SB3302 96TH GENERAL ASSEMBLY

LRB096 17599 RPM 32956 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB3302

Introduced 2/9/2010, by Sen. Deanna Demuzio

SYNOPSIS AS INTRODUCED:

215 ILCS 106/65 new
215 ILCS 170/54 new
305 ILCS 5/5-5.06 new

Amends the Children's Health Insurance Program Act, Covering ALL KIDS Health Insurance Act, and Illinois Public Aid Code. Provides that beginning on July 1, 2010, the Department of Healthcare and Family Services shall develop incentive programs for dentists who perform dental services on adults and children covered under the respective Acts. Provides that the incentive programs shall include pilot programs in designated shortage areas that increase rates up to 64% of the reimbursement level that the State reimburses dentists for dental services provided to State employees. Provides that the Department shall increase the rate level of dental specialty services that are provided to children to equal that which the State reimburses dentists for dental services provided to State employees for certain services. Provides that the Department shall develop and implement an incentive program that rewards dentists who are enrolled in the program with a bonus for providing services to a higher annual percentage of patients relative to the number of patients to whom the dentist provided services in the previous year. Provides that the bonus payments shall be based and paid on a graduated scale.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning insurance.

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

Section 5. The Children's Health Insurance Program Act is amended by adding Section 65 as follows:

(215 ILCS 106/65 new)

Sec. 65. Provider incentives. Beginning on July 1, 2010, the Department shall develop incentive programs for dentists who perform dental services on children covered under this Act. The incentive programs shall include pilot programs in designated shortage areas that increase rates up to 64% of the reimbursement level that the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act. The Department shall increase the rate level of dental specialty services that are provided to children covered under this Act to equal that which the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act for the services defined by the Code of Dental Terminology as specialty codes. The Department shall develop and implement an incentive program that rewards dentists who are enrolled in the program with a bonus for providing services to a higher annual percentage of patients relative to the number of patients to whom the dentist provided services in the previous year; the bonus payments shall be based and paid on a graduated scale of 25% increase, 50% increase, 75% increase, and 100% increase in new patients treated.

Section 10. The Covering ALL KIDS Health Insurance Act is amended by adding Section 54 as follows:

(215 ILCS 170/54 new)

Sec. 54. Provider incentives. Beginning on July 1, 2010, the Department shall develop incentive programs for dentists who perform dental services on children covered under this Act. The incentive programs shall include pilot programs in designated shortage areas that increase rates up to 64% of the reimbursement level that the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act. The Department shall increase the rate level of dental specialty services that are provided to children covered under this Act to equal that which the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act for the services defined by the Code of Dental Terminology as specialty codes. The Department shall develop and implement an incentive program that rewards dentists who are enrolled in the program with a bonus for providing services to a higher annual percentage of patients relative to the number of patients to whom the dentist provided services in the previous year; the bonus payments shall be based and paid on a graduated scale of 25% increase, 50% increase, 75% increase, and 100% increase in new patients treated.

Section 15. The Illinois Public Aid Code is amended by adding Section 5-5.06 as follows:

(305 ILCS 5/5-5.06 new)

Sec. 5-5.06. Provider incentives. Beginning on July 1, 2010, the Department of Healthcare and Family Services shall develop incentive programs for dentists who perform dental services on adults and children covered under this Act. The incentive programs shall include pilot programs in designated shortage areas that increase rates up to 64% of the reimbursement level that the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act. The Department shall increase the rate level of dental specialty services that are provided to children covered under this Act to equal that which the State reimburses dentists for dental services provided to State employees under the State Employees Group Insurance Act for the services defined by the Code of Dental Terminology as specialty codes. The Department shall develop and implement an incentive program that rewards dentists who are enrolled in the program with a bonus for providing services to a higher annual percentage of patients relative to the number of patients to whom the dentist provided services in the previous year; the bonus payments shall be based and paid on a graduated scale of 25% increase, 50% increase, 75% increase, and 100% increase in new patients treated.