Comments: IL HB3245 | 2019-2020 | 101st General Assembly

Illinois House Bill 3245 (Prior Session Legislation)

Bill Title: Amends the Illinois Public Aid Code. Provides that on and after January 1, 2020 no recipient of medical assistance shall be required to enroll or transition to the State's managed care medical assistance program. Provides that any recipient enrolled in a managed care health plan on January 1, 2020 shall be given the option to disenroll from the State's managed care medical assistance program and receive coverage under the State's fee-for-service program. Provides that on and after January 1, 2020, the Department of Healthcare and Family Services shall not enter into any new contract or agreement with a managed care organization (MCO) to provide services where payment for medical services is made on a capitated basis. Provides that the Department shall not renew, renter, renegotiate, change orders, or amend any contract or agreement it entered with a MCO that was solicited under the State of Illinois Medicaid Managed Care Organization Request for Proposals (2018-24-001) (Request for Proposals (2018-24-001)). Provides that any recipient who is enrolled in a managed care health plan administered by a MCO that entered a contract with the Department under the Request for Proposals (2018-24-001) shall be transitioned to the State's fee-for-service program upon the expiration of the MCO's contract with the Department. Requires the Department to establish, by rule, an appeals and grievance process that includes: (i) an expedited internal review of an appeal involving an adverse determination; (ii) a final adverse determination; and (iii) a standard external review. Requires the Department to notify a recipient in writing of the recipient's right to request an external review. Repeals a provision concerning procurement requirements for MCO contracts.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Introduced - Dead) 2020-06-23 - Rule 19(b) / Re-referred to Rules Committee [HB3245 Detail]

Text: Latest bill text (Introduced) [HTML]