Sen. Mattie Hunter

Filed: 4/11/2008





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



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1 adult psychiatric services on an outpatient basis are
2 adequately reimbursed for the cost of providing these services.
3 Therefore, in order to determine the actual costs, the
4 Department of Healthcare and Family Services shall develop a
5 cost-reporting mechanism for service providers as defined in
6 this Section by no later than January 1, 2009. The Department
7 of Healthcare and Family Services shall consult with service
8 providers as defined in this Section to assist with the
9 development of the cost-reporting mechanism. By no later than
10 March 1, 2009, the Department of Healthcare and Family Services
11 shall report to the Governor and the General Assembly on the
12 results of the cost-reporting mechanism. This report shall
13 include, but need not be limited to, details on the development
14 of the cost-reporting mechanism and its accurate reflection of
15 the actual costs to service providers for providing child and
16 adult psychiatric services. The Department of Healthcare and
17 Family Services shall, subject to appropriation, establish a
18 separate cost-based reimbursement rate based on the
19 cost-reporting mechanism for psychiatrists who provide child
20 and adult psychiatric services on an outpatient basis for
21 service providers as defined by this Section.
22     (b) This Section applies only to psychiatrists who provide
23 child and adult psychiatric services on an outpatient basis for
24 service providers as defined in this Section.
25     (c) For purposes of this Section:
26     "Cost-based reimbursement rate" means a rate of



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1 reimbursement equal to the allowable and audited reasonable
2 costs reported.
3     "Psychiatrist" means a psychiatrist as defined in Section
4 1-121 of the Mental Health and Developmental Disabilities Code.
5     "Service provider" means any of the following that
6 demonstrates a combined Medicaid, poverty, and uninsured
7 patient population penetration rate of 60% or greater:
8         (1) An entity certified by the Illinois Department of
9     Human Services under the Medicaid Community Mental Health
10     Services Program under 59 Ill. Adm. Code 132.
11         (2) A person, corporation, or entity that furnishes
12     medical, educational, psychiatric, vocational, or
13     rehabilitative services to a recipient under this Code and
14     enters into a contract or agreement with one or more of the
15     following State agencies to provide such services:
16             (A) The Department of Human Services.
17             (B) The Department of Children and Family
18         Services.
19             (C) The Department of Corrections.
20             (D) The Department of Juvenile Justice.
21         (3) A community mental health board established under
22     the Community Mental Health Act.
23     "Service provider" does not include an employee of a State
24 agency or county agency.
25     Section 99. Effective date. This Act takes effect upon



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1 becoming law.".