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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Dental Practice Act is amended by | ||||||||||||||||||||||||||
5 | changing Section 18 as follows:
| ||||||||||||||||||||||||||
6 | (225 ILCS 25/18)
(from Ch. 111, par. 2318)
| ||||||||||||||||||||||||||
7 | (Section scheduled to be repealed on January 1, 2016)
| ||||||||||||||||||||||||||
8 | Sec. 18. Acts constituting the practice of dental hygiene;
| ||||||||||||||||||||||||||
9 | limitations. | ||||||||||||||||||||||||||
10 | (a) A person practices dental hygiene within the meaning of | ||||||||||||||||||||||||||
11 | this Act when
he or she performs the following acts under the | ||||||||||||||||||||||||||
12 | supervision of a dentist:
| ||||||||||||||||||||||||||
13 | (i) the operative procedure of dental hygiene, | ||||||||||||||||||||||||||
14 | consisting of oral
prophylactic procedures;
| ||||||||||||||||||||||||||
15 | (ii) the exposure and processing of X-Ray films of | ||||||||||||||||||||||||||
16 | the teeth and
surrounding structures;
| ||||||||||||||||||||||||||
17 | (iii) the application to the surfaces of the teeth | ||||||||||||||||||||||||||
18 | or gums of chemical
compounds designed to be | ||||||||||||||||||||||||||
19 | desensitizing agents or effective agents in the
| ||||||||||||||||||||||||||
20 | prevention of dental caries or periodontal disease;
| ||||||||||||||||||||||||||
21 | (iv) all services which may be performed by a
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22 | dental assistant as specified by rule pursuant to | ||||||||||||||||||||||||||
23 | Section 17;
|
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| |||||||
1 | (v) administration and monitoring of nitrous oxide | ||||||
2 | upon successful
completion of a
training program | ||||||
3 | approved by the Department;
| ||||||
4 | (vi) administration of local anesthetics upon | ||||||
5 | successful completion of
a
training program approved | ||||||
6 | by the Department; and
| ||||||
7 | (vii) such other procedures and acts as shall be | ||||||
8 | prescribed
by
rule or regulation of the Department.
| ||||||
9 | (b) A dental hygienist may be employed or engaged only:
| ||||||
10 | (1) by a dentist;
| ||||||
11 | (2) by a federal, State, county, or municipal agency or | ||||||
12 | institution;
| ||||||
13 | (3) by a public or private school; or
| ||||||
14 | (4) by a public clinic operating under the direction of | ||||||
15 | a hospital or
federal,
State, county, municipal, or other | ||||||
16 | public agency or institution.
| ||||||
17 | (c) When employed or engaged in the office of a dentist, a | ||||||
18 | dental hygienist
may
perform, under general supervision, those | ||||||
19 | procedures found in items (i) through
(iv) of
subsection (a) of | ||||||
20 | this Section, provided the patient has been examined by the
| ||||||
21 | dentist
within one year of the provision of dental hygiene | ||||||
22 | services, the dentist has
approved the
dental hygiene services | ||||||
23 | by a notation in the patient's record and the patient
has been
| ||||||
24 | notified that the dentist may be out of the office during the | ||||||
25 | provision of
dental hygiene
services.
| ||||||
26 | (d) If a patient of record is unable to travel to a dental |
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| |||||||
1 | office because of
illness,
infirmity, or
imprisonment, a dental | ||||||
2 | hygienist may perform, under the general supervision of
a | ||||||
3 | dentist,
those procedures found in items (i) through (iv) of | ||||||
4 | subsection (a) of this
Section,
provided the patient is located | ||||||
5 | in a long-term care facility licensed by the
State of Illinois,
| ||||||
6 | a mental health or developmental disability facility, or a | ||||||
7 | State or federal
prison. The dentist
shall personally examine | ||||||
8 | and diagnose the patient and determine which
services are | ||||||
9 | necessary to be performed, which shall be contained in an order | ||||||
10 | to the hygienist and a notation in the patient's record.
