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<xml>
<title>Illinois General Assembly - Bill Status for HB 4545         </title>
<shortdesc>MEDICAID-MANAGED CARE</shortdesc>
<sponsor>
<sponsorhead1>House Sponsors</sponsorhead1><sponsors>Rep. Jackie Haas, Norine K. Hammond, Chris Bos and Angelica Guerrero-Cuellar</sponsors>
<sponsorhead2>Senate Sponsors</sponsorhead2><altsponsors>(Sen. Dave Syverson)</altsponsors>
</sponsor>
<lastaction>
<statusdate>1/10/2023</statusdate><chamber>House</chamber><action>Session Sine Die</action>
</lastaction>
<synopsis>
<synopsistitle></synopsistitle>
<reference>305 ILCS 5/5-30.12a new</reference><aliasreference></aliasreference><reference>305 ILCS 5/5-45 new</reference><aliasreference></aliasreference><SynopsisText>     Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to explore, by July 1, 2023, the availability of and, if reasonably available, procure technology that: (i) allows the Department's Medical Electronic Data Interchange (MEDI) system to update recipient eligibility and coverage information for providers in real time; and (ii) allows the Department to transmit updated recipient eligibility and coverage information to managed care organizations under contract with the Department to ensure the information contained in the MEDI system corresponds with the information maintained by managed care organizations in their web-based provider portals. Provides that notwithstanding any provision of this Code to the contrary, in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than 2 years after the claim's payment date. Provides that the 2-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond 2 years. Effective immediately.</SynopsisText><synopsistitle>House Floor Amendment No. 1</synopsistitle>
<SynopsisText>Replaces everything after the enacting clause. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by October 1, 2023 the Department of Healthcare and Family Services shall ensure the Illinois Medicaid Program Advanced Cloud Technology system is updated daily with eligibility coverage information from the integrated eligibility system. Provides that notwithstanding any other provision of the Code, in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than one year after the claim's payment date. Provides that the one-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond one year. Effective immediately.</SynopsisText></synopsis>
<actions>
<statusdate>1/13/2022</statusdate><chamber>House</chamber><action>Filed with the Clerk by Rep. Jackie Haas</action>
<statusdate>1/21/2022</statusdate><chamber>House</chamber><action>First Reading</action>
<statusdate>1/21/2022</statusdate><chamber>House</chamber><action>Referred to Rules Committee</action>
<statusdate>2/1/2022</statusdate><chamber>House</chamber><action>Assigned to Human Services Committee</action>
<statusdate>2/16/2022</statusdate><chamber>House</chamber><action>Do Pass / Short Debate Human Services Committee;  015-000-000</action>
<statusdate>2/16/2022</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Norine K. Hammond</action>
<statusdate>2/17/2022</statusdate><chamber>House</chamber><action>Placed on Calendar 2nd Reading - Short Debate</action>
<statusdate>3/1/2022</statusdate><chamber>House</chamber><action>House Floor Amendment No. 1 Filed with Clerk by Rep. Jackie Haas</action>
<statusdate>3/1/2022</statusdate><chamber>House</chamber><action>House Floor Amendment No. 1 Referred to Rules Committee</action>
<statusdate>3/2/2022</statusdate><chamber>House</chamber><action>House Floor Amendment No. 1 Rules Refers to Human Services Committee</action>
<statusdate>3/2/2022</statusdate><chamber>House</chamber><action>Second Reading - Short Debate</action>
<statusdate>3/2/2022</statusdate><chamber>House</chamber><action>Held on Calendar Order of Second Reading - Short Debate</action>
<statusdate>3/3/2022</statusdate><chamber>House</chamber><action>House Floor Amendment No. 1 Recommends Be Adopted Human Services Committee;  014-000-000</action>
<statusdate>3/4/2022</statusdate><chamber>House</chamber><action>House Floor Amendment No. 1 Adopted</action>
<statusdate>3/4/2022</statusdate><chamber>House</chamber><action>Placed on Calendar Order of 3rd Reading - Short Debate</action>
<statusdate>3/4/2022</statusdate><chamber>House</chamber><action>Third Reading - Short Debate - Passed 103-001-000</action>
<statusdate>3/4/2022</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Chris Bos</action>
<statusdate>3/7/2022</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Angelica Guerrero-Cuellar</action>
<statusdate>3/7/2022</statusdate><chamber>Senate</chamber><action>Arrive in Senate</action>
<statusdate>3/7/2022</statusdate><chamber>Senate</chamber><action>Placed on Calendar Order of First Reading March 8, 2022</action>
<statusdate>3/16/2022</statusdate><chamber>Senate</chamber><action>Chief Senate Sponsor Sen. Dave Syverson</action>
<statusdate>3/16/2022</statusdate><chamber>Senate</chamber><action>First Reading</action>
<statusdate>3/16/2022</statusdate><chamber>Senate</chamber><action>Referred to Assignments</action>
<statusdate>1/10/2023</statusdate><chamber>House</chamber><action>Session Sine Die</action>
</actions>
</xml>

