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Public Act 098-0303 |
HB2802 Enrolled | LRB098 05642 KTG 35681 b |
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by |
changing Section 5-5 as follows: |
(305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
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Sec. 5-5. Medical services. The Illinois Department, by |
rule, shall
determine the quantity and quality of and the rate |
of reimbursement for the
medical assistance for which
payment |
will be authorized, and the medical services to be provided,
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which may include all or part of the following: (1) inpatient |
hospital
services; (2) outpatient hospital services; (3) other |
laboratory and
X-ray services; (4) skilled nursing home |
services; (5) physicians'
services whether furnished in the |
office, the patient's home, a
hospital, a skilled nursing home, |
or elsewhere; (6) medical care, or any
other type of remedial |
care furnished by licensed practitioners; (7)
home health care |
services; (8) private duty nursing service; (9) clinic
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services; (10) dental services, including prevention and |
treatment of periodontal disease and dental caries disease for |
pregnant women, provided by an individual licensed to practice |
dentistry or dental surgery; for purposes of this item (10), |
"dental services" means diagnostic, preventive, or corrective |
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procedures provided by or under the supervision of a dentist in |
the practice of his or her profession; (11) physical therapy |
and related
services; (12) prescribed drugs, dentures, and |
prosthetic devices; and
eyeglasses prescribed by a physician |
skilled in the diseases of the eye,
or by an optometrist, |
whichever the person may select; (13) other
diagnostic, |
screening, preventive, and rehabilitative services, including |
to ensure that the individual's need for intervention or |
treatment of mental disorders or substance use disorders or |
co-occurring mental health and substance use disorders is |
determined using a uniform screening, assessment, and |
evaluation process inclusive of criteria, for children and |
adults; for purposes of this item (13), a uniform screening, |
assessment, and evaluation process refers to a process that |
includes an appropriate evaluation and, as warranted, a |
referral; "uniform" does not mean the use of a singular |
instrument, tool, or process that all must utilize; (14)
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transportation and such other expenses as may be necessary; |
(15) medical
treatment of sexual assault survivors, as defined |
in
Section 1a of the Sexual Assault Survivors Emergency |
Treatment Act, for
injuries sustained as a result of the sexual |
assault, including
examinations and laboratory tests to |
discover evidence which may be used in
criminal proceedings |
arising from the sexual assault; (16) the
diagnosis and |
treatment of sickle cell anemia; and (17)
any other medical |
care, and any other type of remedial care recognized
under the |
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laws of this State, but not including abortions, or induced
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miscarriages or premature births, unless, in the opinion of a |
physician,
such procedures are necessary for the preservation |
of the life of the
woman seeking such treatment, or except an |
induced premature birth
intended to produce a live viable child |
and such procedure is necessary
for the health of the mother or |
her unborn child. The Illinois Department,
by rule, shall |
prohibit any physician from providing medical assistance
to |
anyone eligible therefor under this Code where such physician |
has been
found guilty of performing an abortion procedure in a |
wilful and wanton
manner upon a woman who was not pregnant at |
the time such abortion
procedure was performed. The term "any |
other type of remedial care" shall
include nursing care and |
nursing home service for persons who rely on
treatment by |
spiritual means alone through prayer for healing.
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Notwithstanding any other provision of this Section, a |
comprehensive
tobacco use cessation program that includes |
purchasing prescription drugs or
prescription medical devices |
approved by the Food and Drug Administration shall
be covered |
under the medical assistance
program under this Article for |
persons who are otherwise eligible for
assistance under this |
Article.
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Notwithstanding any other provision of this Code, the |
Illinois
Department may not require, as a condition of payment |
for any laboratory
test authorized under this Article, that a |
physician's handwritten signature
appear on the laboratory |
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test order form. The Illinois Department may,
however, impose |
other appropriate requirements regarding laboratory test
order |
documentation.
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On and after July 1, 2012, the Department of Healthcare and |
Family Services may provide the following services to
persons
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eligible for assistance under this Article who are |
participating in
education, training or employment programs |
operated by the Department of Human
Services as successor to |
the Department of Public Aid:
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(1) dental services provided by or under the |
supervision of a dentist; and
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(2) eyeglasses prescribed by a physician skilled in the |
diseases of the
eye, or by an optometrist, whichever the |
person may select.
