IL HB4978 | 2023-2024 | 103rd General Assembly

Status

Spectrum: Partisan Bill (Democrat 2-0)
Status: Introduced on February 7 2024 - 25% progression
Action: 2024-05-31 - Rule 19(a) / Re-referred to Rules Committee
Pending: House Rules Committee
Text: Latest bill text (Introduced) [HTML]

Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to by rule implement a methodology to reimburse hospitals for inpatient stays extended beyond medical necessity due to the inability of the Department, the managed care organization (MCO) in which a medical assistance recipient is enrolled in, or the hospital discharge planner to find an appropriate placement after discharge from the hospital to the next level of care. Requires the Department to by rule implement a methodology effective for dates of service January 1, 2025 and later to reimburse hospitals for emergency department stays extended beyond medical necessity due to the inability of the Department, the MCO, or the hospital discharge planner to find an appropriate placement after discharge from the hospital setting to the next appropriate level of care. Provides that both methodologies shall provide reasonable compensation for the services provided attributable to the hours of the extended stay for which the prevailing rate methodology provides no reimbursement. Contains provisions concerning the rate for inpatient days of care; hourly rates of reimbursement for emergency department stays; a prohibition on MCOs restricting coverage due to delays caused by the Department or the MCOs in completing the pre-admission screening and resident review process; a prohibition on MCOs imposing authorization or documentation requirements and other conditions of reimbursement that are more restrictive than standards under the fee-for-service medical assistance program; sanctions on MCOs for noncompliance; and administrative rules. Effective immediately.

Tracking Information

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Title

DHFS-EXTENDED HOSP STAYS

Sponsors


History

DateChamberAction
2024-05-31HouseRule 19(a) / Re-referred to Rules Committee
2024-05-26HouseCommittee/3rd Reading Deadline Extended-Rule May 31, 2024
2024-05-24HouseCommittee/3rd Reading Deadline Extended-Rule May 27, 2024
2024-04-05HouseCommittee/3rd Reading Deadline Extended-Rule May 24, 2024
2024-04-04HouseTo Medicaid & Managed Care Subcommittee
2024-03-06HouseAdded Co-Sponsor Rep. Dagmara Avelar
2024-02-28HouseAssigned to Appropriations-Health & Human Services Committee
2024-02-08HouseReferred to Rules Committee
2024-02-08HouseFirst Reading
2024-02-07HouseFiled with the Clerk by Rep. Robyn Gabel

Code Citations

ChapterArticleSectionCitation TypeStatute Text
305514-13Amended CodeCitation Text

Illinois State Sources


Bill Comments

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