Healthcare (Medicaid)

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning provider reimbursement rates for medically fragile and technology dependent children, provides that subject to federal approval, on and after January 1, 2026, the reimbursement rates for nursing paid through Nursing and Personal Care Services for non-waiver customers and to providers of private duty nursing services for children eligible for medical assistance shall be 3.5% higher than the reimbursement rates in effect for nursing services on December 31, 2025. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that hypoallergenic formula shall be covered under the medical assistance program for persons otherwise eligible for medical assistance who have been prescribed hypoallergenic formula by a physician. Requires the Department of Healthcare and Family Services to apply for any federal waivers or approvals necessary to implement the amendatory Act. Provides that upon federal approval, the Department shall at a minimum determine by rule the amount of hypoallergenic formula an eligible person shall receive coverage for per day.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025.