Rep. Robyn Gabel

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules, by no later than January 1, 2025, to establish a process under which any provider meeting certain performance standards outlined in the amendatory Act shall be certified for a service authorization exemption from all service authorization programs for a period of no less than one year. Provides that qualification for a service authorization exemption shall be determined by the Department, or its contracted utilization review organization (URO), and shall be binding on a managed care organization (MCO) or the MCO's contracted URO. Provides that a provider shall be eligible for a service authorization exemption if the provider submitted at least 25 service authorization requests to a service authorization program in the preceding calendar year and the service authorization program approved at least 80% of the service authorization requests. Provides that no later than December 1 of each calendar year, each service authorization program shall provide written notification to all providers who qualify for a service authorization exemption for the subsequent calendar year. Requires the Department to adopt rules by January 1, 2025 to establish: (i) a standard method the Department, or its contracted URO, shall use to evaluate whether a provider meets the criteria to qualify for a service authorization exemption; (ii) a standard method the Department, or its contracted URO, shall use to accept and process provider appeals of denied or rescinded exemptions; and (iii) a standard method the MCOs shall use to accept and process professional claims and facility claims, as billed by the provider, for a health care service that is rendered, prescribed, or ordered by a provider granted a service authorization exemption, except in cases of fraud. Contains provisions concerning annual reviews by the Department of service authorization denials made under each service authorization program; quarterly reports issued by the Department that detail the performance of each service authorization program; sanctions on MCOs for noncompliance with any provision of the amendatory Act. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to: (1) adopt a single, uniform service authorization program under which service authorization determinations for all individuals enrolled in a managed care organization (MCO) shall be made by the Department's contracted utilization review organization (URO), as defined; (2) require all service authorization determinations made by the URO to be binding upon the MCO; (3) prohibit an MCO from denying or reducing payment of a claim, or recouping payment of a paid claim, for health care services approved by the URO, except in cases of fraud; (4) adopt certain rules concerning service authorization determinations; (5) seek approval from the federal Centers for Medicare and Medicaid Services for enhanced federal matching funds for such improvements to the Department's Medicaid Management Information System to implement the single, uniform service authorization program; and other matters. Makes these changes applicable to managed care contracts issued, amended, delivered, or renewed on or after January 1, 2025. Makes changes to provisions on when an MCO is required to pay for post-stabilization services as a covered service. Prohibits MCOs and the URO from imposing any requirements for prior approval of emergency services. Provides that MCOs are not obligated to cover health care services, as defined, that are provided on an emergency basis but are not covered services under its contract with the Department. Requires the Department to impose sanctions on an MCO for noncompliance, including, but not limited to, financial penalties, suspension of enrollment of new enrollees, and termination of the MCO's contract with the Department. Effective immediately.

Amends the Open Space Lands Acquisition and Development Act. Provides that a local government that has submitted a distressed location project as defined by Department of Natural Resources rule shall be eligible for assistance up to 100% for the acquisition of open space lands and for capital development and improvement projects on distressed location projects. Provides that no less than 10% of the amount appropriated under the Act in any fiscal year shall be made available as grants to distressed communities.

RESOLVED, BY THE SENATE OF THE ONE HUNDRED THIRD GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, THE HOUSE OF REPRESENTATIVES CONCURRING HEREIN, that when the Senate adjourns on Sunday, May 26, 2024, it stands adjourned until the call of the President; and when the House of Representatives adjourns, it stands adjourned until the call of the Speaker.

Maddy summaryThis bill is a House Resolution that formally congratulates St. Joseph Church in Island Grove, Illinois, on its 150th anniversary. The document outlines the church's history, including its founding in 1872, its destruction by fire in 1917, and its subsequent rebuilding. It does not create new laws or change any policies but serves as a ceremonial gesture of appreciation from the Illinois House of Representatives to the local community.

Declares October of 2024 as Domestic Violence Awareness Month and supports and commends the efforts of the people and organizations who work tirelessly to help victims break free of the devastating effects of domestic abuse.

Maddy summaryThis bill designates September 7, 2024, as Duchenne Muscular Dystrophy Awareness Day in Illinois. It aims to raise public attention about the condition, which causes progressive muscle weakness and affects approximately 15,000 people in the United States. The resolution also thanks the Parent Project Muscular Dystrophy for their work in addressing the disease.

Urges the Illinois Department of Public Health (IDPH) to continue taking appropriate action to facilitate equitable access to adolescent and adult vaccinations, including establishing appropriate programs and initiatives to raise public awareness on the importance of adolescent and adult vaccinations. Urges the IDPH to continue working with the Centers for Disease Control (CDC), in-state healthcare providers, and patients to implement an effective and actionable state immunization strategy that includes adult immunizations. Urges the IDPH to continue increasing community resilience to communicable and other emerging disease threats. Urges the IDPH to continue determining goals on which to center the immunization plan. Urges the IDPH to continue exploring federal funding opportunities and partnerships to support vaccine awareness and access programs aligned with the goals established in the state immunization strategy.

Amends the State Commemorative Dates Act. Provides that first full week of March each year is designated as Soil Health Week to be observed throughout the State as a week to celebrate and raise awareness regarding the importance of soil health to Illinois agriculture and Illinois farmers.

Congratulates the Decalogue Society of Lawyers, outgoing President Judge Megan Goldish, incoming President Joel B. Bruckman, and all members of its executive committee and board of managers on the 90th anniversary of its founding.