Bill Status of HB 5560   98th General Assembly


Short Description:  MEDICAID-MANAGED CARE-PAYMENTS

House Sponsors
Rep. Robyn Gabel-Patricia R. Bellock

Last Action  View All Actions

DateChamber Action
  12/3/2014HouseSession Sine Die

Statutes Amended In Order of Appearance
305 ILCS 5/5-30a new

Synopsis As Introduced
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that in the event that a hospital is not a contracted provider with a Medicaid managed care payor, and an enrollee of that Medicaid managed care payor requires care at that non-contracted facility, the Medicaid managed care payor shall be required to pay the non-contracted facility no less than the equivalent of what the State payment rate would be for the same non-elective services, including all policy adjustments and outlier payments. Provides that hospital triage services required under the federal Emergency Medical Treatment and Labor Act for enrollees presenting in the emergency room shall be considered a non-elective service as the provider is required by law to provide such services; and that the Medicaid managed care payor shall not be required to pay a State equivalent rate for any service deemed elective but may instead negotiate an agreement for such elective services with the non-contracted provider or redirect the enrollee within its contracted provider network. Effective immediately.

Actions 
DateChamber Action
  2/13/2014HouseFiled with the Clerk by Rep. Robyn Gabel
  2/14/2014HouseAdded Chief Co-Sponsor Rep. Patricia R. Bellock
  2/14/2014HouseFirst Reading
  2/14/2014HouseReferred to Rules Committee
  12/3/2014HouseSession Sine Die

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