104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB3434
 
Introduced , by Rep. Norma Hernandez
 
SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5
    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that subject to federal approval, within 12 months after the effective date of the amendatory Act, nutrition care services and medical nutrition therapy provided by a registered dietitian licensed under the Dietitian Nutritionist Practice Act who is acting within the scope of his or her license shall be covered under the medical assistance program. Provides that the covered services may be aimed at prevention, delay, management, treatment, or rehabilitation of a disease or condition and include nutrition assessment, nutrition intervention, nutrition counseling, and nutrition monitoring and evaluation. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment, if required, to implement the amendatory Act. Provides that the Department shall adopt rules to implement the amendatory Act, including rules that ensure coverage for individuals with chronic conditions without prior authorization.


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A BILL FOR
 
HB3434LRB104 10161 KTG 20233 b


1    AN ACT concerning public aid.

2    Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:

4    Section 5. The Illinois Public Aid Code is amended by 
5changing Section 5-5 as follows:

6    (305 ILCS 5/5-5)
7    Sec. 5-5. Medical services.  The Illinois Department, by 
8rule, shall determine the quantity and quality of and the rate 
9of reimbursement for the medical assistance for which payment 
10will be authorized, and the medical services to be provided, 
11which may include all or part of the following: (1) inpatient 
12hospital services; (2) outpatient hospital services; (3) other 
13laboratory and X-ray services; (4) skilled nursing home 
14services; (5) physicians' services whether furnished in the 
15office, the patient's home, a hospital, a skilled nursing 
16home, or elsewhere; (6) medical care, or any other type of 
17remedial care furnished by licensed practitioners; (7) home 
18health care services; (8) private duty nursing service; (9) 
19clinic services; (10) dental services, including prevention 
20and treatment of periodontal disease and dental caries disease 
21for pregnant individuals, provided by an individual licensed 
22to practice dentistry or dental surgery; for purposes of this 
23item (10), "dental services" means diagnostic, preventive, or 
 
 
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1corrective procedures provided by or under the supervision of 
2a dentist in the practice of his or her profession; (11) 
3physical therapy and related services; (12) prescribed drugs, 
4dentures, and prosthetic devices; and eyeglasses prescribed by 
5a physician skilled in the diseases of the eye, or by an 
6optometrist, whichever the person may select; (13) other 
7diagnostic, screening, preventive, and rehabilitative 
8services, including to ensure that the individual's need for 
9intervention or treatment of mental disorders or substance use 
10disorders or co-occurring mental health and substance use 
11disorders is determined using a uniform screening, assessment, 
12and evaluation process inclusive of criteria, for children and 
13adults; for purposes of this item (13), a uniform screening, 
14assessment, and evaluation process refers to a process that 
15includes an appropriate evaluation and, as warranted, a 
16referral; "uniform" does not mean the use of a singular 
17instrument, tool, or process that all must utilize; (14) 
18transportation and such other expenses as may be necessary; 
19(15) medical treatment of sexual assault survivors, as defined 
20in Section 1a of the Sexual Assault Survivors Emergency 
21Treatment Act, for injuries sustained as a result of the 
22sexual assault, including examinations and laboratory tests to 
23discover evidence which may be used in criminal proceedings 
24arising from the sexual assault; (16) the diagnosis and 
25treatment of sickle cell anemia; (16.5) services performed by 
26a chiropractic physician licensed under the Medical Practice 
 
 
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1Act of 1987 and acting within the scope of his or her license, 
2including, but not limited to, chiropractic manipulative 
3treatment; and (17) any other medical care, and any other type 
4of remedial care recognized under the laws of this State. The 
5term "any other type of remedial care" shall include nursing 
6care and nursing home service for persons who rely on 
7treatment by spiritual means alone through prayer for healing. 
8    Notwithstanding any other provision of this Section, a 
9comprehensive tobacco use cessation program that includes 
10purchasing prescription drugs or prescription medical devices 
11approved by the Food and Drug Administration shall be covered 
12under the medical assistance program under this Article for 
13persons who are otherwise eligible for assistance under this 
14Article. 
15    Notwithstanding any other provision of this Code, 
16reproductive health care that is otherwise legal in Illinois 
17shall be covered under the medical assistance program for 
18persons who are otherwise eligible for medical assistance 
19under this Article. 
20    Notwithstanding any other provision of this Section, all 
21tobacco cessation medications approved by the United States 
22Food and Drug Administration and all individual and group 
23tobacco cessation counseling services and telephone-based 
24counseling services and tobacco cessation medications provided 
25through the Illinois Tobacco Quitline shall be covered under 
26the medical assistance program for persons who are otherwise 
 
 
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1eligible for assistance under this Article. The Department 
2shall comply with all federal requirements necessary to obtain 
3federal financial participation, as specified in 42 CFR 
4433.15(b)(7), for telephone-based counseling services provided 
5through the Illinois Tobacco Quitline, including, but not 
6limited to: (i) entering into a memorandum of understanding or 
7interagency agreement with the Department of Public Health, as 
8administrator of the Illinois Tobacco Quitline; and (ii) 
9developing a cost allocation plan for Medicaid-allowable 
10Illinois Tobacco Quitline services in accordance with 45 CFR 
1195.507. The Department shall submit the memorandum of 
12understanding or interagency agreement, the cost allocation 
13plan, and all other necessary documentation to the Centers for 
14Medicare and Medicaid Services for review and approval. 
15Coverage under this paragraph shall be contingent upon federal 
16approval.
17    Notwithstanding any other provision of this Code, the 
18Illinois Department may not require, as a condition of payment 
19for any laboratory test authorized under this Article, that a 
20physician's handwritten signature appear on the laboratory 
21test order form. The Illinois Department may, however, impose 
22other appropriate requirements regarding laboratory test order 
23documentation. 
24    Upon receipt of federal approval of an amendment to the 
25Illinois Title XIX State Plan for this purpose, the Department 
26shall authorize the Chicago Public Schools (CPS) to procure a 
 
