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 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 benefits provided under the Supplemental Nutrition Assistance Program (SNAP) to work a minimum amount of hours in order to maintain eligibility for SNAP benefits.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2027, the reimbursement rates for all dental services for children shall be increased 50% above the rates in effect on December 31, 2025. Effective January 1, 2027.
Creates the Lead-Safe Water for Families Act. Provides that the Department of Healthcare and Family Services shall establish and administer a program to provide lead-reducing water filters at no cost to Medicaid-eligible households with children or expectant mothers. Requires outreach, application procedures, and rulemaking. Requires annual reporting to the General Assembly. Declares findings and states the purpose of the Act. Defines terms.
Amends the Illinois Insurance Code. Provides that, in conducting utilization review of all covered health care services for the diagnosis, prevention, and treatment of mental, emotional, and nervous disorders or conditions, an insurer shall apply the criteria and guidelines set forth in the most recent version of the treatment criteria developed by an unaffiliated professional organization (instead of an unaffiliated nonprofit professional association) for the relevant clinical specialty or, for Medicaid managed care organizations, criteria and guidelines determined by the Department of Healthcare and Family Services that are consistent with generally accepted standards of mental, emotional, nervous or substance use disorder or condition care. Provides that insurers may not apply utilization review criteria developed by any entity that has a financial stake in the outcome of the utilization review decisions. Makes changes to provisions concerning utilization review relating to level of care placement, continued stay, transfer, discharge, or any other patient care decisions that are within the scope of the specified sources.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2027, the reimbursement rates for all dental services for children shall be increased 50% above the rates in effect on December 31, 2025. Effective January 1, 2027.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2027, the rates paid for children's dental comprehensive oral exams, periodic oral exams, problem focused exams, behavior management codes, sealants, resin-based composites-posterior teeth, and extraction and surgical extraction codes shall be increased by 33% above the rates in effect on December 31, 2025. Effective January 1, 2027.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides medical assistance coverage for sickle cell disease (rather than sickle cell anemia).
Provides that the Act may be referred to as the Safe Place to Go Act. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services' Division of Behavioral Health and Recovery, to apply for a Medicaid State Plan amendment or federal waiver within 12 months after the effective date of the amendatory Act to draw federal financial participation for crisis triage and stabilization services provided by behavioral health urgent care centers to support adults or children 5 years of age and older who are in an active mental health crisis and adults 18 years of age and older in a substance use crisis. Sets forth the services provided by behavioral health urgent care centers that shall be covered, including, but not limited to, crisis triage services, crisis stabilization services, and medication monitoring. Contains provisions concerning the use of the Illinois Mental Health Crisis Assessment Tool to determine an individual's eligibility or medical need for crisis stabilization services; telehealth and on-site services; safe sobering services; linkages to enable rapid transition to next level of care; length of stay; the development of a single bundle rate for crisis triage services and 2 separate per diem reimbursement rates for crisis stabilization services and safe sobering services; no prior authorization requirements; and the establishment of a working group to provide meaningful input on the establishment, operations, staffing, and financing of behavioral health urgent care centers. Requires the Department to adopt rules within 6 months after federal approval of its State Plan amendment or federal waiver application, if granted. 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 shall 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 Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the supportive living facilities program, prohibits a supportive living dementia care setting from limiting a resident's access to the sink, microwave, or refrigerator located within the respective resident's room, provided a comprehensive safety assessment deems the resident's use of the appliances safe. Requires the comprehensive safety assessment to be conducted prior to any resident moving in and at least once per quarter thereafter. Requires social and recreational programming to be provided no less than 3 times daily, including at least one time and location separate from a meal service. Requires newly constructed supportive living dementia care settings to provide no less than 300 square feet for a single occupancy apartment or no less than 450 square feet for a double occupancy apartment, which may include the closets and bathroom. Requires each apartment to include a sink, microwave, and refrigerator within the unit. Provides that any newly constructed supportive living dementia care setting shall provide a common area completely separate from the dining area.
