Illinois House Bill 1654 (Prior Session Legislation)

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Spectrum: Partisan Bill (Democrat 1-0)
Status: Introduced on February 1 2019 - 25% progression, died in committee
Action: 2019-03-29 - House Committee Amendment No. 1 Rule 19(c) / Re-referred to Rules Committee
Pending: House Rules Committee
Text: Latest bill text (Introduced) [HTML]

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to calculate the payout ratios reported by managed care organizations no less frequently than annually and to post these calculations on its website. Provides that the minimum payout ratio shall be 85% and that a managed care organization not meeting the 85% threshold must refund to the State, for each coverage year, an amount equal to the difference between the calculated payout ratio and 85% multiplied by coverage year revenue for that managed care organization. Requires the Department to exclusively use paid claims data submitted by managed care organizations in establishing managed care capitation rates. Provides that managed care organizations shall not be reimbursed by the State for any costs associated with health insurance fees. Provides that beginning July 1, 2019, in addition to any other payments made for inpatient Medicaid inpatient services, the Department must make the following add-on enhancement payments for each covered inpatient day for any patient covered by any medical assistance program administered by the Department: (i) for each general acute care hospital with a rate year 2017 Medicaid inpatient utilization rate equal to or greater than 47%, an additional $172 per inpatient day; (ii) for each hospital defined as a children's hospital under the Code with a rate year 2017 Medicaid inpatient utilization rate equal to or greater than 59%, an additional $200 per inpatient day; and (iii) for each critical access hospital, an additional $600 per inpatient day. Provides that the Department must require managed care organizations to make the same inpatient high-volume add-on enhancements for inpatient days of care. Effective July 1, 2019.

MEDICAID-MCO-PAYOUT RATIOS

Rep. Fred Crespo [D]

Date	Chamber	Action
2019-03-29	House	House Committee Amendment No. 1 Rule 19(c) / Re-referred to Rules Committee
2019-03-29	House	Rule 19(a) / Re-referred to Rules Committee
2019-03-28	House	House Committee Amendment No. 1 Rules Refers to Appropriations-Human Services Committee
2019-03-27	House	House Committee Amendment No. 1 Referred to Rules Committee
2019-03-27	House	House Committee Amendment No. 1 Filed with Clerk by Rep. Fred Crespo
2019-03-22	House	To Medicaid & Managed Care Subcommittee
2019-02-13	House	Assigned to Appropriations-Human Services Committee
2019-02-04	House	Referred to Rules Committee
2019-02-04	House	First Reading
2019-02-01	House	Filed with the Clerk by Rep. Fred Crespo

Chapter	Article	Section	Citation Type	Statute Text
305	5	14-13	New Code	See Bill Text
305	5	5-30	Amended Code	Citation Text

Type	Source
Summary	https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1654&GAID=15&DocTypeID=HB&SessionID=108&GA=101
Text	https://www.ilga.gov/legislation/101/HB/10100HB1654.htm
Amendment	https://www.ilga.gov/legislation/101/HB/10100HB1654ham001.htm