 
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1vendor or vendors to manufacture eyeglasses for individuals 
2enrolled in a school within the CPS system. CPS shall ensure 
3that its vendor or vendors are enrolled as providers in the 
4medical assistance program and in any capitated Medicaid 
5managed care entity (MCE) serving individuals enrolled in a 
6school within the CPS system. Under any contract procured 
7under this provision, the vendor or vendors must serve only 
8individuals enrolled in a school within the CPS system. Claims 
9for services provided by CPS's vendor or vendors to recipients 
10of benefits in the medical assistance program under this Code, 
11the Children's Health Insurance Program, or the Covering ALL 
12KIDS Health Insurance Program shall be submitted to the 
13Department or the MCE in which the individual is enrolled for 
14payment and shall be reimbursed at the Department's or the 
15MCE's established rates or rate methodologies for eyeglasses. 
16    On and after July 1, 2012, the Department of Healthcare 
17and Family Services may provide the following services to 
18persons eligible for assistance under this Article who are 
19participating in education, training or employment programs 
20operated by the Department of Human Services as successor to 
21the Department of Public Aid:
22        (1) dental services provided by or under the 
23 supervision of a dentist; and 
24        (2) eyeglasses prescribed by a physician skilled in 
25 the diseases of the eye, or by an optometrist, whichever 
26 the person may select.
 
 
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1    On and after July 1, 2018, the Department of Healthcare 
2and Family Services shall provide dental services to any adult 
3who is otherwise eligible for assistance under the medical 
4assistance program. As used in this paragraph, "dental 
5services" means diagnostic, preventative, restorative, or 
6corrective procedures, including procedures and services for 
7the prevention and treatment of periodontal disease and dental 
8caries disease, provided by an individual who is licensed to 
9practice dentistry or dental surgery or who is under the 
10supervision of a dentist in the practice of his or her 
11profession.
12    On and after July 1, 2018, targeted dental services, as 
13set forth in Exhibit D of the Consent Decree entered by the 
14United States District Court for the Northern District of 
15Illinois, Eastern Division, in the matter of Memisovski v. 
16Maram, Case No. 92 C 1982, that are provided to adults under 
17the medical assistance program shall be established at no less 
18than the rates set forth in the "New Rate" column in Exhibit D 
19of the Consent Decree for targeted dental services that are 
20provided to persons under the age of 18 under the medical 
21assistance program. 
22    Subject to federal approval, on and after January 1, 2025, 
23the rates paid for sedation evaluation and the provision of 
24deep sedation and intravenous sedation for the purpose of 
25dental services shall be increased by 33% above the rates in 
26effect on December 31, 2024. The rates paid for nitrous oxide 
 
 
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1sedation shall not be impacted by this paragraph and shall 
2remain the same as the rates in effect on December 31, 2024. 
3    Notwithstanding any other provision of this Code and 
4subject to federal approval, the Department may adopt rules to 
5allow a dentist who is volunteering his or her service at no 
6cost to render dental services through an enrolled 
7not-for-profit health clinic without the dentist personally 
8enrolling as a participating provider in the medical 
9assistance program. A not-for-profit health clinic shall 
10include a public health clinic or Federally Qualified Health 
11Center or other enrolled provider, as determined by the 
12Department, through which dental services covered under this 
13Section are performed. The Department shall establish a 
14process for payment of claims for reimbursement for covered 
15dental services rendered under this provision. 
16    Subject to appropriation and to federal approval, the 
17Department shall file administrative rules updating the 
18Handicapping Labio-Lingual Deviation orthodontic scoring tool 
19by January 1, 2025, or as soon as practicable. 
20    On and after January 1, 2022, the Department of Healthcare 
21and Family Services shall administer and regulate a 
22school-based dental program that allows for the out-of-office 
23delivery of preventative dental services in a school setting 
24to children under 19 years of age. The Department shall 
25establish, by rule, guidelines for participation by providers 
26and set requirements for follow-up referral care based on the 
 
 
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1requirements established in the Dental Office Reference Manual 
2published by the Department that establishes the requirements 
3for dentists participating in the All Kids Dental School 
4Program. Every effort shall be made by the Department when 
5developing the program requirements to consider the different 
6geographic differences of both urban and rural areas of the 
7State for initial treatment and necessary follow-up care. No 
8provider shall be charged a fee by any unit of local government 
9to participate in the school-based dental program administered 
10by the Department. Nothing in this paragraph shall be 
11construed to limit or preempt a home rule unit's or school 
12district's authority to establish, change, or administer a 
13school-based dental program in addition to, or independent of, 
14the school-based dental program administered by the 
15Department. 
16    The Illinois Department, by rule, may distinguish and 
17classify the medical services to be provided only in 
18accordance with the classes of persons designated in Section 
195-2. 
20    The Department of Healthcare and Family Services must 
21provide coverage and reimbursement for amino acid-based 
22elemental formulas, regardless of delivery method, for the 
23diagnosis and treatment of (i) eosinophilic disorders and (ii) 
24short bowel syndrome when the prescribing physician has issued 
25a written order stating that the amino acid-based elemental 
26formula is medically necessary. 
 
 
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1    The Illinois Department shall authorize the provision of, 
2and shall authorize payment for, screening by low-dose 
3mammography for the presence of occult breast cancer for 
4individuals 35 years of age or older who are eligible for 
5medical assistance under this Article, as follows:
6        (A) A baseline mammogram for individuals 35 to 39 
7 years of age. 
8        (B) An annual mammogram for individuals 40 years of 
9 age or older.
10        (C) A mammogram at the age and intervals considered 
11 medically necessary by the individual's health care 
12 provider for individuals under 40 years of age and having 
13 a family history of breast cancer, prior personal history 
14 of breast cancer, positive genetic testing, or other risk 
15 factors.
16        (D) A comprehensive ultrasound screening and MRI of an 
17 entire breast or breasts if a mammogram demonstrates 
18 heterogeneous or dense breast tissue or when medically 
19 necessary as determined by a physician licensed to 
20 practice medicine in all of its branches. 
21        (E) A screening MRI when medically necessary, as 
22 determined by a physician licensed to practice medicine in 
23 all of its branches. 
24        (F) A diagnostic mammogram when medically necessary, 
25 as determined by a physician licensed to practice medicine 
26 in all its branches, advanced practice registered nurse, 
 
