99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB0788

 

Introduced 2/5/2015, by Sen. Heather A. Steans

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-30.2 new

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop and implement an algorithm that is based on quality scores and other operational proficiency criteria developed, defined, and adopted by the Department, by rule, to automatically assign Medicaid enrollees served under the Family Health Plan and the Integrated Care Program and those Medicaid enrollees eligible for medical assistance pursuant to the Patient Protection and Affordable Care Act into managed care entities, including Accountable Care Entities, Care Coordination Entities, Children with Special Needs Care Coordination Entities, Managed Care Community Networks, and Managed Care Organizations. Provides that the algorithm developed and implemented shall favor assignment into managed care entities with the highest quality scores and levels of compliance with the operational proficiency criteria established.


LRB099 05889 KTG 25937 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB0788LRB099 05889 KTG 25937 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 5. The Illinois Public Aid Code is amended by
5adding Section 5-30.2 as follows:
 
6    (305 ILCS 5/5-30.2 new)
7    Sec. 5-30.2. Managed care; automatic assignment. The
8Department shall develop and implement an algorithm that is
9based on quality scores and other operational proficiency
10criteria developed, defined, and adopted by the Department, by
11rule, to automatically assign Medicaid enrollees served under
12the Family Health Plan and the Integrated Care Program and
13those Medicaid enrollees eligible for medical assistance
14pursuant to the Patient Protection and Affordable Care Act
15(P.L. 111-148) into managed care entities, including
16Accountable Care Entities, Care Coordination Entities,
17Children with Special Needs Care Coordination Entities,
18Managed Care Community Networks, and Managed Care
19Organizations. The algorithm developed and implemented shall
20favor assignment into managed care entities with the highest
21quality scores and levels of compliance with the operational
22proficiency criteria established.