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| | 100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB1379 Introduced 2/9/2017, by Sen. David Koehler - Kyle McCarter SYNOPSIS AS INTRODUCED:
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Amends the Children's Health Insurance Program Act. In a provision concerning care coordination, provides that mandatory assignments into managed care organizations must not occur when 50% of persons eligible for selecting a managed care service are covered through an integrated care program until the Department of Healthcare and Family Services demonstrates that the net per-recipient cost paid by non-federal, State revenue sources in those contracts, adjusted for age and gender, is less than the non-federal, net State per-recipient cost in fee-for-service for fiscal year 2014 and the health outcome goals required in contracts have been achieved. Requires that all per-recipient cost calculations be performed between like eligibility categories. Excludes Hospital Assessment Program payments from these calculations. Requires the Department to annually calculate and publish on its website a report on the per-recipient cost calculations and certain other information.
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| | A BILL FOR |
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| | SB1379 | | LRB100 08706 SMS 18842 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Children's Health Insurance Program Act is |
5 | | amended by changing Section 23 as follows:
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6 | | (215 ILCS 106/23) |
7 | | Sec. 23. Care coordination. |
8 | | (a) At least 50% of recipients eligible for comprehensive |
9 | | medical benefits in all medical assistance programs or other |
10 | | health benefit programs administered by the Department, |
11 | | including the Children's Health Insurance Program Act and the |
12 | | Covering ALL KIDS Health Insurance Act, shall be enrolled in a |
13 | | care coordination program by no later than January 1, 2015. |
14 | | However, mandatory assignments into managed care organizations |
15 | | must not occur when 50% of persons eligible for selecting a |
16 | | managed care service are covered through an integrated care |
17 | | program until the Department demonstrates that the net |
18 | | per-recipient cost paid by non-federal, State revenue sources |
19 | | in those contracts, adjusted for age and gender, is less than |
20 | | the non-federal, net State per-recipient cost in |
21 | | fee-for-service for fiscal year 2014 and the health outcome |
22 | | goals required in those contracts have been achieved. All |
23 | | per-recipient cost calculations shall be performed between |