 
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1 or physician assistant. 
2        (G) Molecular breast imaging (MBI) and MRI of an 
3 entire breast or breasts if a mammogram demonstrates 
4 heterogeneous or dense breast tissue or when medically 
5 necessary as determined by a physician licensed to 
6 practice medicine in all of its branches, advanced 
7 practice registered nurse, or physician assistant. 
8    The Department shall not impose a deductible, coinsurance, 
9copayment, or any other cost-sharing requirement on the 
10coverage provided under this paragraph; except that this 
11sentence does not apply to coverage of diagnostic mammograms 
12to the extent such coverage would disqualify a high-deductible 
13health plan from eligibility for a health savings account 
14pursuant to Section 223 of the Internal Revenue Code (26 
15U.S.C. 223). 
16    All screenings shall include a physical breast exam, 
17instruction on self-examination and information regarding the 
18frequency of self-examination and its value as a preventative 
19tool.
20    For purposes of this Section:
21    "Diagnostic mammogram" means a mammogram obtained using 
22diagnostic mammography.
23    "Diagnostic mammography" means a method of screening that 
24is designed to evaluate an abnormality in a breast, including 
25an abnormality seen or suspected on a screening mammogram or a 
26subjective or objective abnormality otherwise detected in the 
 
 
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1breast.
2    "Low-dose mammography" means the x-ray examination of the 
3breast using equipment dedicated specifically for mammography, 
4including the x-ray tube, filter, compression device, and 
5image receptor, with an average radiation exposure delivery of 
6less than one rad per breast for 2 views of an average size 
7breast. The term also includes digital mammography and 
8includes breast tomosynthesis.
9    "Breast tomosynthesis" means a radiologic procedure that 
10involves the acquisition of projection images over the 
11stationary breast to produce cross-sectional digital 
12three-dimensional images of the breast.
13    If, at any time, the Secretary of the United States 
14Department of Health and Human Services, or its successor 
15agency, promulgates rules or regulations to be published in 
16the Federal Register or publishes a comment in the Federal 
17Register or issues an opinion, guidance, or other action that 
18would require the State, pursuant to any provision of the 
19Patient Protection and Affordable Care Act (Public Law 
20111-148), including, but not limited to, 42 U.S.C. 
2118031(d)(3)(B) or any successor provision, to defray the cost 
22of any coverage for breast tomosynthesis outlined in this 
23paragraph, then the requirement that an insurer cover breast 
24tomosynthesis is inoperative other than any such coverage 
25authorized under Section 1902 of the Social Security Act, 42 
26U.S.C. 1396a, and the State shall not assume any obligation 
 
 
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1for the cost of coverage for breast tomosynthesis set forth in 
2this paragraph.
3    On and after January 1, 2016, the Department shall ensure 
4that all networks of care for adult clients of the Department 
5include access to at least one breast imaging Center of 
6Imaging Excellence as certified by the American College of 
7Radiology.
8    On and after January 1, 2012, providers participating in a 
9quality improvement program approved by the Department shall 
10be reimbursed for screening and diagnostic mammography at the 
11same rate as the Medicare program's rates, including the 
12increased reimbursement for digital mammography and, after 
13January 1, 2023 (the effective date of Public Act 102-1018), 
14breast tomosynthesis.
15    The Department shall convene an expert panel including 
16representatives of hospitals, free-standing mammography 
17facilities, and doctors, including radiologists, to establish 
18quality standards for mammography.
19    On and after January 1, 2017, providers participating in a 
20breast cancer treatment quality improvement program approved 
21by the Department shall be reimbursed for breast cancer 
22treatment at a rate that is no lower than 95% of the Medicare 
23program's rates for the data elements included in the breast 
24cancer treatment quality program.
25    The Department shall convene an expert panel, including 
26representatives of hospitals, free-standing breast cancer 
 
 
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1treatment centers, breast cancer quality organizations, and 
2doctors, including radiologists that are trained in all forms 
3of FDA-approved FDA approved breast imaging technologies, 
4breast surgeons, reconstructive breast surgeons, oncologists, 
5and primary care providers to establish quality standards for 
6breast cancer treatment.
7    Subject to federal approval, the Department shall 
8establish a rate methodology for mammography at federally 
9qualified health centers and other encounter-rate clinics. 
10These clinics or centers may also collaborate with other 
11hospital-based mammography facilities. By January 1, 2016, the 
12Department shall report to the General Assembly on the status 
13of the provision set forth in this paragraph.
14    The Department shall establish a methodology to remind 
15individuals who are age-appropriate for screening mammography, 
16but who have not received a mammogram within the previous 18 
17months, of the importance and benefit of screening 
18mammography. The Department shall work with experts in breast 
19cancer outreach and patient navigation to optimize these 
20reminders and shall establish a methodology for evaluating 
21their effectiveness and modifying the methodology based on the 
22evaluation.
23    The Department shall establish a performance goal for 
24primary care providers with respect to their female patients 
25over age 40 receiving an annual mammogram. This performance 
26goal shall be used to provide additional reimbursement in the 
 
 
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1form of a quality performance bonus to primary care providers 
2who meet that goal.
3    The Department shall devise a means of case-managing or 
4patient navigation for beneficiaries diagnosed with breast 
5cancer. This program shall initially operate as a pilot 
6program in areas of the State with the highest incidence of 
7mortality related to breast cancer. At least one pilot program 
8site shall be in the metropolitan Chicago area and at least one 
9site shall be outside the metropolitan Chicago area. On or 
10after July 1, 2016, the pilot program shall be expanded to 
11include one site in western Illinois, one site in southern 
12Illinois, one site in central Illinois, and 4 sites within 
13metropolitan Chicago. An evaluation of the pilot program shall 
14be carried out measuring health outcomes and cost of care for 
15those served by the pilot program compared to similarly 
16situated patients who are not served by the pilot program. 
17    The Department shall require all networks of care to 
18develop a means either internally or by contract with experts 
19in navigation and community outreach to navigate cancer 
20patients to comprehensive care in a timely fashion. The 
21Department shall require all networks of care to include 
22access for patients diagnosed with cancer to at least one 
23academic commission on cancer-accredited cancer program as an 
24in-network covered benefit.
25    The Department shall provide coverage and reimbursement 
26for a human papillomavirus (HPV) vaccine that is approved for 
 
