SB0788 EngrossedLRB099 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, within a reasonable period of time after
9relevant data from managed care entities has been collected and
10analyzed, but no earlier than January 1, 2017, develop and
11implement within each enrollment region an algorithm that takes
12into account quality scores and other operational proficiency
13criteria developed, defined, and adopted by the Department, to
14automatically assign Medicaid enrollees served under the
15Family Health Plan and the Integrated Care Program and those
16Medicaid enrollees eligible for medical assistance pursuant to
17the Patient Protection and Affordable Care Act (Public Law
18111-148) into managed care entities, including Accountable
19Care Entities, Managed Care Community Networks, and Managed
20Care Organizations. The quality metrics used shall be
21measurable for all entities. The algorithm shall not use the
22quality and proficiency metrics to reassign enrollees out of
23any plan that they are enrolled with at the time and shall only



SB0788 Engrossed- 2 -LRB099 05889 KTG 25937 b

1be used if the client has not voluntarily selected a primary
2care physician and a managed care entity. Clients shall have
3one opportunity within 90 calendar days after auto assignment
4by algorithm to select a different managed care entity. The
5algorithm developed and implemented shall favor assignment
6into managed care entities with the highest quality scores and
7levels of compliance with the operational proficiency criteria