SB1938sam001 95TH GENERAL ASSEMBLY

Sen. Mattie Hunter

Filed: 3/11/2008

 

 


 

 


 
09500SB1938sam001 LRB095 18039 DRJ 48156 a

1
AMENDMENT TO SENATE BILL 1938

2     AMENDMENT NO. ______. Amend Senate Bill 1938 by replacing
3 everything after the enacting clause with the following:
 
4     "Section 5. The Illinois Public Aid Code is amended by
5 adding Section 5-5.26 as follows:
 
6     (305 ILCS 5/5-5.26 new)
7     Sec. 5-5.26. Child and adult psychiatric services.
8     (a) The General Assembly finds that direct access to
9 psychiatric mental health services for children and adults
10 suffering from mental illness will improve the quality of life
11 for these individuals and will reduce health care costs by
12 avoiding the need for more costly inpatient hospitalization.
13 Thus, it is the intent of the General Assembly to ensure that
14 psychiatrists providing child and adult psychiatric services
15 on an outpatient basis are adequately reimbursed for the cost
16 of providing these services. Therefore, the Department of

 

 

09500SB1938sam001 - 2 - LRB095 18039 DRJ 48156 a

1 Healthcare and Family Services, by rule, shall develop a
2 cost-reporting mechanism for service providers as defined in
3 this Section, which shall form the basis for any reimbursements
4 made to psychiatrists providing child and adult psychiatric
5 services in a "service provider" setting as defined in this
6 Section. No later than July 1, 2009, the Department of
7 Healthcare and Family Service, by rule, shall establish a
8 separate cost-based reimbursement rate based on the
9 cost-reporting mechanism for psychiatrists who provide child
10 and adult psychiatric services on an outpatient basis for
11 service providers as defined by this Section.
12     (b) This Section applies only to psychiatrists who provide
13 child and adult psychiatric services on an outpatient basis for
14 service providers as defined in this Section.
15     (c) For purposes of this Section:
16     "Cost-based reimbursement rate" means a rate of
17 reimbursement equal to the allowable and audited reasonable
18 costs reported.
19     "Psychiatrist" means a psychiatrist as defined in Section
20 1-121 of the Mental Health and Developmental Disabilities Code.
21     "Service provider" means any of the following that
22 demonstrates a combined Medicaid, poverty, and uninsured
23 patient population penetration rate of 60% or greater:
24         (1) An entity certified by the Illinois Department of
25     Human Services under the Medicaid Community Mental Health
26     Services Program under 59 Ill. Adm. Code 132.

 

 

09500SB1938sam001 - 3 - LRB095 18039 DRJ 48156 a

1         (2) A person, corporation, or entity that furnishes
2     medical, educational, psychiatric, vocational, or
3     rehabilitative services to a recipient under this Code and
4     enters into a contract or agreement with one or more of the
5     following State agencies to provide such services:
6             (A) The Department of Human Services.
7             (B) The Department of Children and Family
8         Services.
9             (C) The Department of Corrections.
10             (D) The Department of Juvenile Justice.
11         (3) A community mental health board established under
12     the Community Mental Health Act.
13     "Service provider" does not include an employee of a State
14 agency or county agency.
 
15     Section 99. Effective date. This Act takes effect upon
16 becoming law.".