SB 254 Illinois Senate · 102nd Regular Session

MEDICAID-HOSPITAL PAYMENTS

Summary
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning July 1, 2021, to receive the additional Long-Acting Injectable for Mental Health or Addiction Medicaid payment, a hospital shall submit a separate professional claim specifying "place of service 21 – Inpatient Hospital". Provides that the professional claim shall include the hospital as the billing provider and list the practitioner performing the procedure as the rendering provider. Requires the hospital to use the appropriate Healthcare Common Procedure Coding System Level II procedure code and the National Drug Code. Requires facilities participating in the federal 340B Drug Pricing Program to continue to bill the 340B actual acquisition cost for the medication. Provides that long-acting injectable medications for mental health or addiction shall not be subject to prior authorization under the medical assistance program or under any Medicaid managed-care plans when initiated at an inpatient hospital setting or when continued at an outpatient treatment facility. Effective July 1, 2021.
Bill status failed 1 of 4 stages cleared
Introduction
Feb 2021
Committee Review
Floor Vote
Governor
Introduced Feb 17, 2021 Last action Jan 10, 2023
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Full legislative history

Actions timeline

Total actions
9
Key actions
0
Committee
3
Apr 16, 2021
Committee
Rule 3-9(a) / Re-referred to Assignments
upper
Mar 3, 2021
Committee
Assigned to Appropriations
upper
Feb 17, 2021
Committee
Referred to Assignments
upper
1 primary · 1 co-sponsor

Sponsors