HB1668 95TH GENERAL ASSEMBLY

LRB095 09052 DRJ 29243 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB1668

Introduced 2/22/2007___________, by

SYNOPSIS AS INTRODUCED:

305 ILCS 5/2-16	from Ch. 23, par. 2-16
305 ILCS 5/5-5.23a new

Amends the Illinois Public Aid Code. Provides that a "service provider" may be another entity besides a person or corporation. Provides that the Department of Healthcare and Family Services, by rule, shall apply a comparable, prospective cost-reimbursement methodology for service providers to provide child and adult psychiatric services on an outpatient basis with the stipulation that the service provider meet certain criteria. Provides for reimbursement of advanced practice nurses providing such services at 100% of the established physician rate. Effective January 1, 2008.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by changing Section 2-16 and by adding Section 5-5.23a as follows:

(305 ILCS 5/2-16) (from Ch. 23, par. 2-16)

Sec. 2-16. "Service provider": A person, or corporation, or entity who furnishes medical, educational, psychiatric, vocational or rehabilitative services to a recipient under this Code, but excluding an employee of the Illinois Department or a County Department.

(Source: P.A. 82-555.)

(305 ILCS 5/5-5.23a new)

Sec. 5-5.23a. Child and adult psychiatric services. The Department of Healthcare and Family Services, by rule, shall apply a comparable, prospective cost-reimbursement methodology, as referenced in Section 5-5.20, for service providers to provide child and adult psychiatric services on an outpatient basis with the stipulation that the service provider meet all of the following criteria:

(1) Be a service provider that is tax exempt under Section 501(c)(3) of the Internal Revenue Code.

(2) Be licensed by the Illinois Department of Human Services as a Medicaid Rehabilitation Organization (MRO).

(3) Demonstrate a combined Medicaid, poverty, and uninsured patient population penetration rate of 60% or greater.

Advanced practice nurses providing child or adult psychiatric services in the course of employment by or under contract with such an eligible service provider must be reimbursed at 100% of the established physician rate, based on the approved scope of Medicaid services and within the collaborative agreement between the medical doctor and advanced practice nurse. An eligible service provider must submit documented proof of eligibility for this reimbursement on an annual basis to the Department of Healthcare and Family Services for continued participation in the program.

Section 99. Effective date. This Act takes effect January 1, 2008.