Such | ||||||
11 | order must be implemented within 120 days
of its issuance, and | ||||||
12 | an updated medical history and observation of oral
conditions
| ||||||
13 | must be performed by the hygienist immediately prior to | ||||||
14 | beginning the
procedures to ensure that the patient's health | ||||||
15 | has not changed in any
manner to warrant a reexamination by the | ||||||
16 | dentist.
| ||||||
17 | (e) School-based oral health care,
consisting of and | ||||||
18 | limited to oral prophylactic
procedures, sealants, and | ||||||
19 | fluoride treatments,
may be provided by a dental hygienist
| ||||||
20 | under the general supervision of a dentist. A dental hygienist | ||||||
21 | may not provide
other dental hygiene treatment in a | ||||||
22 | school-based setting, including but not
limited to | ||||||
23 | administration or monitoring of nitrous oxide or | ||||||
24 | administration of
local anesthetics. The school-based | ||||||
25 | procedures may be performed provided the
patient is located at | ||||||
26 | a public or private school and the program is being
conducted |
| |||||||
| |||||||
1 | by a State, county or local public health department initiative | ||||||
2 | or in
conjunction with a dental school or dental hygiene | ||||||
3 | program.
The dentist shall personally examine and diagnose the | ||||||
4 | patient and
determine
which services are necessary to be | ||||||
5 | performed, which shall be contained in an
order to the
| ||||||
6 | hygienist and a notation in the patient's record. Any such | ||||||
7 | order for sealants must be implemented within 120 days after | ||||||
8 | its issuance. Any such order for oral prophylactic procedures | ||||||
9 | or fluoride treatments must be implemented within 180 days | ||||||
10 | after its issuance. An updated medical history and observation | ||||||
11 | of
oral conditions
must be
performed by the hygienist | ||||||
12 | immediately prior to beginning the procedures to
ensure that
| ||||||
13 | the patient's health has not changed in any manner to warrant a | ||||||
14 | reexamination
by the
dentist.
| ||||||
15 | (f) Without the supervision of a dentist, a dental | ||||||
16 | hygienist
may (i) perform
dental health education functions , | ||||||
17 | (ii)
and may record case histories and oral
conditions | ||||||
18 | observed , and (iii) provide fluoride treatments and teeth | ||||||
19 | cleaning and sealant services, if appropriate, to children who | ||||||
20 | are eligible participants in the State's Medicaid program, | ||||||
21 | pursuant to Section 5-5 of the Illinois Public Aid Code .
| ||||||
22 | (f-5) Any dental hygienist who provides services to | ||||||
23 | eligible children under item (iii) of subsection (f) of this | ||||||
24 | Section shall attempt to identify and provide to the child's | ||||||
25 | parent or guardian the name of a licensed dentist who is a | ||||||
26 | provider of medical services under the State's Medicaid |
| |||||||
| |||||||
1 | program. Any dental hygienist who provides services to eligible | ||||||
2 | children under item (iii) of subsection (f) of this Section and | ||||||
3 | who practices in a public health clinic as set forth in | ||||||
4 | subdivision (4) of subsection (b) of this Section shall refer | ||||||
5 | for treatment any child with needs outside of the dental | ||||||
6 | hygienist's scope of practice.
| ||||||
7 | (g) The number of dental hygienists practicing in a dental | ||||||
8 | office shall
not
exceed, at any one time, 4 times the number of | ||||||
9 | dentists practicing in the
office at the time.
| ||||||
10 | (Source: P.A. 93-113, eff. 1-1-04; 93-821, eff. 7-28-04 .)
