Bill Text: IL HB4139 | 2019-2020 | 101st General Assembly | Introduced

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that if a Medicaid enrollee of a managed care organization selects a plan based on the in-network status of (i) an existing primary care provider or (ii) up to 2 existing specialty care providers for an existing condition that is under active treatment, the managed care organization may not change the Medicaid enrollee's selected provider in (i) or (ii) for the remainder of the 12-month period following enrollment in the managed care health plan without permission by the Medicaid enrollee. Permits the Department of Healthcare and Family Services to adopt any rules necessary to administer the amendatory Act. Provides that nothing in the amendatory Act shall be construed to prohibit a Medicaid enrollee from changing his or her primary care provider as authorized by Department rules.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2020-01-22 - Referred to Rules Committee [HB4139 Detail]

Download: Illinois-2019-HB4139-Introduced.html

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101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 HB4139 Introduced , by Rep. Deanne M. Mazzochi SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-30.15 new
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that if a Medicaid enrollee of a managed care organization selects a plan based on the in-network status of (i) an existing primary care provider or (ii) up to 2 existing specialty care providers for an existing condition that is under active treatment, the managed care organization may not change the Medicaid enrollee's selected provider in (i) or (ii) for the remainder of the 12-month period following enrollment in the managed care health plan without permission by the Medicaid enrollee. Permits the Department of Healthcare and Family Services to adopt any rules necessary to administer the amendatory Act. Provides that nothing in the amendatory Act shall be construed to prohibit a Medicaid enrollee from changing his or her primary care provider as authorized by Department rules.
LRB101 13166 KTG 64065 b
FISCAL NOTE ACT MAY APPLY
A BILL FOR
HB4139 LRB101 13166 KTG 64065 b
AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
adding Section 5-30.15 as follows:
(305 ILCS 5/5-30.15 new)
Sec. 5-30.15. Change in provider; managed care
restrictions. If a Medicaid enrollee of a managed care
organization selects a plan based on the in-network status of
(i) an existing primary care provider or (ii) up to 2 existing
specialty care providers for an existing condition that is
under active treatment, the managed care organization may not
change the Medicaid enrollee's selected provider in (i) or (ii)
for the remainder of the 12-month period following enrollment
in the managed care health plan without permission by the
Medicaid enrollee. The Department may adopt any rules necessary
to administer this Section. Nothing in this Section shall be
construed to prohibit a Medicaid enrollee from changing his or
her primary care provider as authorized by Department rules.