Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning October 1, 2026, for rate year 2027 and thereafter, the Medicaid inpatient utilization rate, as defined and used in the determination of eligibility for specified inpatient adjustment payments to hospitals, shall be modified to exclude, from both the numerator and denominator, all days reimbursed by the Department of Human Services for mental health services provided under a specified provision of the Code of Criminal Procedure of 1963 as contracted by the Department of Healthcare and Family Services. Effective immediately.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules that require managed care organizations (MCOs) to utilize a universal provider application developed by a council for affordable quality healthcare, as defined, for the purpose of credentialing a health care professional or a health care provider who seeks to participate in an MCO's provider network. Provides that the rules may also require the use of a CAQH application for the renewal of credentials; and that the Department may revise the CAQH universal provider application or the application for renewal of credentials to conform to industry or national standards for credentialing health care professionals or health care providers. Provides that within 180 days after the adoption of rules, health and dental plan carriers must accept the universal provider application and the application for the renewal of credentials approved by the Department. Requires all MCOs to provide a provider network consultant to act as a liaison between a health care provider and the MCO. Require the Department to employ provider enrollment consultants to assist health care providers with enrollment in the Illinois Medicaid Program Advanced Cloud Technology system, help navigate the enrollment and provider credentialing process by serving as the liaison between health care providers and MCOs, and other matters. Amends the Illinois Insurance Code. In provisions concerning recoupments, requires a health care professional or health care provider to be provided a remittance advice that includes an explanation of a recoupment or offset taken by a managed care organization. Removes provisions permitting insurers contracted with the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement. Provides that no contract between an MCO and health care professional or provider may provide for recoupments in violation of the Code. Effective January 1, 2027.
Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that beginning July 1, 2026, the Department of Human Services shall reissue the original cost and wage survey for costs associated with the administration of services to persons with intellectual and developmental disabilities in community day services that was contained in the Department's Guidehouse Rate Study. Provides that the cost and wage survey shall be used to effectuate rate increases in transportation funding for the administration of community day services to persons with intellectual and developmental disabilities and may include provider contact information, total costs of employee salaries and benefits, staff turnover, and other information. Requires the Department to adopt rules. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that removes the 5 hour per day billing maximums at community day services. Provides that the amendment shall not modify monthly and yearly billing maximums for community day services. Provides that implementation is contingent on federal approval. Effective July 1, 2026.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for dates of service beginning on and after January 1, 2027, the Department of Healthcare and Family Services shall, for healthcare common procedure coding system codes relating to complex rehabilitation technology wheelchair repair and accessories, apply a reimbursement rate under the Medical Assistance program equivalent to the maximum fee paid in Illinois under the federal Medicare program, including fees under the KU modifier, if applicable. Effective immediately.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, on and after January 1, 2027, certain services shall be eligible for reimbursement at approved programs through the Brain Injury waiver for eligible individuals over the age of 21, including, but not limited to: (1) case management; (2) nursing services; (3) medical oversight by consulting medical director; (4) physical therapy; and (5) occupational therapy. Requires the Department of Human Services to reimburse approved programs at the rates in effect for the Home and Community-Based Services Waiver program most recently approved. Effective January 1, 2027.
Creates the Illinois All-Payer Health Care Payment and Global Budget Act. Creates the Illinois Health Care Cost and Payment Board as an independent body within the Department of Healthcare and Family Services and sets forth its membership and powers. Defines "commercial payer" as any health insurance issuer, health maintenance organization, or third-party administrator subject to regulation by the Illinois Department of Insurance, excluding self-funded plans governed solely by ERISA. Provides that all commercial payers shall reimburse hospitals for covered services at standardized rates established by the Board. Defines "global hospital budget" as a prospective, fixed annual operating revenue amount established for a hospital to cover all inpatient and outpatient hospital services. Provides that the Board shall establish prospective annual global hospital budgets for Illinois hospitals. Provides that the Board shall establish a unified health care data system in coordination with State agencies. Creates the Health Care Payment Reform Advisory Council to advise the Board. Provides that the Governor, in consultation with the Board, shall seek all necessary federal approvals, including Medicare demonstrations and Medicaid waivers, to implement the Act. Amends the Illinois Administrative Procedure Act, Hospital Licensing Act, Illinois Insurance Code, Health Maintenance Organization Act, and Illinois Public Aid Code with regard to the new Act. Contains a severability clause. Effective immediately.
