Signed by Governor JB Pritzker

Vote Smart's Synopsis:

Vote to amend and pass a bill establishes reporting requirements for pharmacy benefit managers in Illinois.

Highlights:

• Transfers the remaining balance from the Electronic Health Record Initiative Fund into the Public Aid Recoveries Trust Fund on January 1, 2025, and dissolves the Electronic Health Record Initiative Fund (Illinois Public Aid Code, Sec. 1).

• Transfers the remaining balance from the Juvenile Rehabilitation Services Medicaid Matching Fund into the Public Aid Recoveries Trust Fund on January 1, 2026, and dissolves the Juvenile Rehabilitation Services Medicaid Matching Fund (Illinois Public Aid Code, Sec. 1).

• Repeals a requirement for the Department of Healthcare and Family Services to conduct annual audits of the County Provider Trust Fund (Illinois Public Aid Code, Sec. 1).

• Transfers the remaining balance from the Provider Inquiry Trust Fund into the Healthcare Provider Relief Fund on January 1, 2025, and dissolves the Provider Inquiry Trust Fund (Illinois Public Aid Code, Sec. 1).

• Repeals the Supportive Living Faculty Funding Article and the Supportive Living Faculty Fund (Illinois Public Aid Code, Sec. 1).

• Requires add-on rates for physicians and nurses with certain certifications to be increased to at least $264.42 per hour (for the base unit rate plus the add-on) with dates of service on and after January 1, 2025 (Illinois Public Aid Code, Sec. 1).

• Requires the Department of Children and Family Services to pay for all inpatient stays at a hospital beginning on the 3rd day that a child is in the hospital beyond medical necessity and the child is unable to go home (Illinois Public Aid Code, Sec. 1).

• Requires the Department of Healthcare and Family Services to reimburse Children’s Community-Based Healthcare Centers at the lower of their customary charge to the public or $1,300, starting January 1, 2025 (Illinois Public Aid Code, Sec. 1).

• Increases reimbursement and coverage rates for certain medical services (Illinois Public Aid Code, Sec. 1).

• Increases the Tier 1 and Tier 2 assessment amounts for managed care organizations (Illinois Public Aid Code, Sec. 1).

• Requires a safety-net hospital health care equity add-on payment to be paid for each inpatient General Acute and Psychiatric day of care, beginning on July 1, 2024 (Illinois Public Aid Code, Sec. 1).

• Requires a safety-net hospital low-volume add-on payment of $200 to be paid for each inpatient General Acute and Psychiatric day of care, for any safety-net hospital that provided less than 11,000 Medicaid inpatient days of care, starting on and after July 1, 2024 (Illinois Public Aid Code, Sec. 1).

• Specifies that hospitals with over 9,000 Medicaid acute care inpatient admissions per year are not in the category of safety-net hospitals (Illinois Public Aid Code, Sec. 1).

• Requires facility fees for the birthing person and the baby to be at least 80% of the statewide average facility rate made to a hospital (Illinois Public Aid Code, Sec. 1).

• Requires a payment of at least $10 per day, per single-room occupancy to be added to the existing $25.50 per day, per single-room occupancy for a total of at least $35.50 per day, per single-room occupancy (Illinois Public Aid Code, Sec. 1).

• Requires Medicaid rates for supportive lining services to be at least 54.75% of the average total nursing services per diem rate for the geographic areas defined by the Department of Healthcare and Family Services with all the add-ons for nursing facilities beginning January 1, 2025 (Illinois Public Aid Code, Sec. 1).

• Requires a payment of at least $8.75 per day, per dual-occupancy room to be added to the existing $14.50 additional per day, per dual-occupancy room rate for a total of at least $23.25, beginning January 1, 2025 (Illinois Public Aid Code, Sec. 1).

Full Bill Text