| ||||||
11 | Section 10. The Illinois Public Aid Code is amended by | ||||||
12 | changing Section 5-5 as follows: | ||||||
13 | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
| ||||||
14 | Sec. 5-5. Medical services. The Illinois Department, by | ||||||
15 | rule, shall
determine the quantity and quality of and the rate | ||||||
16 | of reimbursement for the
medical assistance for which
payment | ||||||
17 | will be authorized, and the medical services to be provided,
| ||||||
18 | which may include all or part of the following: (1) inpatient | ||||||
19 | hospital
services; (2) outpatient hospital services; (3) other | ||||||
20 | laboratory and
X-ray services; (4) skilled nursing home | ||||||
21 | services; (5) physicians'
services whether furnished in the | ||||||
22 | office, the patient's home, a
hospital, a skilled nursing home, | ||||||
23 | or elsewhere; (6) medical care, or any
other type of remedial | ||||||
24 | care furnished by licensed practitioners; (7)
home health care |
| |||||||
| |||||||
1 | services; (8) private duty nursing service; (9) clinic
| ||||||
2 | services; (10) dental services, including prevention and | ||||||
3 | treatment of periodontal disease and dental caries disease for | ||||||
4 | pregnant women and fluoride treatments and teeth cleaning and | ||||||
5 | sealant services provided to children by dental hygienists ; | ||||||
6 | (11) physical therapy and related
services; (12) prescribed | ||||||
7 | drugs, dentures, and prosthetic devices; and
eyeglasses | ||||||
8 | prescribed by a physician skilled in the diseases of the eye,
| ||||||
9 | or by an optometrist, whichever the person may select; (13) | ||||||
10 | other
diagnostic, screening, preventive, and rehabilitative | ||||||
11 | services; (14)
transportation and such other expenses as may be | ||||||
12 | necessary; (15) medical
treatment of sexual assault survivors, | ||||||
13 | as defined in
Section 1a of the Sexual Assault Survivors | ||||||
14 | Emergency Treatment Act, for
injuries sustained as a result of | ||||||
15 | the sexual assault, including
examinations and laboratory | ||||||
16 | tests to discover evidence which may be used in
criminal | ||||||
17 | proceedings arising from the sexual assault; (16) the
diagnosis | ||||||
18 | and treatment of sickle cell anemia; and (17)
any other medical | ||||||
19 | care, and any other type of remedial care recognized
under the | ||||||
20 | laws of this State, but not including abortions, or induced
| ||||||
21 | miscarriages or premature births, unless, in the opinion of a | ||||||
22 | physician,
such procedures are necessary for the preservation | ||||||
23 | of the life of the
woman seeking such treatment, or except an | ||||||
24 | induced premature birth
intended to produce a live viable child | ||||||
25 | and such procedure is necessary
for the health of the mother or | ||||||
26 | her unborn child. The Illinois Department,
by rule, shall |
| |||||||
| |||||||
1 | prohibit any physician from providing medical assistance
to | ||||||
2 | anyone eligible therefor under this Code where such physician | ||||||
3 | has been
found guilty of performing an abortion procedure in a | ||||||
4 | wilful and wanton
manner upon a woman who was not pregnant at | ||||||
5 | the time such abortion
procedure was performed. The term "any | ||||||
6 | other type of remedial care" shall
include nursing care and | ||||||
7 | nursing home service for persons who rely on
treatment by | ||||||
8 | spiritual means alone through prayer for healing.
| ||||||
9 | Notwithstanding any other provision of this Section, a | ||||||
10 | comprehensive
tobacco use cessation program that includes | ||||||
11 | purchasing prescription drugs or
prescription medical devices | ||||||
12 | approved by the Food and Drug administration shall
be covered | ||||||
13 | under the medical assistance
program under this Article for | ||||||
14 | persons who are otherwise eligible for
assistance under this | ||||||
15 | Article.
| ||||||
16 | Notwithstanding any other provision of this Code, the | ||||||
17 | Illinois
Department may not require, as a condition of payment | ||||||
18 | for any laboratory
test authorized under this Article, that a | ||||||
19 | physician's handwritten signature
appear on the laboratory | ||||||
20 | test order form. The Illinois Department may,
however, impose | ||||||
21 | other appropriate requirements regarding laboratory test
order | ||||||
22 | documentation.
