HB5241 Engrossed LRB096 16158 KTG 31409 b

1     AN ACT concerning public aid.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Public Aid Code is amended by
5 adding Section 5-2.01 as follows:
 
6     (305 ILCS 5/5-2.01 new)
7     Sec. 5-2.01. Medicaid accountability through transparency
8 program.
9     (a) Internet-based transparency program. The Director of
10 the Department of Healthcare and Family Services shall be
11 authorized to implement a program under which the Director
12 shall make available through the Department's public Internet
13 website information on medical claims reimbursed under the
14 State's medical assistance program insofar as such information
15 has been de-identified in accordance with regulations
16 promulgated pursuant to the Illinois Health Insurance
17 Portability and Accountability Act. In implementing the
18 program, the Director shall ensure the following:
19         (1) The information made so available shall be in a
20     format that is easily accessible, useable, and
21     understandable to the public, including individuals
22     interested in improving the quality of care provided to
23     individuals eligible for items and services under this

 

 

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1     Article, researchers, health care providers, and
2     individuals interested in reducing the prevalence of waste
3     and fraud under this Article.
4         (2) The information made so available shall be as
5     current as deemed practical by the Director and shall be
6     updated at least once per calendar quarter.
7         (3) The information made so available shall be
8     aggregated to a level to ensure patient confidentiality,
9     but shall, to the extent feasible, allow for posting of
10     information by provider or vendor name and county, number
11     of individuals served, total patient visits, payment for
12     bills submitted, average cost for bills submitted,
13     adjustments to payments, and total amounts paid.
14         (4) The Director periodically solicits comments from a
15     sampling of individuals who access the information through
16     the program on how to best improve the utility of the
17     program.
18     (b) Use of contractor. For purposes of implementing the
19 program under subsection (a) of this Section and ensuring the
20 information made available through the program is periodically
21 updated, the Director may select and enter into a contract with
22 a public or private entity meeting the criteria and
23 qualifications the Director determines appropriate.
24     (c) Annual Reports. Not later than 12 months after the
25 effective date of this amendatory Act of the 96th General
26 Assembly and annually thereafter, the Director shall submit to

 

 

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1 the General Assembly a report on the status of the program
2 authorized under subsection (a). The report shall include
3 details including, but not limited to, the estimated or actual
4 costs of developing and maintaining the reporting system, the
5 actual or potential benefit or adverse consequences associated
6 with the system, and, if applicable, the extent to which
7 information made available through the program is accessed and
8 the extent to which comments received under paragraph (4) of
9 subsection (a) of this Section were used to improve the utility
10 of the program.
 
11     Section 99. Effective date. This Act takes effect upon
12 becoming law.