MEDICAID-MC/DD FACILITIES Senate SponsorsSen. Heather A. Steans-Mattie Hunter-Dave Syverson-Emil Jones, III-Omar Aquino, Julie A. Morrison and Laura M. Murphy House Sponsors(Rep. Gregory Harris-Patricia R. Bellock-Sara Feigenholtz-Tom Demmer-Camille Y. Lilly, Anthony DeLuca, Robyn Gabel, Juliana Stratton, Ryan Spain and Mary E. Flowers) 7/27/2018SenatePublic Act . . . . . . . . . 100-0646 305 ILCS 5/5-5.4hAmends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning Medicaid reimbursement for facilities that serve severely and chronically ill pediatric patients and clinically complex residents, replaces all references to "long-term care facilities for persons under 22 years of age" with "medically complex for the developmentally disabled facilities".House Committee Amendment No. 1 Deletes reference to:305 ILCS 5/5-5.4hAdds reference to:305 ILCS 5/5-2.1aReplaces everything after the enacting clause. Amends the Illinois Public Aid Code. Makes a technical change in a Section regarding the treatment of trusts as they affect eligibility for medical assistance.House Floor Amendment No. 2 Deletes reference to:305 ILCS 5/5-2.1aAdds reference to:5 ILCS 120/2from Ch. 102, par. 425 ILCS 140/7.520 ILCS 505/5.45 new210 ILCS 45/2-217210 ILCS 49/5-104 new210 ILCS 85/6.22305 ILCS 5/5-4.2from Ch. 23, par. 5-4.2305 ILCS 5/5-5.4h305 ILCS 5/5-5.07 new305 ILCS 5/5-30.8 new305 ILCS 5/5A-16Replaces everything after the enacting clause. Amends the Children and Family Services Act. Provides that every child who is in the care of the Department of Children and Family Services pursuant to the Juvenile Court Act of 1987 shall receive the necessary services required by the Act and the Juvenile Court Act of 1987, including any child enrolled in a Medicaid managed care plan. Provides that the Department shall not relinquish its authority or diminish its responsibility to determine and provide necessary services that are in the best interest of a child even if those services are directly or indirectly provided by, coordinated through, or paid for by a managed care organization. Prohibits the Department from requiring any child to participate in Medicaid managed care if the child would otherwise be exempt from enrolling in a Medicaid managed care plan under any rule or statute of this State. Contains provisions concerning the Child Welfare Medicaid Managed Care Implementation Advisory Workgroup and its duty to advise the Department of Children and Family Services on the transition and implementation of managed care for children; membership on the Workgroup; the development and public posting of the Department's transition plan; the contents of the transition plan; reporting requirements; and other matters. Amends the Nursing Home Act. Requires a facility that orders medi-car, service car, or ground ambulance transportation (rather than transportation) of a facility resident by an ambulance service provider to maintain a written record and to provide the ambulance service provider with a Physician Certification Statement on a form prescribed by the Department of Healthcare and Family Services in accordance with a specified Section of the Illinois Public Aid Code. Amends the Specialized Mental Health Rehabilitation Act of 2013. Provides that, for a facility licensed under the Act by June 1, 2018 or provisionally licensed under the Act by June 1, 2018, a payment shall be made for therapeutic visits that have been indicated by an interdisciplinary team as therapeutically beneficial. Provides that payment shall be at 75% of the facility's rate on the effective date of the amendatory Act and may not exceed 20 days in a fiscal year and shall not exceed 10 days consecutively. Amends the Hospital Licensing Act. Provides that if a hospital arranges for medi-car, service car, or ground ambulance transportation (rather than transportation) of a patient of the hospital, the hospital must provide the ambulance service provider, at or prior to transport, a Physician Certification Statement formatted and completed in compliance with federal regulations or an equivalent form developed by the hospital. Requires each hospital to develop a policy requiring a physician or the physician's designee to complete the Physician Certification Statement and to maintain the Physician Certification Statement as part of the patient's medical record. Amends the Illinois Public Aid Code. In provisions concerning ambulance service payments, provides that whenever a patient covered by a medical assistance program administered by the Department of Healthcare and Family Services, including a patient covered under the State's Medicaid managed care program, is transported from a facility and requires non-emergency transportation including ground ambulance, medi-car, or service car transportation, a Physician Certification Statement shall be required. Requires the certification to be completed prior to ordering the transportation service and prior to patient discharge. Contains