| ||||||
23 | The Illinois Department of Healthcare and Family Services
| ||||||
24 | Public Aid shall provide the following services to
persons
| ||||||
25 | eligible for assistance under this Article who are | ||||||
26 | participating in
education, training or employment programs |
| |||||||
| |||||||
1 | operated by the Department of Human
Services as successor to | ||||||
2 | the Department of Public Aid:
| ||||||
3 | (1) dental services, which shall include but not be | ||||||
4 | limited to
prosthodontics; and
| ||||||
5 | (2) eyeglasses prescribed by a physician skilled in the | ||||||
6 | diseases of the
eye, or by an optometrist, whichever the | ||||||
7 | person may select.
| ||||||
8 | The Illinois Department, by rule, may distinguish and | ||||||
9 | classify the
medical services to be provided only in accordance | ||||||
10 | with the classes of
persons designated in Section 5-2.
| ||||||
11 | The Illinois Department shall authorize the provision of, | ||||||
12 | and shall
authorize payment for, screening by low-dose | ||||||
13 | mammography for the presence of
occult breast cancer for women | ||||||
14 | 35 years of age or older who are eligible
for medical | ||||||
15 | assistance under this Article, as follows: a baseline
mammogram | ||||||
16 | for women 35 to 39 years of age and an
annual mammogram for | ||||||
17 | women 40 years of age or older. All screenings
shall
include a | ||||||
18 | physical breast exam, instruction on self-examination and
| ||||||
19 | information regarding the frequency of self-examination and | ||||||
20 | its value as a
preventative tool. As used in this Section, | ||||||
21 | "low-dose mammography" means
the x-ray examination of the | ||||||
22 | breast using equipment dedicated specifically
for mammography, | ||||||
23 | including the x-ray tube, filter, compression device,
image | ||||||
24 | receptor, and cassettes, with an average radiation exposure | ||||||
25 | delivery
of less than one rad mid-breast, with 2 views for each | ||||||
26 | breast.
|
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| |||||||
1 | Any medical or health care provider shall immediately | ||||||
2 | recommend, to
any pregnant woman who is being provided prenatal | ||||||
3 | services and is suspected
of drug abuse or is addicted as | ||||||
4 | defined in the Alcoholism and Other Drug Abuse
and Dependency | ||||||
5 | Act, referral to a local substance abuse treatment provider
| ||||||
6 | licensed by the Department of Human Services or to a licensed
| ||||||
7 | hospital which provides substance abuse treatment services. | ||||||
8 | The Department of Healthcare and Family Services
Public Aid
| ||||||
9 | shall assure coverage for the cost of treatment of the drug | ||||||
10 | abuse or
addiction for pregnant recipients in accordance with | ||||||
11 | the Illinois Medicaid
Program in conjunction with the | ||||||
12 | Department of Human Services.
| ||||||
13 | All medical providers providing medical assistance to | ||||||
14 | pregnant women
under this Code shall receive information from | ||||||
15 | the Department on the
availability of services under the Drug | ||||||
16 | Free Families with a Future or any
comparable program providing | ||||||
17 | case management services for addicted women,
including | ||||||
18 | information on appropriate referrals for other social services
| ||||||
19 | that may be needed by addicted women in addition to treatment | ||||||
20 | for addiction.
| ||||||
21 | The Illinois Department, in cooperation with the | ||||||
22 | Departments of Human
Services (as successor to the Department | ||||||
23 | of Alcoholism and Substance
Abuse) and Public Health, through a | ||||||
24 | public awareness campaign, may
provide information concerning | ||||||
25 | treatment for alcoholism and drug abuse and
addiction, prenatal | ||||||
26 | health care, and other pertinent programs directed at
reducing |
| |||||||
| |||||||
1 | the number of drug-affected infants born to recipients of | ||||||
2 | medical
assistance.
| ||||||
3 | Neither the Illinois Department of Healthcare and Family | ||||||
4 | Services
Public Aid nor the Department of Human
Services shall | ||||||
5 | sanction the recipient solely on the basis of
her substance | ||||||
6 | abuse.