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Notwithstanding any other provision of this Code and |
subject to federal approval, the Department may adopt rules to |
allow a dentist who is volunteering his or her service at no |
cost to render dental services through an enrolled |
not-for-profit health clinic without the dentist personally |
enrolling as a participating provider in the medical assistance |
program. A not-for-profit health clinic shall include a public |
health clinic or Federally Qualified Health Center or other |
enrolled provider, as determined by the Department, through |
which dental services covered under this Section are performed. |
The Department shall establish a process for payment of claims |
for reimbursement for covered dental services rendered under |
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this provision. |
The Illinois Department, by rule, may distinguish and |
classify the
medical services to be provided only in accordance |
with the classes of
persons designated in Section 5-2.
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The Department of Healthcare and Family Services must |
provide coverage and reimbursement for amino acid-based |
elemental formulas, regardless of delivery method, for the |
diagnosis and treatment of (i) eosinophilic disorders and (ii) |
short bowel syndrome when the prescribing physician has issued |
a written order stating that the amino acid-based elemental |
formula is medically necessary.
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The Illinois Department shall authorize the provision of, |
and shall
authorize payment for, screening by low-dose |
mammography for the presence of
occult breast cancer for women |
35 years of age or older who are eligible
for medical |
assistance under this Article, as follows: |
(A) A baseline
mammogram for women 35 to 39 years of |
age.
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(B) An annual mammogram for women 40 years of age or |
older. |
(C) A mammogram at the age and intervals considered |
medically necessary by the woman's health care provider for |
women under 40 years of age and having a family history of |
breast cancer, prior personal history of breast cancer, |
positive genetic testing, or other risk factors. |
(D) A comprehensive ultrasound screening of an entire |
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breast or breasts if a mammogram demonstrates |
heterogeneous or dense breast tissue, when medically |
necessary as determined by a physician licensed to practice |
medicine in all of its branches. |
All screenings
shall
include a physical breast exam, |
instruction on self-examination and
information regarding the |
frequency of self-examination and its value as a
preventative |
tool. For purposes of this Section, "low-dose mammography" |
means
the x-ray examination of the breast using equipment |
dedicated specifically
for mammography, including the x-ray |
tube, filter, compression device,
and image receptor, with an |
average radiation exposure delivery
of less than one rad per |
breast for 2 views of an average size breast.
The term also |
includes digital mammography.
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On and after January 1, 2012, providers participating in a |
quality improvement program approved by the Department shall be |
reimbursed for screening and diagnostic mammography at the same |
rate as the Medicare program's rates, including the increased |
reimbursement for digital mammography. |
The Department shall convene an expert panel including |
representatives of hospitals, free-standing mammography |
facilities, and doctors, including radiologists, to establish |
quality standards. |
Subject to federal approval, the Department shall |
establish a rate methodology for mammography at federally |
qualified health centers and other encounter-rate clinics. |
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These clinics or centers may also collaborate with other |
hospital-based mammography facilities. |
The Department shall establish a methodology to remind |
women who are age-appropriate for screening mammography, but |
who have not received a mammogram within the previous 18 |
months, of the importance and benefit of screening mammography. |
The Department shall establish a performance goal for |
primary care providers with respect to their female patients |
over age 40 receiving an annual mammogram. This performance |
goal shall be used to provide additional reimbursement in the |
form of a quality performance bonus to primary care providers |
who meet that goal. |
The Department shall devise a means of case-managing or |
patient navigation for beneficiaries diagnosed with breast |
cancer. This program shall initially operate as a pilot program |
in areas of the State with the highest incidence of mortality |
related to breast cancer. At least one pilot program site shall |
be in the metropolitan Chicago area and at least one site shall |
be outside the metropolitan Chicago area. An evaluation of the |
pilot program shall be carried out measuring health outcomes |
and cost of care for those served by the pilot program compared |
to similarly situated patients who are not served by the pilot |
program. |
Any medical or health care provider shall immediately |
recommend, to
any pregnant woman who is being provided prenatal |
services and is suspected
of drug abuse or is addicted as |
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defined in the Alcoholism and Other Drug Abuse
and Dependency |
Act, referral to a local substance abuse treatment provider
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licensed by the Department of Human Services or to a licensed
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hospital which provides substance abuse treatment services. |
The Department of Healthcare and Family Services
shall assure |
coverage for the cost of treatment of the drug abuse or
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addiction for pregnant recipients in accordance with the |
Illinois Medicaid
Program in conjunction with the Department of |
Human Services.