provisions concerning the development of a standardized form of the Physician Certification Statement; criteria included on the Physician Certification Statement; the collection of data from Medicaid managed care organizations and transportation brokers regarding denials and appeals related to the missing or incomplete Physician Certification Statement forms and overall compliance; and other matters. Provides that the Department of Children and Family Services shall pay the DCFS per diem rate for inpatient psychiatric stay at a free-standing psychiatric hospital effective the 11th day when a child is in the hospital beyond medical necessity, and the parent or caregiver has denied the child access to the home and has refused or failed to make provisions for another living arrangement for the child or the child's discharge is being delayed due to a pending inquiry or investigation by the Department of Children and Family Services. Provides that licensed medically complex for the developmentally disabled facilities (MC/DD) (rather than licensed long-term care facilities for persons under 22 years of age) that serve severely and chronically ill patients (rather than pediatric patients) shall have a specific reimbursement system designed to recognize the characteristics and needs of the patients they serve. Sets forth certain reimbursement rates for MC/DD facilities for dates of services starting April 1, 2019. Provides that the Department of Healthcare and Family Services shall be responsible for reimbursement calculations and direct payment for services; and that appropriations for medically complex for the developmentally disabled facilities must be shifted from the Department of Human Services to the Department of Healthcare and Family Services. Makes other changes. Requires the Department of Healthcare and Family Services to implement a capitation base rate setting process beginning on the effective date of the amendatory Act for the establishment of Managed Care Organization (MCO) capitated base rate payments from the State. Requires the capitation base rate setting process to include certain elements of transparency. Contains provisions concerning the development of capitation base rates for new capitation rate years; the development of capitation base rates reflecting policy changes; the development of capitation base rates for retroactive policy or fee schedule changes; and meetings between the Department of Healthcare and Family Services and other specified persons and entities to discuss Medicaid capitation rates. Provides that the meetings shall be closed to the public and shall not be subject to the Open Meetings Act; and that records and information produced by the group shall be confidential and not subject to the Freedom of Information Act. Makes conforming changes to the Open Meetings Act and the Freedom of Information Act. Further amends the Illinois Public Aid Code. Provides that if by July 11, 2018 the federal Centers for Medicare and Medicaid Services has neither approved the changes authorized under Public Act 100-581 nor has formally approved an extension of the reimbursement methodologies and payments to hospitals under specified Sections of the Code as they are in effect on June 30, 2018, then certain reimbursement methodologies, supplemental payments, and assessments shall remain in effect. Contains provisions concerning: (1) advance payments to hospitals upon request; and (2) payments to safety-net hospitals and critical access hospitals. Effective immediately.House Floor Amendment No. 3 Further amends the Illinois Public Aid Code. In provisions requiring the Department of Healthcare and Family Services to make monthly advance payments to safety-net hospitals, critical access hospitals, and hospitals upon request, provides that such advance payments (rather than payments) shall be made regardless of federal approval for federal financial participation under Title XIX or XXI of the federal Social Security Act. Makes some technical changes. 2/9/2017SenateFiled with Secretary by Sen. Mattie Hunter 2/9/2017SenateFirst Reading 2/9/2017SenateReferred to Assignments 2/28/2017SenateAssigned to Human Services 3/8/2017SenatePostponed - Human Services 3/15/2017SenateDo Pass Human Services; 006-000-000 3/15/2017SenatePlaced on Calendar Order of 2nd Reading March 16, 2017 4/6/2017SenateSecond Reading 4/6/2017SenatePlaced on Calendar Order of 3rd Reading April 25, 2017 4/27/2017SenateThird Reading - Passed; 053-000-000 4/28/2017HouseArrived in House 4/28/2017HouseChief House Sponsor Rep. Robyn Gabel 4/28/2017HouseFirst Reading 4/28/2017HouseReferred to Rules Committee 5/9/2017HouseAssigned to Special Needs Services 5/19/2017HouseCommittee Deadline Extended-Rule 9(b) May 26, 2017 5/26/2017HouseFinal Action Deadline Extended-9(b) May 31, 2017 5/31/2017HouseRule 19(a) / Re-referred to Rules Committee 10/17/2017HouseAssigned to Executive Committee 10/17/2017HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Barbara