SB2173sam002 95TH GENERAL ASSEMBLY

Sen. William Delgado

Filed: 4/9/2008

09500SB2173sam002 LRB095 15141 RPM 49144 a

AMENDMENT TO SENATE BILL 2173

AMENDMENT NO. ______. Amend Senate Bill 2173, AS AMENDED, by replacing everything after the enacting clause with the following:

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

(215 ILCS 106/65 new)

Sec. 65. Fee schedule. Beginning on January, 1, 2009, reimbursement for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim for payment in accordance with Section 368a of the Illinois Insurance Code.

Section 10. The Covering ALL KIDS Health Insurance Act is amended by adding Section 52.5 as follows:

(215 ILCS 170/52.5 new)

Sec. 52.5. Fee schedule. Beginning on January, 1, 2009, the physician fee schedule for the Covering ALL KIDS Insurance Program for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim for payment in accordance with Section 368a of the Illinois Insurance Code.

Section 15. The Illinois Public Aid Code is amended by adding Section 5-5.05 as follows:

(305 ILCS 5/5-5.05 new)

Sec. 5-5.05. Fee schedule. Notwithstanding any other provision of this Article, beginning on January, 1, 2009, reimbursement for any physician service must not be lower than 60% of Medicare reimbursement in accordance with the Medicare payment localities for Illinois. The physician fee schedule rates must be adjusted to no lower than 80% of Medicare reimbursement by January 1, 2010, and no lower than 100% of Medicare reimbursement by January 1, 2011. All adjustments shall be made without lowering any existing rates that may be higher than the level required by this Section. Reimbursement rules and policies shall not be more restrictive than Medicare physician payment rules and policies by January 1, 2010. Payment for services must be made within 30 days after receipt of a bill or claim or payment in accordance with Section 368a of the Illinois Insurance Code.

Section 99. Effective date. This Act takes effect upon becoming law.".