| ||||||
7 | The Illinois Department shall establish such regulations | ||||||
8 | governing
the dispensing of health services under this Article | ||||||
9 | as it shall deem
appropriate. The Department
should
seek the | ||||||
10 | advice of formal professional advisory committees appointed by
| ||||||
11 | the Director of the Illinois Department for the purpose of | ||||||
12 | providing regular
advice on policy and administrative matters, | ||||||
13 | information dissemination and
educational activities for | ||||||
14 | medical and health care providers, and
consistency in | ||||||
15 | procedures to the Illinois Department.
| ||||||
16 | The Illinois Department may develop and contract with | ||||||
17 | Partnerships of
medical providers to arrange medical services | ||||||
18 | for persons eligible under
Section 5-2 of this Code. | ||||||
19 | Implementation of this Section may be by
demonstration projects | ||||||
20 | in certain geographic areas. The Partnership shall
be | ||||||
21 | represented by a sponsor organization. The Department, by rule, | ||||||
22 | shall
develop qualifications for sponsors of Partnerships. | ||||||
23 | Nothing in this
Section shall be construed to require that the | ||||||
24 | sponsor organization be a
medical organization.
| ||||||
25 | The sponsor must negotiate formal written contracts with | ||||||
26 | medical
providers for physician services, inpatient and |
| |||||||
| |||||||
1 | outpatient hospital care,
home health services, treatment for | ||||||
2 | alcoholism and substance abuse, and
other services determined | ||||||
3 | necessary by the Illinois Department by rule for
delivery by | ||||||
4 | Partnerships. Physician services must include prenatal and
| ||||||
5 | obstetrical care. The Illinois Department shall reimburse | ||||||
6 | medical services
delivered by Partnership providers to clients | ||||||
7 | in target areas according to
provisions of this Article and the | ||||||
8 | Illinois Health Finance Reform Act,
except that:
| ||||||
9 | (1) Physicians participating in a Partnership and | ||||||
10 | providing certain
services, which shall be determined by | ||||||
11 | the Illinois Department, to persons
in areas covered by the | ||||||
12 | Partnership may receive an additional surcharge
for such | ||||||
13 | services.
| ||||||
14 | (2) The Department may elect to consider and negotiate | ||||||
15 | financial
incentives to encourage the development of | ||||||
16 | Partnerships and the efficient
delivery of medical care.
| ||||||
17 | (3) Persons receiving medical services through | ||||||
18 | Partnerships may receive
medical and case management | ||||||
19 | services above the level usually offered
through the | ||||||
20 | medical assistance program.
| ||||||
21 | Medical providers shall be required to meet certain | ||||||
22 | qualifications to
participate in Partnerships to ensure the | ||||||
23 | delivery of high quality medical
services. These | ||||||
24 | qualifications shall be determined by rule of the Illinois
| ||||||
25 | Department and may be higher than qualifications for | ||||||
26 | participation in the
medical assistance program. Partnership |
| |||||||
| |||||||
1 | sponsors may prescribe reasonable
additional qualifications | ||||||
2 | for participation by medical providers, only with
the prior | ||||||
3 | written approval of the Illinois Department.
| ||||||
4 | Nothing in this Section shall limit the free choice of | ||||||
5 | practitioners,
hospitals, and other providers of medical | ||||||
6 | services by clients.
In order to ensure patient freedom of | ||||||
7 | choice, the Illinois Department shall
immediately promulgate | ||||||
8 | all rules and take all other necessary actions so that
provided | ||||||
9 | services may be accessed from therapeutically certified | ||||||
10 | optometrists
to the full extent of the Illinois Optometric | ||||||
11 | Practice Act of 1987 without
discriminating between service | ||||||
12 | providers.
| ||||||
13 | The Department shall apply for a waiver from the United | ||||||
14 | States Health
Care Financing Administration to allow for the | ||||||
15 | implementation of
Partnerships under this Section.