 
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1marketing by the federal Food and Drug Administration for all 
2persons between the ages of 9 and 45. Subject to federal 
3approval, the Department shall provide coverage and 
4reimbursement for a human papillomavirus (HPV) vaccine for 
5persons of the age of 46 and above who have been diagnosed with 
6cervical dysplasia with a high risk of recurrence or 
7progression. The Department shall disallow any 
8preauthorization requirements for the administration of the 
9human papillomavirus (HPV) vaccine. 
10    On or after July 1, 2022, individuals who are otherwise 
11eligible for medical assistance under this Article shall 
12receive coverage for perinatal depression screenings for the 
1312-month period beginning on the last day of their pregnancy. 
14Medical assistance coverage under this paragraph shall be 
15conditioned on the use of a screening instrument approved by 
16the Department.
17    Any medical or health care provider shall immediately 
18recommend, to any pregnant individual who is being provided 
19prenatal services and is suspected of having a substance use 
20disorder as defined in the Substance Use Disorder Act, 
21referral to a local substance use disorder treatment program 
22licensed by the Department of Human Services or to a licensed 
23hospital which provides substance abuse treatment services. 
24The Department of Healthcare and Family Services shall assure 
25coverage for the cost of treatment of the drug abuse or 
26addiction for pregnant recipients in accordance with the 
 
 
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1Illinois Medicaid Program in conjunction with the Department 
2of Human Services. 
3    All medical providers providing medical assistance to 
4pregnant individuals under this Code shall receive information 
5from the Department on the availability of services under any 
6program providing case management services for addicted 
7individuals, including information on appropriate referrals 
8for other social services that may be needed by addicted 
9individuals in addition to treatment for addiction. 
10    The Illinois Department, in cooperation with the 
11Departments of Human Services (as successor to the Department 
12of Alcoholism and Substance Abuse) and Public Health, through 
13a public awareness campaign, may provide information 
14concerning treatment for alcoholism and drug abuse and 
15addiction, prenatal health care, and other pertinent programs 
16directed at reducing the number of drug-affected infants born 
17to recipients of medical assistance. 
18    Neither the Department of Healthcare and Family Services 
19nor the Department of Human Services shall sanction the 
20recipient solely on the basis of the recipient's substance 
21abuse. 
22    The Illinois Department shall establish such regulations 
23governing the dispensing of health services under this Article 
24as it shall deem appropriate. The Department should seek the 
25advice of formal professional advisory committees appointed by 
26the Director of the Illinois Department for the purpose of 
 
 
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1providing regular advice on policy and administrative matters, 
2information dissemination and educational activities for 
3medical and health care providers, and consistency in 
4procedures to the Illinois Department. 
5    The Illinois Department may develop and contract with 
6Partnerships of medical providers to arrange medical services 
7for persons eligible under Section 5-2 of this Code. 
8Implementation of this Section may be by demonstration 
9projects in certain geographic areas. The Partnership shall be 
10represented by a sponsor organization. The Department, by 
11rule, shall develop qualifications for sponsors of 
12Partnerships. Nothing in this Section shall be construed to 
13require that the sponsor organization be a medical 
14organization. 
15    The sponsor must negotiate formal written contracts with 
16medical providers for physician services, inpatient and 
17outpatient hospital care, home health services, treatment for 
18alcoholism and substance abuse, and other services determined 
19necessary by the Illinois Department by rule for delivery by 
20Partnerships. Physician services must include prenatal and 
21obstetrical care. The Illinois Department shall reimburse 
22medical services delivered by Partnership providers to clients 
23in target areas according to provisions of this Article and 
24the Illinois Health Finance Reform Act, except that: 
25        (1) Physicians participating in a Partnership and 
26 providing certain services, which shall be determined by 
 
 
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1 the Illinois Department, to persons in areas covered by 
2 the Partnership may receive an additional surcharge for 
3 such services. 
4        (2) The Department may elect to consider and negotiate 
5 financial incentives to encourage the development of 
6 Partnerships and the efficient delivery of medical care. 
7        (3) Persons receiving medical services through 
8 Partnerships may receive medical and case management 
9 services above the level usually offered through the 
10 medical assistance program. 
11    Medical providers shall be required to meet certain 
12qualifications to participate in Partnerships to ensure the 
13delivery of high quality medical services. These 
14qualifications shall be determined by rule of the Illinois 
15Department and may be higher than qualifications for 
16participation in the medical assistance program. Partnership 
17sponsors may prescribe reasonable additional qualifications 
18for participation by medical providers, only with the prior 
19written approval of the Illinois Department. 
20    Nothing in this Section shall limit the free choice of 
21practitioners, hospitals, and other providers of medical 
22services by clients. In order to ensure patient freedom of 
23choice, the Illinois Department shall immediately promulgate 
24all rules and take all other necessary actions so that 
25provided services may be accessed from therapeutically 
26certified optometrists to the full extent of the Illinois 
 
 
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1Optometric Practice Act of 1987 without discriminating between 
2service providers. 
3    The Department shall apply for a waiver from the United 
4States Health Care Financing Administration to allow for the 
5implementation of Partnerships under this Section. 
6    The Illinois Department shall require health care 
7providers to maintain records that document the medical care 
8and services provided to recipients of Medical Assistance 
9under this Article. Such records must be retained for a period 
10of not less than 6 years from the date of service or as 
11provided by applicable State law, whichever period is longer, 
12except that if an audit is initiated within the required 
13retention period then the records must be retained until the 
14audit is completed and every exception is resolved. The 
15Illinois Department shall require health care providers to 
16make available, when authorized by the patient, in writing, 
17the medical records in a timely fashion to other health care 
18providers who are treating or serving persons eligible for 
19Medical Assistance under this Article. All dispensers of 
20medical services shall be required to maintain and retain 
21business and professional records sufficient to fully and 
22accurately document the nature, scope, details and receipt of 
23the health care provided to persons eligible for medical 
24assistance under this Code, in accordance with regulations 
25promulgated by the Illinois Department. The rules and 
26regulations shall require that proof of the receipt of 
 
