Bill Text: IL SB1522 | 2017-2018 | 100th General Assembly | Introduced


Bill Title: Amends the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop, by rule, a process by which a facility experiencing cash flow problems can request a hardship payment from a managed care organization as an advance against money owed to the facility by the managed care organization.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2017-08-04 - Pursuant to Senate Rule 3-9(b) / Referred to Assignments [SB1522 Detail]

Download: Illinois-2017-SB1522-Introduced.html


100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB1522

Introduced 2/9/2017, by Sen. Heather A. Steans

SYNOPSIS AS INTRODUCED:
305 ILCS 5/5F-33

Amends the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop, by rule, a process by which a facility experiencing cash flow problems can request a hardship payment from a managed care organization as an advance against money owed to the facility by the managed care organization.
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FISCAL NOTE ACT MAY APPLY

A BILL FOR

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1 AN ACT concerning public aid.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Illinois Public Aid Code is amended by
5changing Section 5F-33 as follows:
6 (305 ILCS 5/5F-33)
7 Sec. 5F-33. Payment of claims.
8 (a) Clean claims, as defined by the Department, submitted
9by a provider to a managed care organization in the form and
10manner requested by the managed care organization shall be
11reviewed and paid within 30 days of receipt.
12 (b) A managed care organization must provide a status
13update within 60 days of the submission of a claim.
14 (c) A claim that is rejected or denied shall clearly state
15the reason for the rejection or denial in sufficient detail to
16permit the provider to understand the justification for the
17action.
18 (d) The Department shall work with stakeholders,
19including, but not limited to, managed care organizations and
20nursing home providers, to train them on the application of
21standardized codes for long-term care services.
22 (e) Managed care organizations shall provide a manual
23clearly explaining billing and claims payment procedures,

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1including points of contact for provider services centers,
2within 15 days of a provider entering into a contract with a
3managed care organization. The manual shall include all
4necessary coding and documentation requirements. Providers
5under contract with a managed care organization on the
6effective date of this amendatory Act of the 99th General
7Assembly shall be provided with an electronic copy of these
8requirements within 30 days of the effective date of this
9amendatory Act of the 99th General Assembly. Any changes to
10these requirements shall be delivered electronically to all
11providers under contract with the managed care organization 30
12days prior to the effective date of the change.
13 (f) The Department shall develop, by rule, a process by
14which a facility experiencing cash flow problems can request a
15hardship payment from a managed care organization as an advance
16against money owed to the facility by the managed care
17organization.
18(Source: P.A. 99-719, eff. 1-1-17.)
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