Bill Text: IL HB5285 | 2017-2018 | 100th General Assembly | Introduced

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Bill Title: Amends the State Prompt Payment Act. Provides that after the effective date of the amendatory Act, any bill approved for payment under the Act and pursuant to a health benefit plan under the State Employees Group Insurance Act of 1971 or submitted under Article V of the Illinois Public Aid Code, except a bill for pharmacy or nursing facility services or goods, must be paid or the payment issued to the payee in a timely manner. Provides that if payment is not issued to the payee in a timely manner, the following interest penalty shall apply to any amount approved and unpaid until final payment is made: the sum of the prime commercial rate plus 4.0% per year, applied pro rata for the amount of time the bill remains unpaid. Defines "prime commercial rate". Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2019, psychiatrists approved by the Department of Healthcare and Family Services shall be reimbursed for psychiatric services at a rate that is no lower than 95% of the Medicare program's rates for specified codes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2019-01-08 - Session Sine Die [HB5285 Detail]

Download: Illinois-2017-HB5285-Introduced.html

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100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 HB5285 Introduced , by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED:
30 ILCS 540/3-2
305 ILCS 5/5-5.25a new
Amends the State Prompt Payment Act. Provides that after the effective date of the amendatory Act, any bill approved for payment under the Act and pursuant to a health benefit plan under the State Employees Group Insurance Act of 1971 or submitted under Article V of the Illinois Public Aid Code, except a bill for pharmacy or nursing facility services or goods, must be paid or the payment issued to the payee in a timely manner. Provides that if payment is not issued to the payee in a timely manner, the following interest penalty shall apply to any amount approved and unpaid until final payment is made: the sum of the prime commercial rate plus 4.0% per year, applied pro rata for the amount of time the bill remains unpaid. Defines "prime commercial rate". Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2019, psychiatrists approved by the Department of Healthcare and Family Services shall be reimbursed for psychiatric services at a rate that is no lower than 95% of the Medicare program's rates for specified codes.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning public aid.
WHEREAS, Medicaid reimbursements for psychiatrists have
not increased since 1996; and
WHEREAS, The Psychiatric Leadership Capacity Grants that
were used to help pay for psychiatrist services due to the low
reimbursement rates for psychiatrists were eliminated in 2015;
and
WHEREAS, In 2014, the amount of funding for Psychiatric
Leadership Capacity Grants was $27,000,000; and
WHEREAS, In 2014, Medicaid reimbursement for psychiatrists
was $47,677,158; and
WHEREAS, In 2017, Medicaid reimbursement for psychiatrists
was $21,584,859; and
WHEREAS, The Centers for Medicare and Medicaid Services
recently stated that "low reimbursement rates can impede access
to care"; and
WHEREAS, Underfunding community-centered health care leads
to greater costs because patient care is shifted to inpatient
hospitalizations, emergency rooms, and jails or prisons; and

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WHEREAS, Whereas, according to the Milliman Research
Report, "Addiction and mental health vs. physical health:
Analyzing disparities in network use and provider
reimbursement rates", (December 2017), the reimbursement rates
for the same exact Evaluation & Management (E&M) Codes for
moderate complexity cases are 18.3% higher for primary care
providers than for psychiatrists and 20.1% higher for medical
and surgical specialists than for psychiatrists; and
WHEREAS, Whereas, based on the findings in the Milliman
Research Report, reimbursement rates for psychiatrists in
Illinois are in violation of federal parity law; therefore
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Prompt Payment Act is amended by
changing Section 3-2 as follows:
(30 ILCS 540/3-2)
Sec. 3-2. Beginning July 1, 1993, in any instance where a
State official or agency is late in payment of a vendor's bill
or invoice for goods or services furnished to the State, as
defined in Section 1, properly approved in accordance with
rules promulgated under Section 3-3, the State official or
agency shall pay interest to the vendor in accordance with the

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following:
(1) Any bill, except a bill submitted under Article V
of the Illinois Public Aid Code and except as provided
under paragraphs paragraph (1.05) and (1.06) of this
Section, approved for payment under this Section must be
paid or the payment issued to the payee within 60 days of
receipt of a proper bill or invoice. If payment is not
issued to the payee within this 60-day period, an interest
penalty of 1.0% of any amount approved and unpaid shall be
added for each month or fraction thereof after the end of
this 60-day period, until final payment is made. Any bill,
except a bill for pharmacy or nursing facility services or
goods, and except as provided under paragraphs paragraph
(1.05) and (1.06) of this Section, submitted under Article
V of the Illinois Public Aid Code approved for payment
under this Section must be paid or the payment issued to
the payee within 60 days after receipt of a proper bill or
invoice, and, if payment is not issued to the payee within
this 60-day period, an interest penalty of 2.0% of any
amount approved and unpaid shall be added for each month or
fraction thereof after the end of this 60-day period, until
final payment is made. Any bill for pharmacy or nursing
facility services or goods submitted under Article V of the
Illinois Public Aid Code, except as provided under
paragraphs paragraph (1.05) and (1.06) of this Section, and
approved for payment under this Section must be paid or the