 
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1prescription drugs, dentures, prosthetic devices and 
2eyeglasses by eligible persons under this Section accompany 
3each claim for reimbursement submitted by the dispenser of 
4such medical services. No such claims for reimbursement shall 
5be approved for payment by the Illinois Department without 
6such proof of receipt, unless the Illinois Department shall 
7have put into effect and shall be operating a system of 
8post-payment audit and review which shall, on a sampling 
9basis, be deemed adequate by the Illinois Department to assure 
10that such drugs, dentures, prosthetic devices and eyeglasses 
11for which payment is being made are actually being received by 
12eligible recipients. Within 90 days after September 16, 1984 
13(the effective date of Public Act 83-1439), the Illinois 
14Department shall establish a current list of acquisition costs 
15for all prosthetic devices and any other items recognized as 
16medical equipment and supplies reimbursable under this Article 
17and shall update such list on a quarterly basis, except that 
18the acquisition costs of all prescription drugs shall be 
19updated no less frequently than every 30 days as required by 
20Section 5-5.12. 
21    Notwithstanding any other law to the contrary, the 
22Illinois Department shall, within 365 days after July 22, 2013 
23(the effective date of Public Act 98-104), establish 
24procedures to permit skilled care facilities licensed under 
25the Nursing Home Care Act to submit monthly billing claims for 
26reimbursement purposes. Following development of these 
 
 
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1procedures, the Department shall, by July 1, 2016, test the 
2viability of the new system and implement any necessary 
3operational or structural changes to its information 
4technology platforms in order to allow for the direct 
5acceptance and payment of nursing home claims. 
6    Notwithstanding any other law to the contrary, the 
7Illinois Department shall, within 365 days after August 15, 
82014 (the effective date of Public Act 98-963), establish 
9procedures to permit ID/DD facilities licensed under the ID/DD 
10Community Care Act and MC/DD facilities licensed under the 
11MC/DD Act to submit monthly billing claims for reimbursement 
12purposes. Following development of these procedures, the 
13Department shall have an additional 365 days to test the 
14viability of the new system and to ensure that any necessary 
15operational or structural changes to its information 
16technology platforms are implemented. 
17    The Illinois Department shall require all dispensers of 
18medical services, other than an individual practitioner or 
19group of practitioners, desiring to participate in the Medical 
20Assistance program established under this Article to disclose 
21all financial, beneficial, ownership, equity, surety or other 
22interests in any and all firms, corporations, partnerships, 
23associations, business enterprises, joint ventures, agencies, 
24institutions or other legal entities providing any form of 
25health care services in this State under this Article. 
26    The Illinois Department may require that all dispensers of 
 
 
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1medical services desiring to participate in the medical 
2assistance program established under this Article disclose, 
3under such terms and conditions as the Illinois Department may 
4by rule establish, all inquiries from clients and attorneys 
5regarding medical bills paid by the Illinois Department, which 
6inquiries could indicate potential existence of claims or 
7liens for the Illinois Department. 
8    Enrollment of a vendor shall be subject to a provisional 
9period and shall be conditional for one year. During the 
10period of conditional enrollment, the Department may terminate 
11the vendor's eligibility to participate in, or may disenroll 
12the vendor from, the medical assistance program without cause. 
13Unless otherwise specified, such termination of eligibility or 
14disenrollment is not subject to the Department's hearing 
15process. However, a disenrolled vendor may reapply without 
16penalty. 
17    The Department has the discretion to limit the conditional 
18enrollment period for vendors based upon the category of risk 
19of the vendor.
20    Prior to enrollment and during the conditional enrollment 
21period in the medical assistance program, all vendors shall be 
22subject to enhanced oversight, screening, and review based on 
23the risk of fraud, waste, and abuse that is posed by the 
24category of risk of the vendor. The Illinois Department shall 
25establish the procedures for oversight, screening, and review, 
26which may include, but need not be limited to: criminal and 
 
 
HB3434- 23 -LRB104 10161 KTG 20233 b


1financial background checks; fingerprinting; license, 
2certification, and authorization verifications; unscheduled or 
3unannounced site visits; database checks; prepayment audit 
4reviews; audits; payment caps; payment suspensions; and other 
5screening as required by federal or State law.
6    The Department shall define or specify the following: (i) 
7by provider notice, the "category of risk of the vendor" for 
8each type of vendor, which shall take into account the level of 
9screening applicable to a particular category of vendor under 
10federal law and regulations; (ii) by rule or provider notice, 
11the maximum length of the conditional enrollment period for 
12each category of risk of the vendor; and (iii) by rule, the 
13hearing rights, if any, afforded to a vendor in each category 
14of risk of the vendor that is terminated or disenrolled during 
15the conditional enrollment period. 
16    To be eligible for payment consideration, a vendor's 
17payment claim or bill, either as an initial claim or as a 
18resubmitted claim following prior rejection, must be received 
19by the Illinois Department, or its fiscal intermediary, no 
20later than 180 days after the latest date on the claim on which 
21medical goods or services were provided, with the following 
22exceptions:
23        (1) In the case of a provider whose enrollment is in 
24 process by the Illinois Department, the 180-day period 
25 shall not begin until the date on the written notice from 
26 the Illinois Department that the provider enrollment is 
 
 
HB3434- 24 -LRB104 10161 KTG 20233 b


1 complete.
2        (2) In the case of errors attributable to the Illinois 
3 Department or any of its claims processing intermediaries 
4 which result in an inability to receive, process, or 
5 adjudicate a claim, the 180-day period shall not begin 
6 until the provider has been notified of the error.
7        (3) In the case of a provider for whom the Illinois 
8 Department initiates the monthly billing process.
9        (4) In the case of a provider operated by a unit of 
10 local government with a population exceeding 3,000,000 
11 when local government funds finance federal participation 
12 for claims payments. 
13    For claims for services rendered during a period for which 
14a recipient received retroactive eligibility, claims must be 
15filed within 180 days after the Department determines the 
16applicant is eligible. For claims for which the Illinois 
17Department is not the primary payer, claims must be submitted 
18to the Illinois Department within 180 days after the final 
19adjudication by the primary payer.
20    In the case of long term care facilities, within 120 
21calendar days of receipt by the facility of required 
22prescreening information, new admissions with associated 
23admission documents shall be submitted through the Medical 
24Electronic Data Interchange (MEDI) or the Recipient 
25Eligibility Verification (REV) System or shall be submitted 
26directly to the Department of Human Services using required 
 
