Rep. Greg Harris

Amends the Public Health Standing Orders Act. Makes a technical change in a Section concerning the short title.

Amends the Illinois Public Aid Code. Makes a technical change in a Section regarding Medicaid co-payments.

Creates the Network Adequacy and Transparency Act. Provides that administrators and insurers, prior to going to market, must file with the Department of Insurance for review and approval a description of the services to be offered through a health care network plan with certain criteria included in the description. Provides that the health care network plan shall demonstrate to the Department, prior to approval, a minimum ratio of full-time equivalent providers to plan beneficiaries and maximum travel and distance burdens for plan beneficiaries based in the maximum minutes or miles to be traveled by a plan beneficiary for each county type as defined under the Act. Provides that the Department shall conduct periodic audits of health care network plan to verify compliance with network adequacy standards. Establishes certain notice requirements. Provides that a health care network plan shall provide for continuity of care for its beneficiaries based on certain circumstances. Provides that a health care network plan shall post electronically a current and accurate provider directory and make available in print, upon request, a provider directory each subject to the provision's specifications. Provides that the provisions of the Act are deemed incorporated into the health care providers service contracts entered into on or before the effective date of the Act. Provides that the Department is granted specific authority to issue a cease and desist order against, fine, or otherwise penalize any insurer or administrator for violations of any provision of the Act. Effective January 1, 2017.

Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning the amount and nature of medical assistance.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services, in conjunction with the Department of Insurance, to by rule adopt standards for assessing the solvency and financial soundness of each managed care community network. Provides that any solvency and financial standards adopted for managed care community networks shall be identical to (rather than no more restrictive than) the solvency and financial standards required under Article II of the Health Maintenance Organization Act (rather than the solvency and financial standards adopted under the Social Security Act for provider-sponsored organizations). In provisions concerning entities contracted with the Department of Healthcare and Family Services to coordinate healthcare for medical assistance recipients, provides that the Department shall treat all contracted entities identically in relation to care coordination ratios. Provides that Managed Care Entities are authorized to hire community healthcare workers to meet the mandated care coordination ratios; and that the Department shall define by policy the term "community healthcare workers" no later than January 1, 2016. Requires the Department to treat all contracted entities receiving risk-based capitation payments identically with regards to network adequacy and medical loss ratios. Provides that in conjunction with the Department of Insurance, the Department of Healthcare and Family Services shall ensure that all contracted entities receiving risk-based capitation payments are treated identically with regards to protections against financial insolvency.

Creates the Health Insurance Claims Assessment Act. Imposes an assessment of 1% on claims paid by a health insurance carrier or third-party administrator. Provides that the moneys received and collected under the Act shall be deposited into the Healthcare Provider Relief Fund and used solely for the purpose of funding Medicaid services provided under the medical assistance programs administered by the Department of Healthcare and Family Services.

Amends the Senior Pharmaceutical Assistance Act. Makes a technical change in a Section concerning the short title.

Amends the Senior Citizens and Persons with Disabilities Property Tax Relief Act. Makes a technical change in a Section concerning the short title.

Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning construction of the Code.

Amends the Community Support Systems Act. Makes a technical change in a Section concerning the short title.