SB 1544

Abstract

Amends the Illinois Public Aid Code. Requires long term care facilities to submit admission documents through the Medical Electronic Data Interchange (MEDI) or the Recipient Eligibility Verification (REV) System or a successor system (rather than through the MEDI or REV or a successor system or directly to the Department of Human Services) within 15 days of the facility receiving required prescreening information. Requires prescreening information to be date stamped by the facility upon receipt. Provides that claims that are not submitted and received in compliance with the foregoing requirements shall not be eligible for payment under the medical assistance program, and the State shall have no liability for payment of those claims with one specified exception. Provides that the Department of Healthcare and Family Services shall waive one or more of the timeframes specified under the Code upon determining that services provided were medically necessary and provided in good faith, that failure to meet one or more of the timeframes was an error on the part of an individual employee, and that the withholding of reimbursement would constitute a financial hardship which would jeopardize the ability of the facility to pay its workers, provide for the basic needs of its residents, and ensure the highest quality of care.