 
HB3434- 25 -LRB104 10161 KTG 20233 b


1admission forms. Effective September 1, 2014, admission 
2documents, including all prescreening information, must be 
3submitted through MEDI or REV. Confirmation numbers assigned 
4to an accepted transaction shall be retained by a facility to 
5verify timely submittal. Once an admission transaction has 
6been completed, all resubmitted claims following prior 
7rejection are subject to receipt no later than 180 days after 
8the admission transaction has been completed.
9    Claims that are not submitted and received in compliance 
10with the foregoing requirements shall not be eligible for 
11payment under the medical assistance program, and the State 
12shall have no liability for payment of those claims.
13    To the extent consistent with applicable information and 
14privacy, security, and disclosure laws, State and federal 
15agencies and departments shall provide the Illinois Department 
16access to confidential and other information and data 
17necessary to perform eligibility and payment verifications and 
18other Illinois Department functions. This includes, but is not 
19limited to: information pertaining to licensure; 
20certification; earnings; immigration status; citizenship; wage 
21reporting; unearned and earned income; pension income; 
22employment; supplemental security income; social security 
23numbers; National Provider Identifier (NPI) numbers; the 
24National Practitioner Data Bank (NPDB); program and agency 
25exclusions; taxpayer identification numbers; tax delinquency; 
26corporate information; and death records.
 
 
HB3434- 26 -LRB104 10161 KTG 20233 b


1    The Illinois Department shall enter into agreements with 
2State agencies and departments, and is authorized to enter 
3into agreements with federal agencies and departments, under 
4which such agencies and departments shall share data necessary 
5for medical assistance program integrity functions and 
6oversight. The Illinois Department shall develop, in 
7cooperation with other State departments and agencies, and in 
8compliance with applicable federal laws and regulations, 
9appropriate and effective methods to share such data. At a 
10minimum, and to the extent necessary to provide data sharing, 
11the Illinois Department shall enter into agreements with State 
12agencies and departments, and is authorized to enter into 
13agreements with federal agencies and departments, including, 
14but not limited to: the Secretary of State; the Department of 
15Revenue; the Department of Public Health; the Department of 
16Human Services; and the Department of Financial and 
17Professional Regulation.
18    Beginning in fiscal year 2013, the Illinois Department 
19shall set forth a request for information to identify the 
20benefits of a pre-payment, post-adjudication, and post-edit 
21claims system with the goals of streamlining claims processing 
22and provider reimbursement, reducing the number of pending or 
23rejected claims, and helping to ensure a more transparent 
24adjudication process through the utilization of: (i) provider 
25data verification and provider screening technology; and (ii) 
26clinical code editing; and (iii) pre-pay, pre-adjudicated, or 
 
 
HB3434- 27 -LRB104 10161 KTG 20233 b


1post-adjudicated predictive modeling with an integrated case 
2management system with link analysis. Such a request for 
3information shall not be considered as a request for proposal 
4or as an obligation on the part of the Illinois Department to 
5take any action or acquire any products or services. 
6    The Illinois Department shall establish policies, 
7procedures, standards and criteria by rule for the 
8acquisition, repair and replacement of orthotic and prosthetic 
9devices and durable medical equipment. Such rules shall 
10provide, but not be limited to, the following services: (1) 
11immediate repair or replacement of such devices by recipients; 
12and (2) rental, lease, purchase or lease-purchase of durable 
13medical equipment in a cost-effective manner, taking into 
14consideration the recipient's medical prognosis, the extent of 
15the recipient's needs, and the requirements and costs for 
16maintaining such equipment. Subject to prior approval, such 
17rules shall enable a recipient to temporarily acquire and use 
18alternative or substitute devices or equipment pending repairs 
19or replacements of any device or equipment previously 
20authorized for such recipient by the Department. 
21Notwithstanding any provision of Section 5-5f to the contrary, 
22the Department may, by rule, exempt certain replacement 
23wheelchair parts from prior approval and, for wheelchairs, 
24wheelchair parts, wheelchair accessories, and related seating 
25and positioning items, determine the wholesale price by 
26methods other than actual acquisition costs.
 
 
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1    The Department shall require, by rule, all providers of 
2durable medical equipment to be accredited by an accreditation 
3organization approved by the federal Centers for Medicare and 
4Medicaid Services and recognized by the Department in order to 
5bill the Department for providing durable medical equipment to 
6recipients. No later than 15 months after the effective date 
7of the rule adopted pursuant to this paragraph, all providers 
8must meet the accreditation requirement.
9    In order to promote environmental responsibility, meet the 
10needs of recipients and enrollees, and achieve significant 
11cost savings, the Department, or a managed care organization 
12under contract with the Department, may provide recipients or 
13managed care enrollees who have a prescription or Certificate 
14of Medical Necessity access to refurbished durable medical 
15equipment under this Section (excluding prosthetic and 
16orthotic devices as defined in the Orthotics, Prosthetics, and 
17Pedorthics Practice Act and complex rehabilitation technology 
18products and associated services) through the State's 
19assistive technology program's reutilization program, using 
20staff with the Assistive Technology Professional (ATP) 
21Certification if the refurbished durable medical equipment: 
22(i) is available; (ii) is less expensive, including shipping 
23costs, than new durable medical equipment of the same type; 
24(iii) is able to withstand at least 3 years of use; (iv) is 
25cleaned, disinfected, sterilized, and safe in accordance with 
26federal Food and Drug Administration regulations and guidance 
 
 
HB3434- 29 -LRB104 10161 KTG 20233 b


1governing the reprocessing of medical devices in health care 
2settings; and (v) equally meets the needs of the recipient or 
3enrollee. The reutilization program shall confirm that the 
4recipient or enrollee is not already in receipt of the same or 
5similar equipment from another service provider, and that the 
6refurbished durable medical equipment equally meets the needs 
7of the recipient or enrollee. Nothing in this paragraph shall 
8be construed to limit recipient or enrollee choice to obtain 
9new durable medical equipment or place any additional prior 
10authorization conditions on enrollees of managed care 
11organizations. 
12    The Department shall execute, relative to the nursing home 
13prescreening project, written inter-agency agreements with the 
14Department of Human Services and the Department on Aging, to 
15effect the following: (i) intake procedures and common 
16eligibility criteria for those persons who are receiving 
17non-institutional services; and (ii) the establishment and 
18development of non-institutional services in areas of the 
19State where they are not currently available or are 
20undeveloped; and (iii) notwithstanding any other provision of 
21law, subject to federal approval, on and after July 1, 2012, an 
22increase in the determination of need (DON) scores from 29 to 
2337 for applicants for institutional and home and 
24community-based long term care; if and only if federal 
25approval is not granted, the Department may, in conjunction 
26with other affected agencies, implement utilization controls 
 