Flynn Currie 10/17/2017HouseHouse Committee Amendment No. 1 Referred to Rules Committee 10/17/2017HouseHouse Committee Amendment No. 1 Rules Refers to Executive Committee 10/24/2017HouseHouse Committee Amendment No. 1 Adopted in Executive Committee; by Voice Vote 10/24/2017HouseDo Pass as Amended / Short Debate Executive Committee; 011-000-000 10/24/2017HousePlaced on Calendar 2nd Reading - Short Debate 10/24/2017HouseSecond Reading - Short Debate 10/24/2017HouseHeld on Calendar Order of Second Reading - Short Debate 10/24/2017HouseFinal Action Deadline Extended-9(b) November 10, 2017 11/10/2017HouseRule 19(a) / Re-referred to Rules Committee 1/24/2018HouseApproved for Consideration Rules Committee; 005-000-000 1/24/2018HousePlaced on Calendar 2nd Reading - Short Debate 1/30/2018HouseAlternate Chief Sponsor Changed to Rep. Gregory Harris 5/17/2018HouseSecond Reading - Short Debate 5/17/2018HouseHeld on Calendar Order of Second Reading - Short Debate 5/21/2018HousePlaced on Calendar Order of 3rd Reading - Short Debate 5/25/2018HouseAdded Alternate Chief Co-Sponsor Rep. Patricia R. Bellock 5/25/2018HouseAdded Alternate Chief Co-Sponsor Rep. Sara Feigenholtz 5/25/2018HouseAdded Alternate Chief Co-Sponsor Rep. Tom Demmer 5/25/2018HouseAdded Alternate Chief Co-Sponsor Rep. Anthony DeLuca 5/25/2018HouseFinal Action Deadline Extended-9(b) May 31, 2018 5/28/2018HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Gregory Harris 5/28/2018HouseHouse Floor Amendment No. 2 Referred to Rules Committee 5/29/2018HouseAlternate Chief Co-Sponsor Removed Rep. Anthony DeLuca 5/29/2018HouseAdded Alternate Chief Co-Sponsor Rep. Camille Y. Lilly 5/29/2018HouseAdded Alternate Co-Sponsor Rep. Anthony DeLuca 5/29/2018HouseHouse Floor Amendment No. 2 Rules Refers to Appropriations-Human Services Committee 5/29/2018HouseRecalled to Second Reading - Short Debate 5/29/2018HouseHeld on Calendar Order of Second Reading - Short Debate 5/29/2018HouseHouse Floor Amendment No. 3 Filed with Clerk by Rep. Gregory Harris 5/29/2018HouseHouse Floor Amendment No. 3 Referred to Rules Committee 5/30/2018HouseHouse Floor Amendment No. 2 Recommends Be Adopted Appropriations-Human Services Committee; 017-000-000 5/30/2018HouseHouse Floor Amendment No. 3 Recommends Be Adopted Rules Committee; 004-000-000 5/30/2018HouseHouse Floor Amendment No. 2 Adopted 5/30/2018HouseHouse Floor Amendment No. 3 Adopted 5/30/2018HousePlaced on Calendar Order of 3rd Reading - Short Debate 5/30/2018HouseThird Reading - Short Debate - Passed 104-012-000 5/30/2018HouseAdded Alternate Co-Sponsor Rep. Robyn Gabel 5/30/2018HouseAdded Alternate Co-Sponsor Rep. Juliana Stratton 5/30/2018HouseAdded Alternate Co-Sponsor Rep. Ryan Spain 5/30/2018HouseAdded Alternate Co-Sponsor Rep. Mary E. Flowers 5/30/2018SenateChief Sponsor Changed to Sen. Heather A. Steans 5/30/2018SenateAdded as Chief Co-Sponsor Sen. Mattie Hunter 5/30/2018SenateSecretary's Desk - Concurrence House Amendment(s) 1, 2, 3 5/30/2018SenatePlaced on Calendar Order of Concurrence House Amendment(s) 1, 2, 3 - May 30, 2018 5/30/2018SenateHouse Committee Amendment No. 1 Motion to Concur Filed with Secretary Sen. Heather A. Steans 5/30/2018SenateHouse Committee Amendment No. 1 Motion to Concur Referred to Assignments 5/30/2018SenateHouse Floor Amendment No. 2 Motion to Concur Filed with Secretary Sen. Heather A. Steans 5/30/2018SenateHouse Floor Amendment No. 2 Motion to Concur Referred to Assignments 5/30/2018SenateHouse Floor Amendment No. 3 Motion to Concur Filed with Secretary Sen. Heather A. Steans 5/30/2018SenateHouse Floor Amendment No. 3 Motion to Concur Referred to Assignments 5/30/2018SenateAdded as Chief Co-Sponsor Sen. Dave Syverson 5/30/2018SenateAdded as Chief Co-Sponsor Sen. Emil Jones, III 5/30/2018SenateAdded as Chief Co-Sponsor Sen. Omar Aquino 5/30/2018SenateAdded as Co-Sponsor Sen. Julie A. Morrison 5/30/2018SenateAdded as Co-Sponsor Sen. Laura M. Murphy 5/31/2018SenateHouse Committee Amendment No. 1 Motion to Concur Assignments Referred to Executive 5/31/2018SenateHouse Floor Amendment No. 2 Motion to Concur Assignments Referred to Executive 5/31/2018SenateHouse Floor Amendment No. 3 Motion to Concur Assignments Referred to Executive 5/31/2018SenateHouse Committee Amendment No. 1 Motion To Concur Recommended Do Adopt Executive; 016-000-000 5/31/2018SenateHouse Floor Amendment No. 2 Motion To Concur Recommended Do Adopt Executive; 016-000-000 5/31/2018SenateHouse Floor Amendment No. 3 Motion To Concur Recommended Do Adopt Executive; 016-000-000 5/31/2018SenateHouse Committee Amendment No. 1 Senate Concurs 052-000-000 5/31/2018SenateHouse Floor Amendment No. 2 Senate Concurs 052-000-000 5/31/2018SenateHouse Floor Amendment No. 3 Senate Concurs 052-000-000 5/31/2018SenateSenate Concurs 5/31/2018SenatePassed Both Houses 6/11/2018SenateSent to the Governor 7/27/2018SenateGovernor Approved 7/27/2018SenateEffective Date July 27, 2018 7/27/2018SenatePublic Act . . . . . . . . . 100-0646