MEDICAID-MCO CAPITATION RATES

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that notwithstanding any other provision of the Code, the Department of Healthcare and Family Services shall not require Medicaid managed care organizations, including managed care community networks, to cover material changes to the medical assistance program, including, but not limited to, additional services, increases to rates, or substantive changes to utilization controls, until capitation rates have been updated accordingly and are deemed actuarially sound. Provides that the prohibition does not apply to services for which the Department reimburses Medicaid managed care organizations directly without regard to capitation payments.