 
HB3434- 30 -LRB104 10161 KTG 20233 b


1or changes in benefit packages to effectuate a similar savings 
2amount for this population; and (iv) no later than July 1, 
32013, minimum level of care eligibility criteria for 
4institutional and home and community-based long term care; and 
5(v) no later than October 1, 2013, establish procedures to 
6permit long term care providers access to eligibility scores 
7for individuals with an admission date who are seeking or 
8receiving services from the long term care provider. In order 
9to select the minimum level of care eligibility criteria, the 
10Governor shall establish a workgroup that includes affected 
11agency representatives and stakeholders representing the 
12institutional and home and community-based long term care 
13interests. This Section shall not restrict the Department from 
14implementing lower level of care eligibility criteria for 
15community-based services in circumstances where federal 
16approval has been granted. 
17    The Illinois Department shall develop and operate, in 
18cooperation with other State Departments and agencies and in 
19compliance with applicable federal laws and regulations, 
20appropriate and effective systems of health care evaluation 
21and programs for monitoring of utilization of health care 
22services and facilities, as it affects persons eligible for 
23medical assistance under this Code. 
24    The Illinois Department shall report annually to the 
25General Assembly, no later than the second Friday in April of 
261979 and each year thereafter, in regard to: 
 
 
HB3434- 31 -LRB104 10161 KTG 20233 b


1        (a) actual statistics and trends in utilization of 
2 medical services by public aid recipients; 
3        (b) actual statistics and trends in the provision of 
4 the various medical services by medical vendors; 
5        (c) current rate structures and proposed changes in 
6 those rate structures for the various medical vendors; and 
7        (d) efforts at utilization review and control by the 
8 Illinois Department. 
9    The period covered by each report shall be the 3 years 
10ending on the June 30 prior to the report. The report shall 
11include suggested legislation for consideration by the General 
12Assembly. The requirement for reporting to the General 
13Assembly shall be satisfied by filing copies of the report as 
14required by Section 3.1 of the General Assembly Organization 
15Act, and filing such additional copies with the State 
16Government Report Distribution Center for the General Assembly 
17as is required under paragraph (t) of Section 7 of the State 
18Library Act. 
19    Rulemaking authority to implement Public Act 95-1045, if 
20any, is conditioned on the rules being adopted in accordance 
21with all provisions of the Illinois Administrative Procedure 
22Act and all rules and procedures of the Joint Committee on 
23Administrative Rules; any purported rule not so adopted, for 
24whatever reason, is unauthorized. 
25    On and after July 1, 2012, the Department shall reduce any 
26rate of reimbursement for services or other payments or alter 
 
 
HB3434- 32 -LRB104 10161 KTG 20233 b


1any methodologies authorized by this Code to reduce any rate 
2of reimbursement for services or other payments in accordance 
3with Section 5-5e. 
4    Because kidney transplantation can be an appropriate, 
5cost-effective alternative to renal dialysis when medically 
6necessary and notwithstanding the provisions of Section 1-11 
7of this Code, beginning October 1, 2014, the Department shall 
8cover kidney transplantation for noncitizens with end-stage 
9renal disease who are not eligible for comprehensive medical 
10benefits, who meet the residency requirements of Section 5-3 
11of this Code, and who would otherwise meet the financial 
12requirements of the appropriate class of eligible persons 
13under Section 5-2 of this Code. To qualify for coverage of 
14kidney transplantation, such person must be receiving 
15emergency renal dialysis services covered by the Department. 
16Providers under this Section shall be prior approved and 
17certified by the Department to perform kidney transplantation 
18and the services under this Section shall be limited to 
19services associated with kidney transplantation. 
20    Notwithstanding any other provision of this Code to the 
21contrary, on or after July 1, 2015, all FDA-approved FDA 
22approved forms of medication assisted treatment prescribed for 
23the treatment of alcohol dependence or treatment of opioid 
24dependence shall be covered under both fee-for-service and 
25managed care medical assistance programs for persons who are 
26otherwise eligible for medical assistance under this Article 
 
 
HB3434- 33 -LRB104 10161 KTG 20233 b


1and shall not be subject to any (1) utilization control, other 
2than those established under the American Society of Addiction 
3Medicine patient placement criteria, (2) prior authorization 
4mandate, (3) lifetime restriction limit mandate, or (4) 
5limitations on dosage. 
6    On or after July 1, 2015, opioid antagonists prescribed 
7for the treatment of an opioid overdose, including the 
8medication product, administration devices, and any pharmacy 
9fees or hospital fees related to the dispensing, distribution, 
10and administration of the opioid antagonist, shall be covered 
11under the medical assistance program for persons who are 
12otherwise eligible for medical assistance under this Article. 
13As used in this Section, "opioid antagonist" means a drug that 
14binds to opioid receptors and blocks or inhibits the effect of 
15opioids acting on those receptors, including, but not limited 
16to, naloxone hydrochloride or any other similarly acting drug 
17approved by the U.S. Food and Drug Administration. The 
18Department shall not impose a copayment on the coverage 
19provided for naloxone hydrochloride under the medical 
20assistance program.
21    Upon federal approval, the Department shall provide 
22coverage and reimbursement for all drugs that are approved for 
23marketing by the federal Food and Drug Administration and that 
24are recommended by the federal Public Health Service or the 
25United States Centers for Disease Control and Prevention for 
26pre-exposure prophylaxis and related pre-exposure prophylaxis 
 
