Bill Text: IL HB4545 | 2021-2022 | 102nd General Assembly | Engrossed

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by October 1, 2023 the Department of Healthcare and Family Services shall ensure the Illinois Medicaid Program Advanced Cloud Technology system is updated daily with eligibility coverage information from the integrated eligibility system. Provides that notwithstanding any other provision of the Code, in order to recover an overpayment by recoupment or offset of future payments, a managed care organization's post-payment audit of any claim submitted by a provider must be completed no later than one year after the claim's payment date. Provides that the one-year time limit does not apply to claims that are (i) submitted fraudulently, (ii) known, or should have been known, by the provider to be a pattern of inappropriate billing according to standard provider billing practices, or (iii) subject to any federal law or regulation that permits post-payment audits beyond one year. Effective immediately.

Spectrum: Moderate Partisan Bill (Republican 4-1)

Status: (Engrossed - Dead) 2022-03-16 - Referred to Assignments [HB4545 Detail]

Download: Illinois-2021-HB4545-Engrossed.html

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HB4545 Engrossed LRB102 22906 KTG 32059 b
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
adding Sections 5-30.12a and 5-45 as follows:
(305 ILCS 5/5-30.12a new)
Sec. 5-30.12a. Illinois Medicaid Program Advanced Cloud
Technology. By October 1, 2023, the Department shall ensure
that the Illinois Medicaid Program Advanced Cloud Technology
system is updated daily with eligibility coverage information
from the integrated eligibility system.
(305 ILCS 5/5-45 new)
Sec. 5-45. MCO post-payment audit; time period limitation.
Notwithstanding any other provision of this Code, in order to
recover an overpayment by recoupment or offset of future
payments, a managed care organization's post-payment audit of
any claim submitted by a provider must be completed no later
than one year after the claim's payment date. The one-year
time limit does not apply to claims that are (i) submitted
fraudulently, (ii) known, or should have been known, by the
provider to be a pattern of inappropriate billing according to
standard provider billing practices, or (iii) subject to any

HB4545 Engrossed - 2 - LRB102 22906 KTG 32059 b
federal law or regulation that permits post-payment audits
beyond one year.
Section 99. Effective date. This Act takes effect upon
becoming law.