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Synopsis As Introduced Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for all recipients of medical assistance who are enrolled in a Medicaid Managed Care Entity, information concerning sensitive health services, including information concerning consultations, examinations, and treatments, shall not be divulged directly or indirectly to any person, including by sending a bill for such services or by sending an explanation of benefits provided by the Medicaid Managed Care Entity, unless the recipient who received the sensitive health services requests the information from the Medicaid Managed Care Entity. Provides that the term "Medicaid Managed Care Entity" includes, but is not limited to, Care Coordination Entities, Accountable Care Entities, Managed Care Community Networks, and Managed Care Organizations. Defines "sensitive health services". Provides that nothing in this provision shall be construed to relieve a Medicaid Managed Care Entity or the Department of Healthcare and Family Services of its duty to report incidents of sexually transmitted infections to the Department of Public Health or to the local board of health in accordance with regulations adopted under a statute or ordinance, or to report incidents of sexually transmitted infections as necessary to comply with certain requirements under the Abused and Neglected Child Reporting Act or as otherwise required by State or federal law. Effective immediately.
House Committee Amendment No. 1 Replaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that unless otherwise required by federal law, Medicaid Managed Care Entities shall not divulge, directly or indirectly, including by sending a bill or explanation of benefits, information concerning the sensitive health services received by enrollees of the Medicaid Managed Care Entity to any person other than providers and care coordinators caring for the enrollee and employees of the entity in the course of the entity's internal operations. Provides that the Medicaid Managed Care Entity may divulge information concerning the sensitive health services if the enrollee who received the sensitive health services requests the information from the Medicaid Managed Care Entity and authorized the sending of a bill or explanation of benefits. Provides that communications including, but not limited to, statements of care received or appointment reminders either directly or indirectly to the enrollee from the health care provider, health care professional, and care coordinators, remain permissible. Provides that the term "Medicaid Managed Care Entity" includes Care Coordination Entities, Accountable Care Entities, Managed Care Organizations, and Managed Care Community Networks. Provides that "sensitive health services" means mental health services, substance abuse treatment services, reproductive health services, family planning services, services for sexually transmitted infections and sexually transmitted diseases, and services for sexual assault or domestic abuse. Services include prevention, screening, consultation, examination, treatment, or follow-up. Provides that nothing shall be construed to relieve a Medicaid Managed Care Entity or the Department of any duty to report incidents of sexually transmitted infections to the Department of Public Health or to the local board of health in accordance with regulations adopted under a statute or ordinance or to report incidents of sexually transmitted infections as necessary to comply with the requirements under the Abused and Neglected Child Reporting Act or as otherwise required by State or federal law. Provides that the Department shall create policy in order to implement these requirements. Effective immediately.
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