Amends the Code of Civil Procedure. Creates an eviction moratorium for residential real estate for a 12-month period against a tenant or a member of the tenant's household who: (1) has been unable to work for any period of time because of detention by immigration authorities within the previous 12 months; or (2) has experienced termination of benefits under the federal Supplemental Nutrition Assistance Program (SNAP), Medicaid, or Social Security within the previous 12 months; and (3) the detention or benefit termination has materially affected the tenant's ability to pay the agreed rent. Provides that the court may issue a residential eviction order if a covered tenant poses a direct threat to the health and safety of other tenants or an immediate and severe risk to property. Prohibits a residential landlord from commencing or continuing a residential eviction action a tenant who has provided the landlord with a declaration that the tenant is a covered tenant under the Act during the 12-month period. Prohibits a residential landlord from charging any fees, penalties, or other charges related to the nonpayment of rent by a covered tenant during the 12-month period. Provides that nothing in the Act may be construed as relieving any individual of the obligation to pay rent or comply with any other obligation that an individual may have under a lease or rental agreement. Provides that the Illinois Housing Development Authority may adopt rules to create the required form for a declaration.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, beginning January 1, 2027, to recompute the STAR rating of nursing facilities who had their antipsychotic medication quality measure score suppressed and their STAR rating set to one due to audit action by the federal Centers for Medicare and Medicaid Services. Requires quality payments to such nursing facilities to be made based on the recomputed score. Provides that in order to facilitate the recomputation, nursing facilities may provide the Department with documentation regarding the status of the suppression of the score and STAR rating as well as the quarterly report issued by the federal Centers for Medicare and Medicaid Services that lists the long-stay rating points for the quarter.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall not require recipients of medical assistance who are also former foster care youth, veterans, or people experiencing homelessness to work a minimum amount of hours in order to maintain eligibility for medical assistance. Amends the Administration Article of the Illinois Public Aid Code. Provides that the Department of Human Services shall not require recipients of Supplemental Nutrition Assistance Program (SNAP) benefits who are also former foster care youth, veterans, or people experiencing homelessness to work a minimum amount of hours in order to maintain eligibility for SNAP benefits.
Provides that the Act may be referred to as the Illinois Newborn Equity Support Transfer (NEST) Program Act. Amends the Department of Human Services Act. Requires the Department of Human Services to establish and administer, subject to appropriations, the Illinois Newborn Equity Support Transfer (NEST) Program to provide direct cash assistance to eligible participants by July 1, 2026. Defines "participant" to mean any individual who gives birth in Illinois while enrolled in or eligible for Medicaid through Moms and Babies. Permits the Department to adopt any rules necessary to implement the NEST Program. Provides that program participants shall receive a $1,500 lump sum payment in or around the third trimester of pregnancy, prior to delivery; and a $500 monthly cash payment for the first 6 months following delivery. Requires the Department to submit reports to the General Assembly on a biennial basis that summarizes (1) the number of program participants and distribution across the State, (2) outcomes related to maternal and child health, housing stability, and economic security, or other outcomes identified by the Department in collaboration with stakeholders, and (3) recommendations for program improvements or additional populations beyond Medicaid enrollment to include as participants. Provides that cash disbursements made to participants under the NEST Program shall be considered "guaranteed income" as described in the Hospital Uninsured Patient Discount Act for purposes of determining eligibility for assistance under the Illinois Public Aid Code. Effective immediately.