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All medical providers providing medical assistance to |
pregnant women
under this Code shall receive information from |
the Department on the
availability of services under the Drug |
Free Families with a Future or any
comparable program providing |
case management services for addicted women,
including |
information on appropriate referrals for other social services
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that may be needed by addicted women in addition to treatment |
for addiction.
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The Illinois Department, in cooperation with the |
Departments of Human
Services (as successor to the Department |
of Alcoholism and Substance
Abuse) and Public Health, through a |
public awareness campaign, may
provide information concerning |
treatment for alcoholism and drug abuse and
addiction, prenatal |
health care, and other pertinent programs directed at
reducing |
the number of drug-affected infants born to recipients of |
medical
assistance.
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Neither the Department of Healthcare and Family Services |
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nor the Department of Human
Services shall sanction the |
recipient solely on the basis of
her substance abuse.
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The Illinois Department shall establish such regulations |
governing
the dispensing of health services under this Article |
as it shall deem
appropriate. The Department
should
seek the |
advice of formal professional advisory committees appointed by
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the Director of the Illinois Department for the purpose of |
providing regular
advice on policy and administrative matters, |
information dissemination and
educational activities for |
medical and health care providers, and
consistency in |
procedures to the Illinois Department.
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The Illinois Department may develop and contract with |
Partnerships of
medical providers to arrange medical services |
for persons eligible under
Section 5-2 of this Code. |
Implementation of this Section may be by
demonstration projects |
in certain geographic areas. The Partnership shall
be |
represented by a sponsor organization. The Department, by rule, |
shall
develop qualifications for sponsors of Partnerships. |
Nothing in this
Section shall be construed to require that the |
sponsor organization be a
medical organization.
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The sponsor must negotiate formal written contracts with |
medical
providers for physician services, inpatient and |
outpatient hospital care,
home health services, treatment for |
alcoholism and substance abuse, and
other services determined |
necessary by the Illinois Department by rule for
delivery by |
Partnerships. Physician services must include prenatal and
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obstetrical care. The Illinois Department shall reimburse |
medical services
delivered by Partnership providers to clients |
in target areas according to
provisions of this Article and the |
Illinois Health Finance Reform Act,
except that:
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(1) Physicians participating in a Partnership and |
providing certain
services, which shall be determined by |
the Illinois Department, to persons
in areas covered by the |
Partnership may receive an additional surcharge
for such |
services.
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(2) The Department may elect to consider and negotiate |
financial
incentives to encourage the development of |
Partnerships and the efficient
delivery of medical care.
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(3) Persons receiving medical services through |
Partnerships may receive
medical and case management |
services above the level usually offered
through the |
medical assistance program.
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Medical providers shall be required to meet certain |
qualifications to
participate in Partnerships to ensure the |
delivery of high quality medical
services. These |
qualifications shall be determined by rule of the Illinois
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Department and may be higher than qualifications for |
participation in the
medical assistance program. Partnership |
sponsors may prescribe reasonable
additional qualifications |
for participation by medical providers, only with
the prior |
written approval of the Illinois Department.
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Nothing in this Section shall limit the free choice of |
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practitioners,
hospitals, and other providers of medical |
services by clients.
In order to ensure patient freedom of |
choice, the Illinois Department shall
immediately promulgate |
all rules and take all other necessary actions so that
provided |
services may be accessed from therapeutically certified |
optometrists
to the full extent of the Illinois Optometric |
Practice Act of 1987 without
discriminating between service |
providers.
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The Department shall apply for a waiver from the United |
States Health
Care Financing Administration to allow for the |
implementation of
Partnerships under this Section.
