Bill Amendment: IL SB1575 | 2019-2020 | 101st General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: MEDICAID-PROSTHETIC DEVICES
Status: 2021-01-13 - Session Sine Die [SB1575 Detail]
Download: Illinois-2019-SB1575-Senate_Amendment_001.html
Bill Title: MEDICAID-PROSTHETIC DEVICES
Status: 2021-01-13 - Session Sine Die [SB1575 Detail]
Download: Illinois-2019-SB1575-Senate_Amendment_001.html
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1 | AMENDMENT TO SENATE BILL 1575
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2 | AMENDMENT NO. ______. Amend Senate Bill 1575 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Public Aid Code is amended by | ||||||
5 | adding Section 5-36 as follows:
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6 | (305 ILCS 5/5-36 new) | ||||||
7 | Sec. 5-36. Custom prosthetic and orthotic devices. | ||||||
8 | (a) Coverage for custom prosthetic and orthotic devices | ||||||
9 | under the fee-for-service medical assistance program and under | ||||||
10 | any Medicaid managed care plan shall be no less favorable than | ||||||
11 | the terms and conditions that apply to substantially all | ||||||
12 | medical and surgical benefits provided under the | ||||||
13 | fee-for-service medical assistance program or the Medicaid | ||||||
14 | managed care plan. | ||||||
15 | (b) The Department shall set a rate of reimbursement under | ||||||
16 | the fee-for-service medical assistance program for custom |
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1 | prosthetic and orthotic devices at a rate no less than the | ||||||
2 | Medicare rate for the year minus 6%. The Department shall set a | ||||||
3 | rate of reimbursement payable by contracted managed care | ||||||
4 | organizations to contracted, in-network providers for custom | ||||||
5 | prosthetic and orthotic devices at a rate no less than the | ||||||
6 | Medicare rate for the year minus 6%. | ||||||
7 | (c) Notwithstanding any other law or any other contract | ||||||
8 | terms and conditions, nothing in this Section shall be | ||||||
9 | construed to allow the Department or its contracted managed | ||||||
10 | care organizations to enter into sole source contracts for the | ||||||
11 | provision of custom prosthetic or orthotic devices to | ||||||
12 | recipients of medical assistance or Medicaid managed care | ||||||
13 | enrollees. | ||||||
14 | (d) The Department and contracted managed care | ||||||
15 | organizations must comply with the Orthotics, Prosthetics, and | ||||||
16 | Pedorthics Practice Act when making payments for custom | ||||||
17 | orthotic and custom prosthetic devices. ".
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