| ||||||
16 | The Illinois Department shall require health care | ||||||
17 | providers to maintain
records that document the medical care | ||||||
18 | and services provided to recipients
of Medical Assistance under | ||||||
19 | this Article. The Illinois Department shall
require health care | ||||||
20 | providers to make available, when authorized by the
patient, in | ||||||
21 | writing, the medical records in a timely fashion to other
| ||||||
22 | health care providers who are treating or serving persons | ||||||
23 | eligible for
Medical Assistance under this Article. All | ||||||
24 | dispensers of medical services
shall be required to maintain | ||||||
25 | and retain business and professional records
sufficient to | ||||||
26 | fully and accurately document the nature, scope, details and
|
| |||||||
| |||||||
1 | receipt of the health care provided to persons eligible for | ||||||
2 | medical
assistance under this Code, in accordance with | ||||||
3 | regulations promulgated by
the Illinois Department. The rules | ||||||
4 | and regulations shall require that proof
of the receipt of | ||||||
5 | prescription drugs, dentures, prosthetic devices and
| ||||||
6 | eyeglasses by eligible persons under this Section accompany | ||||||
7 | each claim
for reimbursement submitted by the dispenser of such | ||||||
8 | medical services.
No such claims for reimbursement shall be | ||||||
9 | approved for payment by the Illinois
Department without such | ||||||
10 | proof of receipt, unless the Illinois Department
shall have put | ||||||
11 | into effect and shall be operating a system of post-payment
| ||||||
12 | audit and review which shall, on a sampling basis, be deemed | ||||||
13 | adequate by
the Illinois Department to assure that such drugs, | ||||||
14 | dentures, prosthetic
devices and eyeglasses for which payment | ||||||
15 | is being made are actually being
received by eligible | ||||||
16 | recipients. Within 90 days after the effective date of
this | ||||||
17 | amendatory Act of 1984, the Illinois Department shall establish | ||||||
18 | a
current list of acquisition costs for all prosthetic devices | ||||||
19 | and any
other items recognized as medical equipment and | ||||||
20 | supplies reimbursable under
this Article and shall update such | ||||||
21 | list on a quarterly basis, except that
the acquisition costs of | ||||||
22 | all prescription drugs shall be updated no
less frequently than | ||||||
23 | every 30 days as required by Section 5-5.12.
| ||||||
24 | The rules and regulations of the Illinois Department shall | ||||||
25 | require
that a written statement including the required opinion | ||||||
26 | of a physician
shall accompany any claim for reimbursement for |
| |||||||
| |||||||
1 | abortions, or induced
miscarriages or premature births. This | ||||||
2 | statement shall indicate what
procedures were used in providing | ||||||
3 | such medical services.
| ||||||
4 | The Illinois Department shall require all dispensers of | ||||||
5 | medical
services, other than an individual practitioner or | ||||||
6 | group of practitioners,
desiring to participate in the Medical | ||||||
7 | Assistance program
established under this Article to disclose | ||||||
8 | all financial, beneficial,
ownership, equity, surety or other | ||||||
9 | interests in any and all firms,
corporations, partnerships, | ||||||
10 | associations, business enterprises, joint
ventures, agencies, | ||||||
11 | institutions or other legal entities providing any
form of | ||||||
12 | health care services in this State under this Article.
| ||||||
13 | The Illinois Department may require that all dispensers of | ||||||
14 | medical
services desiring to participate in the medical | ||||||
15 | assistance program
established under this Article disclose, | ||||||
16 | under such terms and conditions as
the Illinois Department may | ||||||
17 | by rule establish, all inquiries from clients
and attorneys | ||||||
18 | regarding medical bills paid by the Illinois Department, which
| ||||||
19 | inquiries could indicate potential existence of claims or liens | ||||||
20 | for the
Illinois Department.
| ||||||
21 | Enrollment of a vendor that provides non-emergency medical | ||||||
22 | transportation,
defined by the Department by rule,
shall be
| ||||||
23 | conditional for 180 days. During that time, the Department of | ||||||
24 | Healthcare and Family Services
Public Aid may
terminate the | ||||||
25 | vendor's eligibility to participate in the medical assistance
| ||||||
26 | program without cause. That termination of eligibility is not |
| |||||||
| |||||||
1 | subject to the
Department's hearing process.
