Bill Text: IL HB2985 | 2019-2020 | 101st General Assembly | Introduced

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Bill Title: Amends the Illinois Public Aid Code. Requires Medicaid managed care organizations to verify payer source using the Medical Electronic Data Interchange (MEDI) System, or its successor, prior to denying a claim for services provided to a nursing home resident not assigned to the managed care organization on the most recent patient credit file. Requires the Department of Healthcare and Family Services to grant Medicaid managed care organizations access to MEDI, or its successor, for the purpose of verifying payer source and resident liability. Effective immediately.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2019-03-29 - Rule 19(a) / Re-referred to Rules Committee [HB2985 Detail]

Download: Illinois-2019-HB2985-Introduced.html

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101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 HB2985 Introduced , by Rep. Sonya M. Harper SYNOPSIS AS INTRODUCED:
305 ILCS 5/5F-31
Amends the Illinois Public Aid Code. Requires Medicaid managed care organizations to verify payer source using the Medical Electronic Data Interchange (MEDI) System, or its successor, prior to denying a claim for services provided to a nursing home resident not assigned to the managed care organization on the most recent patient credit file. Requires the Department of Healthcare and Family Services to grant Medicaid managed care organizations access to MEDI, or its successor, for the purpose of verifying payer source and resident liability. Effective immediately.
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A BILL FOR
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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5F-31 as follows:
(305 ILCS 5/5F-31)
Sec. 5F-31. Patient credit files; denials of claims.
(a) To reduce the number of claim denials resulting from
coverage plan errors, the Department shall provide each nursing
home enrolled in one or more Medicaid managed care networks
with the corresponding patient credit file at the same time the
Department provides the files to the managed care organization.
(b) Medicaid managed care organizations shall verify payer
source using the Medical Electronic Data Interchange (MEDI)
System, or its successor, prior to denying a claim for services
provided to a nursing home resident not assigned to the managed
care organization on the most recent patient credit file. The
Department shall grant Medicaid managed care organizations
access to MEDI, or its successor, for the purpose of verifying
payer source and resident liability.
(Source: P.A. 100-1085, eff. 1-1-19.)
Section 99. Effective date. This Act takes effect upon

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becoming law.