MEDICAL ASSISTANCE-RATES-MCO Senate SponsorsSen. Heather A. Steans 1/9/2019SenateSession Sine Die 20 ILCS 505/17a-4from Ch. 23, par. 5017a-4Amends the Children and Family Services Act. Makes a technical change in a Section concerning grants for community-based youth services.Senate Committee Amendment No. 1 Deletes reference to:20 ILCS 505/17a-4Adds reference to:305 ILCS 5/5-30.8 newReplaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, for the establishment of Managed Care Organization (MCO) capitated rate payments from the State, the Department of Healthcare and Family Services shall implement a base rate setting process beginning on the effective date of the amendatory Act which shall include specified elements of transparency, including: (1) work groups with participating MCOs and a statewide trade association representing a majority of participating MCOs to discuss the development of any new or updated hospital fee schedules or other provider fee schedules; (2) at the request of the Medicaid health plans, meetings between the Department, its contracted actuary, all participating MCOs, and consulting actuaries contracted with statewide trade association representing a majority of Medicaid health plans; and (3) arbitration by a third party actuary to settle any dispute between the MCOs and the State's actuaries about base capitation rates. Provides that for the development of rates for new rate years, the Department shall: (i) take into account emerging experience in the development of the annual MCO base rates; (ii) meet with MCOs, no less than 6 months prior to submission of the new rates to the Centers for Medicare and Medicaid Services, to review data and the Department's written draft assumptions to be used in the development of base rates for the following year; (iii) provide the MCOs with draft capitated base rates no less than 2 months prior to the submission of the new rates to the Centers for Medicare and Medicaid Services; and (iv) provide the MCOs with a final actuarial report regarding the final base rates for the following year prior to the submission of final rates to the Centers for Medicare and Medicaid Services. Sets forth certain actions the Department must perform when developing rates that reflect policy changes, including: (a) providing advance notice to MCOs of any significant policy change no later than 90 days prior to the effective date of the policy change; and (b) meeting with the MCOs regarding the initial data collection needed to establish base rates for the policy change. Sets forth certain actions the Department must perform when developing rates for retroactive policy or rate changes, including meet with the MCOs regarding the initial data collection needed to establish rates for the policy change and meeting with MCOs to review data and the Department's written draft assumptions to be used in the development of rates for the following year. 2/6/2018SenateFiled with Secretary by Sen. Heather A. Steans 2/6/2018SenateFirst Reading 2/6/2018SenateReferred to Assignments 3/14/2018SenateAssigned to Human Services 3/20/2018SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. Heather A. Steans 3/20/2018SenateSenate Committee Amendment No. 1 Referred to Assignments 4/4/2018SenateSenate Committee Amendment No. 1 Assignments Refers to Human Services 4/10/2018SenateSenate Committee Amendment No. 1 Adopted 4/11/2018SenateDo Pass as Amended Human Services; 007-000-000 4/11/2018SenatePlaced on Calendar Order of 2nd Reading April 12, 2018 4/25/2018SenateSecond Reading 4/25/2018SenatePlaced on Calendar Order of 3rd Reading April 26, 2018 4/27/2018SenateRule 3-9(a) / Re-referred to Assignments 5/1/2018SenateRule 2-10 Third Reading Deadline Established As May 3, 2018 5/1/2018SenateApproved for Consideration Assignments 5/1/2018SenatePlaced on Calendar Order of 3rd Reading May 2, 2018 5/3/2018SenateRule 3-9(a) / Re-referred to Assignments 1/9/2019SenateSession Sine Die