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payment issued to the payee within 60 days of receipt of a
proper bill or invoice. If payment is not issued to the
payee within this 60-day period, an interest penalty of
1.0% of any amount approved and unpaid shall be added for
each month or fraction thereof after the end of this 60-day
period, until final payment is made.
(1.05) For State fiscal year 2012 and future fiscal
years, any bill approved for payment under this Section
must be paid or the payment issued to the payee within 90
days of receipt of a proper bill or invoice. If payment is
not issued to the payee within this 90-day period, an
interest penalty of 1.0% of any amount approved and unpaid
shall be added for each month, or 0.033% (one-thirtieth of
one percent) of any amount approved and unpaid for each
day, after the end of this 90-day period, until final
payment is made.
(1.06) After the effective date of this amendatory Act
of the 100th General Assembly, any bill approved for
payment under this Section and pursuant to a health benefit
plan under the State Employees Group Insurance Act of 1971
or submitted under Article V of the Illinois Public Aid
Code, except a bill for pharmacy or nursing facility
services or goods, must be paid or the payment issued to
the payee in a timely manner under this Section. If payment
is not issued to the payee in a timely manner under this
Section, the following interest penalty shall apply to any

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amount approved and unpaid until final payment is made: the
sum of the prime commercial rate plus 4.0% per year,
applied pro rata for the amount of time the bill remains
unpaid. As used in this paragraph, "prime commercial rate"
means the Wall Street Journal Prime Rate, as published from
time to time.
(1.1) A State agency shall review in a timely manner
each bill or invoice after its receipt. If the State agency
determines that the bill or invoice contains a defect
making it unable to process the payment request, the agency
shall notify the vendor requesting payment as soon as
possible after discovering the defect pursuant to rules
promulgated under Section 3-3; provided, however, that the
notice for construction related bills or invoices must be
given not later than 30 days after the bill or invoice was
first submitted. The notice shall identify the defect and
any additional information necessary to correct the
defect. If one or more items on a construction related bill
or invoice are disapproved, but not the entire bill or
invoice, then the portion that is not disapproved shall be
paid.
(2) Where a State official or agency is late in payment
of a vendor's bill or invoice properly approved in
accordance with this Act, and different late payment terms
are not reduced to writing as a contractual agreement, the
State official or agency shall automatically pay interest

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penalties required by this Section amounting to $50 or more
to the appropriate vendor. Each agency shall be responsible
for determining whether an interest penalty is owed and for
paying the interest to the vendor. Except as provided in
paragraph (4), an individual interest payment amounting to
$5 or less shall not be paid by the State. Interest due to
a vendor that amounts to greater than $5 and less than $50
shall not be paid but shall be accrued until all interest
due the vendor for all similar warrants exceeds $50, at
which time the accrued interest shall be payable and
interest will begin accruing again, except that interest
accrued as of the end of the fiscal year that does not
exceed $50 shall be payable at that time. In the event an
individual has paid a vendor for services in advance, the
provisions of this Section shall apply until payment is
made to that individual.
(3) The provisions of Public Act 96-1501 reducing the
interest rate on pharmacy claims under Article V of the
Illinois Public Aid Code to 1.0% per month shall apply to
any pharmacy bills for services and goods under Article V
of the Illinois Public Aid Code received on or after the
date 60 days before January 25, 2011 (the effective date of
Public Act 96-1501) except as provided under paragraph
(1.05) of this Section.
(4) Interest amounting to less than $5 shall not be
paid by the State, except for claims (i) to the Department

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of Healthcare and Family Services or the Department of
Human Services, (ii) pursuant to Article V of the Illinois
Public Aid Code, the Covering ALL KIDS Health Insurance
Act, or the Children's Health Insurance Program Act, and
(iii) made (A) by pharmacies for prescriptive services or
(B) by any federally qualified health center for
prescriptive services or any other services.
(Source: P.A. 96-555, eff. 8-18-09; 96-802, eff. 1-1-10;
96-959, eff. 7-1-10; 96-1000, eff. 7-2-10; 96-1501, eff.
1-25-11; 96-1530, eff. 2-16-11; 97-72, eff. 7-1-11; 97-74, eff.
6-30-11; 97-348, eff. 8-12-11; 97-813, eff. 7-13-12; 97-932,
eff. 8-10-12; 97-1142, eff. 12-28-12.)
Section 10. The Illinois Public Aid Code is amended by
adding Section 5-5.25a as follows:
(305 ILCS 5/5-5.25a new)
Sec. 5-5.25a. Psychiatric treatment; payment rate
increases. On and after January 1, 2019, psychiatrists approved
by the Department shall be reimbursed for psychiatric services
at a rate that is no lower than 95% of the Medicare program's
rates for the following codes: 99213, 99214, 99215, 90792,
90833, and 90834.