HB 5868

Abstract

Amends the Illinois Insurance Code. Permits a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after the effective date of the amendatory Act to provide coverage for residential extended care services and supports for persons suffering from alcoholism or other drug addiction so long as: (1) a health care clinic or any other specified entity has conducted an individualized assessment of the person's condition prior to discharge and has identified the person as being at risk of a drug or alcohol relapse and in need of supportive services to maintain long-term recovery; (2) the residential extended care services and supports are administered by a community-based agency that is licensed by or under contract with the Department of Human Services; and (3) the residential extended care services and supports are administered upon the referral of a health care clinic or any other specified entity. Sets forth the services available for coverage. Requires the Department of Insurance to rate each community-based agency that is licensed by or under contract with the Department of Human Services to provide residential extended care services and supports and to publish the results on its official website. Amends the Illinois Public Aid Code. Permits the fee-for-service and managed care medical assistance programs established under the Code to provide coverage for residential extended care services and supports for any person suffering from alcoholism or other drug addiction who is at risk of a drug or alcohol relapse following discharge from a health care clinic or any other specified entity. Sets forth the conditions that must be met to qualify for coverage and makes other changes.