| ||||||
2 | The Illinois Department shall establish policies, | ||||||
3 | procedures,
standards and criteria by rule for the acquisition, | ||||||
4 | repair and replacement
of orthotic and prosthetic devices and | ||||||
5 | durable medical equipment. Such
rules shall provide, but not be | ||||||
6 | limited to, the following services: (1)
immediate repair or | ||||||
7 | replacement of such devices by recipients without
medical | ||||||
8 | authorization; and (2) rental, lease, purchase or | ||||||
9 | lease-purchase of
durable medical equipment in a | ||||||
10 | cost-effective manner, taking into
consideration the | ||||||
11 | recipient's medical prognosis, the extent of the
recipient's | ||||||
12 | needs, and the requirements and costs for maintaining such
| ||||||
13 | equipment. Such rules shall enable a recipient to temporarily | ||||||
14 | acquire and
use alternative or substitute devices or equipment | ||||||
15 | pending repairs or
replacements of any device or equipment | ||||||
16 | previously authorized for such
recipient by the Department.
| ||||||
17 | The Department shall execute, relative to the nursing home | ||||||
18 | prescreening
project, written inter-agency agreements with the | ||||||
19 | Department of Human
Services and the Department on Aging, to | ||||||
20 | effect the following: (i) intake
procedures and common | ||||||
21 | eligibility criteria for those persons who are receiving
| ||||||
22 | non-institutional services; and (ii) the establishment and | ||||||
23 | development of
non-institutional services in areas of the State | ||||||
24 | where they are not currently
available or are undeveloped.
| ||||||
25 | The Illinois Department shall develop and operate, in | ||||||
26 | cooperation
with other State Departments and agencies and in |
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1 | compliance with
applicable federal laws and regulations, | ||||||
2 | appropriate and effective
systems of health care evaluation and | ||||||
3 | programs for monitoring of
utilization of health care services | ||||||
4 | and facilities, as it affects
persons eligible for medical | ||||||
5 | assistance under this Code.
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6 | The Illinois Department shall report annually to the | ||||||
7 | General Assembly,
no later than the second Friday in April of | ||||||
8 | 1979 and each year
thereafter, in regard to:
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9 | (a) actual statistics and trends in utilization of | ||||||
10 | medical services by
public aid recipients;
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11 | (b) actual statistics and trends in the provision of | ||||||
12 | the various medical
services by medical vendors;
| ||||||
13 | (c) current rate structures and proposed changes in | ||||||
14 | those rate structures
for the various medical vendors; and
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15 | (d) efforts at utilization review and control by the | ||||||
16 | Illinois Department.
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17 | The period covered by each report shall be the 3 years | ||||||
18 | ending on the June
30 prior to the report. The report shall | ||||||
19 | include suggested legislation
for consideration by the General | ||||||
20 | Assembly. The filing of one copy of the
report with the | ||||||
21 | Speaker, one copy with the Minority Leader and one copy
with | ||||||
22 | the Clerk of the House of Representatives, one copy with the | ||||||
23 | President,
one copy with the Minority Leader and one copy with | ||||||
24 | the Secretary of the
Senate, one copy with the Legislative | ||||||
25 | Research Unit, and such additional
copies
with the State | ||||||
26 | Government Report Distribution Center for the General
Assembly |
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1 | as is required under paragraph (t) of Section 7 of the State
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2 | Library Act shall be deemed sufficient to comply with this | ||||||
3 | Section.
| ||||||
4 | (Source: P.A. 92-16, eff. 6-28-01; 92-651, eff. 7-11-02; | ||||||
5 | 92-789, eff. 8-6-02; 93-632, eff. 2-1-04; 93-841, eff. 7-30-04; | ||||||
6 | 93-981, eff. 8-23-04; revised 12-15-05.)
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7 | Section 99. Effective date. This Act takes effect January | ||||||
8 | 1, 2008.
|