Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that subject to federal approval, within 12 months after the effective date of the amendatory Act, nutrition care services and medical nutrition therapy provided by a registered dietitian licensed under the Dietitian Nutritionist Practice Act who is acting within the scope of his or her license shall be covered under the medical assistance program. Provides that the covered services may be aimed at prevention, delay, management, treatment, or rehabilitation of a disease or condition and include nutrition assessment, nutrition intervention, nutrition counseling, and nutrition monitoring and evaluation. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment, if required, to implement the amendatory Act. Provides that the Department shall adopt rules to implement the amendatory Act, including rules that ensure coverage for individuals with chronic conditions without prior authorization.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after January 1, 2026, 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, 2026.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that upon application to the Department of Healthcare and Family Services, supportive living program settings may convert non-dementia care setting units to dementia care setting units. Provides that all conversions must be operational within one year of approval and meet criteria specific to certification for dementia care setting units outlined in the Illinois Administrative Code.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for dates of service starting July 1, 2025, reimbursement calculations and direct payment for services provided by facilities licensed under the ID/DD Community Care Act are the responsibility of the Department of Healthcare and Family Services instead of the Department of Human Services. Requires appropriations for the facilities licensed under the ID/DD Community Care Act to be shifted from the Department of Human Services to the Department of Healthcare and Family Services. Provides that nothing shall prohibit the Department of Healthcare and Family Services from paying more than the rates specified in the Code. Requires the Department of Healthcare and Family Services to work with the Department of Human Services to study and review the reimbursement calculations and direct payments for facilities licensed under the ID/DD Community Care Act and for facilities licensed under the MC/DD Act. Effective July 1, 2025.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning medical assistance for employed persons with disabilities and employed persons with a medically improved disability, provides that, subject to federal approval, the Department of Healthcare and Family Services shall eliminate income eligibility standards for such persons to the extent permitted by federal law and shall eliminate the consideration of assets when determining such persons eligibility for medical assistance to the extent permitted by federal law.
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.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on January 1, 2026 the reimbursement rates for applied behavior analysis services for the treatment of autism spectrum disorder shall be increased by 3.5% above the reimbursement rates in effect on December 31, 2025.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes a provision that requires the termination of medical assistance for childless adults who do not otherwise qualify for assistance if Illinois' federal medical assistance percentage for such persons is reduced below 90%. Effective immediately.
Provides that, if and only if House Bill 4907 of the 103rd General Assembly becomes law, then the Medical Assistance Article of the Illinois Public Aid Code is amended by adding new provisions concerning PDPM Strive staffing ratio calculations for nursing facilities. Provides that, beginning January 1, 2026, the staffing percentage used in the calculation of the per diem staffing add-on shall be its PDPM STRIVE Staffing Ratio. Sets forth how to calculate a nursing facility's PDPM STRIVE Staffing Ratio, PDPM STRIVE Staffing Target, Illinois Adjusted Facility Case-Mix Hours Per Resident Per Day, and STRIVE staffing fee schedule. Effective immediately or on the date House Bill 4907 of the 103rd General Assembly takes effect, whichever is later.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning Medicaid Access Adjustment payments to nursing facilities, provides that, for dates of service beginning July 1, 2025, the Medicaid Access Adjustment shall be increased to $5.75. Effective immediately.