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The Illinois Department shall require health care |
providers to maintain
records that document the medical care |
and services provided to recipients
of Medical Assistance under |
this Article. Such records must be retained for a period of not |
less than 6 years from the date of service or as provided by |
applicable State law, whichever period is longer, except that |
if an audit is initiated within the required retention period |
then the records must be retained until the audit is completed |
and every exception is resolved. The Illinois Department shall
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require health care providers to make available, when |
authorized by the
patient, in writing, the medical records in a |
timely fashion to other
health care providers who are treating |
or serving persons eligible for
Medical Assistance under this |
Article. All dispensers of medical services
shall be required |
to maintain and retain business and professional records
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sufficient to fully and accurately document the nature, scope, |
details and
receipt of the health care provided to persons |
eligible for medical
assistance under this Code, in accordance |
with regulations promulgated by
the Illinois Department. The |
rules and regulations shall require that proof
of the receipt |
of prescription drugs, dentures, prosthetic devices and
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eyeglasses by eligible persons under this Section accompany |
each claim
for reimbursement submitted by the dispenser of such |
medical services.
No such claims for reimbursement shall be |
approved for payment by the Illinois
Department without such |
proof of receipt, unless the Illinois Department
shall have put |
into effect and shall be operating a system of post-payment
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audit and review which shall, on a sampling basis, be deemed |
adequate by
the Illinois Department to assure that such drugs, |
dentures, prosthetic
devices and eyeglasses for which payment |
is being made are actually being
received by eligible |
recipients. Within 90 days after the effective date of
this |
amendatory Act of 1984, the Illinois Department shall establish |
a
current list of acquisition costs for all prosthetic devices |
and any
other items recognized as medical equipment and |
supplies reimbursable under
this Article and shall update such |
list on a quarterly basis, except that
the acquisition costs of |
all prescription drugs shall be updated no
less frequently than |
every 30 days as required by Section 5-5.12.
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The rules and regulations of the Illinois Department shall |
require
that a written statement including the required opinion |
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of a physician
shall accompany any claim for reimbursement for |
abortions, or induced
miscarriages or premature births. This |
statement shall indicate what
procedures were used in providing |
such medical services.
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The Illinois Department shall require all dispensers of |
medical
services, other than an individual practitioner or |
group of practitioners,
desiring to participate in the Medical |
Assistance program
established under this Article to disclose |
all financial, beneficial,
ownership, equity, surety or other |
interests in any and all firms,
corporations, partnerships, |
associations, business enterprises, joint
ventures, agencies, |
institutions or other legal entities providing any
form of |
health care services in this State under this Article.
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The Illinois Department may require that all dispensers of |
medical
services desiring to participate in the medical |
assistance program
established under this Article disclose, |
under such terms and conditions as
the Illinois Department may |
by rule establish, all inquiries from clients
and attorneys |
regarding medical bills paid by the Illinois Department, which
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inquiries could indicate potential existence of claims or liens |
for the
Illinois Department.
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Enrollment of a vendor
shall be
subject to a provisional |
period and shall be conditional for one year. During the period |
of conditional enrollment, the Department may
terminate the |
vendor's eligibility to participate in, or may disenroll the |
vendor from, the medical assistance
program without cause. |
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Unless otherwise specified, such termination of eligibility or |
disenrollment is not subject to the
Department's hearing |
process.
However, a disenrolled vendor may reapply without |
penalty.
