Bill Text: IL HB4736 | 2017-2018 | 100th General Assembly | Chaptered

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that notwithstanding any other provision of law, the Department of Healthcare and Family Services shall not require children made eligible for medical assistance through any home and community-based services waiver program for medically fragile and technology dependent children authorized under the Social Security Act to enroll in or transition to the State's managed care medical assistance program. Provides that any medically fragile and technology dependent child who is enrolled in the State's managed care medical assistance program on or before the effective date of the amendatory Act shall be given the option to disenroll from the State's managed care medical assistance program and receive medical assistance coverage under the State's traditional fee-for-service program.

Spectrum: Slight Partisan Bill (Democrat 11-4)

Status: (Passed) 2018-08-20 - Public Act . . . . . . . . . 100-0990 [HB4736 Detail]

Download: Illinois-2017-HB4736-Chaptered.html

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Public Act 100-0990
HB4736 Enrolled LRB100 17508 KTG 32677 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
changing Section 5-2b and by adding Section 5-30a as follows:
(305 ILCS 5/5-2b)
Sec. 5-2b. Medically fragile and technology dependent
children eligibility and program. Notwithstanding any other
provision of law except as provided in Section 5-30a, on and
after September 1, 2012, subject to federal approval, medical
assistance under this Article shall be available to children
who qualify as persons with a disability, as defined under the
federal Supplemental Security Income program and who are
medically fragile and technology dependent. The program shall
allow eligible children to receive the medical assistance
provided under this Article in the community and must maximize,
to the fullest extent permissible under federal law, federal
reimbursement and family cost-sharing, including co-pays,
premiums, or any other family contributions, except that the
Department shall be permitted to incentivize the utilization of
selected services through the use of cost-sharing adjustments.
The Department shall establish the policies, procedures,
standards, services, and criteria for this program by rule.

(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
(305 ILCS 5/5-30a new)
Sec. 5-30a. Exemptions from managed care enrollment;
children. Notwithstanding any other provision of law, the
Department shall not require any of the following children to
enroll in or transition to the State's managed care medical
assistance program:
(1) Children who are authorized by the Department to
receive in-home shift nursing services as required by the
federal Early and Periodic Screening, Diagnostic and
Treatment (EPSDT) provisions under 42 CFR 441.50 et seq.
(2) Children made eligible for medical assistance
through any home and community-based services waiver
program for medically fragile and technology dependent
children authorized under Section 1915(c) of the Social
Security Act.
Any children who meet the criteria under paragraph (1) or
(2) and who are enrolled in the State's managed care medical
assistance program on or before the effective date of this
amendatory Act of the 100th General Assembly shall be given the
option to disenroll from the State's managed care medical
assistance program and receive medical assistance coverage
under the State's traditional fee-for-service program.