a waiver or State Plan amendment to implement the requirements of this Section. Beginning in State Fiscal Year 2025, and every State fiscal year thereafter, reimbursement rates for those community-based mental health and substance use disorder services shall be adjusted upward by an amount equal to the Consumer Price Index-U from the previous year, not to exceed 5% in any State fiscal year. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

(c) As used in this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

Section 99. Effective date. This Act takes effect upon becoming law.