Bill Text: IL SB2306 | 2015-2016 | 99th General Assembly | Chaptered
Bill Title: Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning construction of the Code.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Passed) 2016-08-26 - Public Act . . . . . . . . . 99-0898 [SB2306 Detail]
Download: Illinois-2015-SB2306-Chaptered.html
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Public Act 099-0898 | ||||
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois, | ||||
represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
adding Section 5-30.3 as follows:
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(305 ILCS 5/5-30.3 new) | ||||
Sec. 5-30.3. Managed care; automatic assignment. The
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Department shall, within a reasonable period of time after
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relevant data from managed care entities has been collected and
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analyzed, but no earlier than January 1, 2017, seek input from | ||||
the managed care entities and other stakeholders and develop | ||||
and
implement within each enrollment region an algorithm | ||||
preserving existing provider-beneficiary relationships that | ||||
takes
into account quality scores and other operational | ||||
proficiency
criteria developed, defined, and adopted by the | ||||
Department, to
automatically assign Medicaid enrollees served | ||||
under the
Family Health Plan and the Integrated Care Program | ||||
and those
Medicaid enrollees eligible for medical assistance | ||||
pursuant to
the Patient Protection and Affordable Care Act | ||||
(Public Law 111-148) into managed care entities, including | ||||
Accountable
Care Entities, Managed Care Community Networks, | ||||
and Managed
Care Organizations. The quality metrics used shall | ||||
be
measurable for all entities. The algorithm shall not use the
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quality and proficiency metrics to reassign enrollees out of
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any plan in which they are enrolled at the time and shall only
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be used if the client has not voluntarily selected a primary
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care physician and a managed care entity or care coordination
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entity. Clients shall have one opportunity within 90 calendar
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days after auto-assignment by algorithm to select a different
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managed care entity. The algorithm developed and implemented
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shall favor assignment into managed care entities with the
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highest quality scores and levels of compliance with the
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