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.


LRB103 38878 KTG 69015 b

 

 

A BILL FOR

 

SB3522LRB103 38878 KTG 69015 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.55 as follows:
 
6    (5 ILCS 100/5-45.55 new)
7    Sec. 5-45.55. Emergency rulemaking; reimbursement rates
8for psychiatric evaluations and medication monitoring. To
9provide for the expeditious and timely implementation of
10Section 5-5.05h of the Illinois Public Aid Code, emergency
11rules implementing Section 5-5.05h of the Illinois Public Aid
12Code may be adopted in accordance with Section 5-45 by the
13Department of Healthcare and Family Services. The adoption of
14emergency rules authorized by Section 5-45 and this Section is
15deemed to be necessary for the public interest, safety, and
16welfare.
17    This Section is repealed one year after the effective date
18of this amendatory Act of the 103rd General Assembly.
 
19    Section 5. The Illinois Public Aid Code is amended by
20adding Section 5-5.05h as follows:
 
21    (305 ILCS 5/5-5.05h new)

 

 

SB3522- 2 -LRB103 38878 KTG 69015 b

1    Sec. 5-5.05h. Reimbursement rates for psychiatric
2evaluations and medication monitoring.
3    (a) Beginning on January 1, 2025, rates for psychiatric
4evaluations performed by community mental health centers and
5substance use disorder treatment providers and practitioners
6as set forth on the Department's Practitioner Fee Schedule
7shall be increased to $237.57. Beginning on January 1, 2025,
8rates for medication monitoring performed by community mental
9health centers and substance use disorder treatment providers
10and practitioners as set forth on the Department's
11Practitioner Fee Schedule shall be increased to $140.77 per
12quarter hour.
13    (b) No existing or future reimbursement rates or add-ons
14shall be reduced or changed to address the rate increases
15proposed under this Section. No later than October 1, 2024,
16the Department shall submit any necessary application to the
17federal Centers for Medicare and Medicaid Services for a
18waiver or State Plan amendment to implement the requirements
19of this Section. Beginning in State Fiscal Year 2025, and
20every State fiscal year thereafter, reimbursement rates for
21those community-based mental health and substance use disorder
22services shall be adjusted upward by an amount equal to the
23Consumer Price Index-U from the previous year, not to exceed
245% in any State fiscal year. If there is a decrease in the
25Consumer Price Index-U, rates shall remain unchanged for that
26State fiscal year. The Department shall adopt rules, including

 

 

SB3522- 3 -LRB103 38878 KTG 69015 b

1emergency rules under Section 5-45.1 of the Illinois
2Administrative Procedure Act, to implement the provisions of
3this Section.
4    (c) As used in this Section, "consumer price index-u"
5means the index published by the Bureau of Labor Statistics of
6the United States Department of Labor that measures the
7average change in prices of goods and services purchased by
8all urban consumers, United States city average, all items,
91982-84 = 100.
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.