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The Department has the discretion to limit the conditional |
enrollment period for vendors based upon category of risk of |
the vendor. |
Prior to enrollment and during the conditional enrollment |
period in the medical assistance program, all vendors shall be |
subject to enhanced oversight, screening, and review based on |
the risk of fraud, waste, and abuse that is posed by the |
category of risk of the vendor. The Illinois Department shall |
establish the procedures for oversight, screening, and review, |
which may include, but need not be limited to: criminal and |
financial background checks; fingerprinting; license, |
certification, and authorization verifications; unscheduled or |
unannounced site visits; database checks; prepayment audit |
reviews; audits; payment caps; payment suspensions; and other |
screening as required by federal or State law. |
The Department shall define or specify the following: (i) |
by provider notice, the "category of risk of the vendor" for |
each type of vendor, which shall take into account the level of |
screening applicable to a particular category of vendor under |
federal law and regulations; (ii) by rule or provider notice, |
the maximum length of the conditional enrollment period for |
each category of risk of the vendor; and (iii) by rule, the |
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hearing rights, if any, afforded to a vendor in each category |
of risk of the vendor that is terminated or disenrolled during |
the conditional enrollment period. |
To be eligible for payment consideration, a vendor's |
payment claim or bill, either as an initial claim or as a |
resubmitted claim following prior rejection, must be received |
by the Illinois Department, or its fiscal intermediary, no |
later than 180 days after the latest date on the claim on which |
medical goods or services were provided, with the following |
exceptions: |
(1) In the case of a provider whose enrollment is in |
process by the Illinois Department, the 180-day period |
shall not begin until the date on the written notice from |
the Illinois Department that the provider enrollment is |
complete. |
(2) In the case of errors attributable to the Illinois |
Department or any of its claims processing intermediaries |
which result in an inability to receive, process, or |
adjudicate a claim, the 180-day period shall not begin |
until the provider has been notified of the error. |
(3) In the case of a provider for whom the Illinois |
Department initiates the monthly billing process. |
For claims for services rendered during a period for which |
a recipient received retroactive eligibility, claims must be |
filed within 180 days after the Department determines the |
applicant is eligible. For claims for which the Illinois |
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Department is not the primary payer, claims must be submitted |
to the Illinois Department within 180 days after the final |
adjudication by the primary payer. |
In the case of long term care facilities, admission |
documents shall be submitted within 30 days of an admission to |
the facility through the Medical Electronic Data Interchange |
(MEDI) or the Recipient Eligibility Verification (REV) System, |
or shall be submitted directly to the Department of Human |
Services using required admission forms. Confirmation numbers |
assigned to an accepted transaction shall be retained by a |
facility to verify timely submittal. Once an admission |
transaction has been completed, all resubmitted claims |
following prior rejection are subject to receipt no later than |
180 days after the admission transaction has been completed. |
Claims that are not submitted and received in compliance |
with the foregoing requirements shall not be eligible for |
payment under the medical assistance program, and the State |
shall have no liability for payment of those claims. |
To the extent consistent with applicable information and |
privacy, security, and disclosure laws, State and federal |
agencies and departments shall provide the Illinois Department |
access to confidential and other information and data necessary |
to perform eligibility and payment verifications and other |
Illinois Department functions. This includes, but is not |
limited to: information pertaining to licensure; |
certification; earnings; immigration status; citizenship; wage |
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reporting; unearned and earned income; pension income; |
employment; supplemental security income; social security |
numbers; National Provider Identifier (NPI) numbers; the |
National Practitioner Data Bank (NPDB); program and agency |
exclusions; taxpayer identification numbers; tax delinquency; |
corporate information; and death records. |
The Illinois Department shall enter into agreements with |
State agencies and departments, and is authorized to enter into |
agreements with federal agencies and departments, under which |
such agencies and departments shall share data necessary for |
medical assistance program integrity functions and oversight. |
The Illinois Department shall develop, in cooperation with |
other State departments and agencies, and in compliance with |
applicable federal laws and regulations, appropriate and |
effective methods to share such data. At a minimum, and to the |
extent necessary to provide data sharing, the Illinois |
Department shall enter into agreements with State agencies and |
departments, and is authorized to enter into agreements with |
federal agencies and departments, including but not limited to: |
the Secretary of State; the Department of Revenue; the |
Department of Public Health; the Department of Human Services; |
and the Department of Financial and Professional Regulation. |
Beginning in fiscal year 2013, the Illinois Department |
shall set forth a request for information to identify the |
benefits of a pre-payment, post-adjudication, and post-edit |
claims system with the goals of streamlining claims processing |
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and provider reimbursement, reducing the number of pending or |
rejected claims, and helping to ensure a more transparent |
adjudication process through the utilization of: (i) provider |
data verification and provider screening technology; and (ii) |
clinical code editing; and (iii) pre-pay, pre- or |
post-adjudicated predictive modeling with an integrated case |
management system with link analysis. Such a request for |
information shall not be considered as a request for proposal |
or as an obligation on the part of the Illinois Department to |
take any action or acquire any products or services. |
The Illinois Department shall establish policies, |
procedures,
standards and criteria by rule for the acquisition, |
repair and replacement
of orthotic and prosthetic devices and |
durable medical equipment. Such
rules shall provide, but not be |
limited to, the following services: (1)
immediate repair or |
replacement of such devices by recipients; and (2) rental, |
lease, purchase or lease-purchase of
durable medical equipment |
in a cost-effective manner, taking into
consideration the |
recipient's medical prognosis, the extent of the
recipient's |
needs, and the requirements and costs for maintaining such
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equipment. Subject to prior approval, such rules shall enable a |
recipient to temporarily acquire and
use alternative or |
substitute devices or equipment pending repairs or
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replacements of any device or equipment previously authorized |
for such
recipient by the Department.