 
HB3434- 34 -LRB104 10161 KTG 20233 b


1services, including, but not limited to, HIV and sexually 
2transmitted infection screening, treatment for sexually 
3transmitted infections, medical monitoring, assorted labs, and 
4counseling to reduce the likelihood of HIV infection among 
5individuals who are not infected with HIV but who are at high 
6risk of HIV infection.
7    A federally qualified health center, as defined in Section 
81905(l)(2)(B) of the federal Social Security Act, shall be 
9reimbursed by the Department in accordance with the federally 
10qualified health center's encounter rate for services provided 
11to medical assistance recipients that are performed by a 
12dental hygienist, as defined under the Illinois Dental 
13Practice Act, working under the general supervision of a 
14dentist and employed by a federally qualified health center. 
15    Within 90 days after October 8, 2021 (the effective date 
16of Public Act 102-665), the Department shall seek federal 
17approval of a State Plan amendment to expand coverage for 
18family planning services that includes presumptive eligibility 
19to individuals whose income is at or below 208% of the federal 
20poverty level. Coverage under this Section shall be effective 
21beginning no later than December 1, 2022.
22    Subject to approval by the federal Centers for Medicare 
23and Medicaid Services of a Title XIX State Plan amendment 
24electing the Program of All-Inclusive Care for the Elderly 
25(PACE) as a State Medicaid option, as provided for by Subtitle 
26I (commencing with Section 4801) of Title IV of the Balanced 
 
 
HB3434- 35 -LRB104 10161 KTG 20233 b


1Budget Act of 1997 (Public Law 105-33) and Part 460 
2(commencing with Section 460.2) of Subchapter E of Title 42 of 
3the Code of Federal Regulations, PACE program services shall 
4become a covered benefit of the medical assistance program, 
5subject to criteria established in accordance with all 
6applicable laws.
7    Notwithstanding any other provision of this Code, 
8community-based pediatric palliative care from a trained 
9interdisciplinary team shall be covered under the medical 
10assistance program as provided in Section 15 of the Pediatric 
11Palliative Care Act.
12    Notwithstanding any other provision of this Code, within 
1312 months after June 2, 2022 (the effective date of Public Act 
14102-1037) and subject to federal approval, acupuncture 
15services performed by an acupuncturist licensed under the 
16Acupuncture Practice Act who is acting within the scope of his 
17or her license shall be covered under the medical assistance 
18program. The Department shall apply for any federal waiver or 
19State Plan amendment, if required, to implement this 
20paragraph. The Department may adopt any rules, including 
21standards and criteria, necessary to implement this paragraph. 
22    Notwithstanding any other provision of this Code, the 
23medical assistance program shall, subject to federal approval, 
24reimburse hospitals for costs associated with a newborn 
25screening test for the presence of metachromatic 
26leukodystrophy, as required under the Newborn Metabolic 
 
 
HB3434- 36 -LRB104 10161 KTG 20233 b


1Screening Act, at a rate not less than the fee charged by the 
2Department of Public Health. Notwithstanding any other 
3provision of this Code, the medical assistance program shall, 
4subject to appropriation and federal approval, also reimburse 
5hospitals for costs associated with all newborn screening 
6tests added on and after August 9, 2024 (the effective date of 
7Public Act 103-909) this amendatory Act of the 103rd General 
8Assembly to the Newborn Metabolic Screening Act and required 
9to be performed under that Act at a rate not less than the fee 
10charged by the Department of Public Health. The Department 
11shall seek federal approval before the implementation of the 
12newborn screening test fees by the Department of Public 
13Health. 
14    Notwithstanding any other provision of this Code, 
15beginning on January 1, 2024, subject to federal approval, 
16cognitive assessment and care planning services provided to a 
17person who experiences signs or symptoms of cognitive 
18impairment, as defined by the Diagnostic and Statistical 
19Manual of Mental Disorders, Fifth Edition, shall be covered 
20under the medical assistance program for persons who are 
21otherwise eligible for medical assistance under this Article. 
22    Notwithstanding any other provision of this Code, 
23medically necessary reconstructive services that are intended 
24to restore physical appearance shall be covered under the 
25medical assistance program for persons who are otherwise 
26eligible for medical assistance under this Article. As used in 
 
 
HB3434- 37 -LRB104 10161 KTG 20233 b


1this paragraph, "reconstructive services" means treatments 
2performed on structures of the body damaged by trauma to 
3restore physical appearance. 
4    Notwithstanding any other provision of this Code, within 
512 months after the effective date of this amendatory Act of 
6the 104th General Assembly, subject to federal approval, 
7nutrition care services and medical nutrition therapy provided 
8by a registered dietitian licensed under the Dietitian 
9Nutritionist Practice Act who is acting within the scope of 
10his or her license shall be covered under the medical 
11assistance program. Services covered under this paragraph may 
12be aimed at prevention, delay, management, treatment, or 
13rehabilitation of a disease or condition and include, as 
14defined in Section 10 of the Dietitian Nutritionist Practice 
15Act, nutrition assessment, nutrition intervention, nutrition 
16counseling, and nutrition monitoring and evaluation. The 
17Department shall submit a Title XIX State Plan amendment, if 
18required, to implement this paragraph. The Department shall 
19adopt rules to implement this paragraph, including rules that 
20ensure coverage for individuals with chronic conditions 
21without prior authorization.    
22(Source: P.A. 102-43, Article 30, Section 30-5, eff. 7-6-21; 
23102-43, Article 35, Section 35-5, eff. 7-6-21; 102-43, Article 
2455, Section 55-5, eff. 7-6-21; 102-95, eff. 1-1-22; 102-123, 
25eff. 1-1-22; 102-558, eff. 8-20-21; 102-598, eff. 1-1-22; 
26102-655, eff. 1-1-22; 102-665, eff. 10-8-21; 102-813, eff. 
 
 
HB3434- 38 -LRB104 10161 KTG 20233 b


15-13-22; 102-1018, eff. 1-1-23; 102-1037, eff. 6-2-22; 
2102-1038, eff. 1-1-23; 103-102, Article 15, Section 15-5, eff. 
31-1-24; 103-102, Article 95, Section 95-15, eff. 1-1-24; 
4103-123, eff. 1-1-24; 103-154, eff. 6-30-23; 103-368, eff. 
51-1-24; 103-593, Article 5, Section 5-5, eff. 6-7-24; 103-593, 
6Article 90, Section 90-5, eff. 6-7-24; 103-605, eff. 7-1-24; 
7103-808, eff. 1-1-26; 103-909, eff. 8-9-24; 103-1040, eff. 
88-9-24; revised 10-10-24.)