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The Department shall execute, relative to the nursing home |
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prescreening
project, written inter-agency agreements with the |
Department of Human
Services and the Department on Aging, to |
effect the following: (i) intake
procedures and common |
eligibility criteria for those persons who are receiving
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non-institutional services; and (ii) the establishment and |
development of
non-institutional services in areas of the State |
where they are not currently
available or are undeveloped; and |
(iii) notwithstanding any other provision of law, subject to |
federal approval, on and after July 1, 2012, an increase in the |
determination of need (DON) scores from 29 to 37 for applicants |
for institutional and home and community-based long term care; |
if and only if federal approval is not granted, the Department |
may, in conjunction with other affected agencies, implement |
utilization controls or changes in benefit packages to |
effectuate a similar savings amount for this population; and |
(iv) no later than July 1, 2013, minimum level of care |
eligibility criteria for institutional and home and |
community-based long term care ; and (v) no later than October |
1, 2013, establish procedures to permit long term care |
providers access to eligibility scores for individuals with an |
admission date who are seeking or receiving services from the |
long term care provider . In order to select the minimum level |
of care eligibility criteria, the Governor shall establish a |
workgroup that includes affected agency representatives and |
stakeholders representing the institutional and home and |
community-based long term care interests. This Section shall |
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not restrict the Department from implementing lower level of |
care eligibility criteria for community-based services in |
circumstances where federal approval has been granted.
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The Illinois Department shall develop and operate, in |
cooperation
with other State Departments and agencies and in |
compliance with
applicable federal laws and regulations, |
appropriate and effective
systems of health care evaluation and |
programs for monitoring of
utilization of health care services |
and facilities, as it affects
persons eligible for medical |
assistance under this Code.
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The Illinois Department shall report annually to the |
General Assembly,
no later than the second Friday in April of |
1979 and each year
thereafter, in regard to:
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(a) actual statistics and trends in utilization of |
medical services by
public aid recipients;
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(b) actual statistics and trends in the provision of |
the various medical
services by medical vendors;
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(c) current rate structures and proposed changes in |
those rate structures
for the various medical vendors; and
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(d) efforts at utilization review and control by the |
Illinois Department.
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The period covered by each report shall be the 3 years |
ending on the June
30 prior to the report. The report shall |
include suggested legislation
for consideration by the General |
Assembly. The filing of one copy of the
report with the |
Speaker, one copy with the Minority Leader and one copy
with |
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the Clerk of the House of Representatives, one copy with the |
President,
one copy with the Minority Leader and one copy with |
the Secretary of the
Senate, one copy with the Legislative |
Research Unit, and such additional
copies
with the State |
Government Report Distribution Center for the General
Assembly |
as is required under paragraph (t) of Section 7 of the State
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Library Act shall be deemed sufficient to comply with this |
Section.
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Rulemaking authority to implement Public Act 95-1045, if |
any, is conditioned on the rules being adopted in accordance |
with all provisions of the Illinois Administrative Procedure |
Act and all rules and procedures of the Joint Committee on |
Administrative Rules; any purported rule not so adopted, for |
whatever reason, is unauthorized. |
On and after July 1, 2012, the Department shall reduce any |
rate of reimbursement for services or other payments or alter |
any methodologies authorized by this Code to reduce any rate of |
reimbursement for services or other payments in accordance with |
Section 5-5e. |
(Source: P.A. 96-156, eff. 1-1-10; 96-806, eff. 7-1-10; 96-926, |
eff. 1-1-11; 96-1000, eff. 7-2-10; 97-48, eff. 6-28-11; 97-638, |
eff. 1-1-12; 97-689, eff. 6-14-12; 97-1061, eff. 8-24-12; |
revised 9-20-12.)
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Section 99. Effective date. This Act takes effect upon |
becoming law.
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