Don Harmon
- Democratic
- Senator
- District 39
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a provider who has exhausted the written internal appeals process of a managed care organization (MCO) shall be entitled to an external independent third-party review of the MCO's final decision that denies, in whole or in part, a health care service to an enrollee or a claim for reimbursement to a provider for a health care service rendered to an enrollee of the Medicaid managed care organization. Requires an MCO's final decision letter to a provider to include: (i) a statement that the provider's internal appeal rights within the MCO have been exhausted; (ii) a statement that the provider is entitled to an external independent third-party review; (iii) the time period granted to request an external independent third-party review; and (iv) the mailing address to initiate an external independent third-party review. Provides that a party shall be entitled to appeal a final decision of the external independent third-party review within 30 days after the date upon which the appealing party receives the external independent third-party review. Provides that a final decision by the Director of Healthcare and Family Services shall be final and reviewable under the Administrative Review Law. Contains provisions concerning fees to help defray the cost of the administrative hearings; the specific claims of services that are appealable; and the Department's rulemaking authority. Effective immediately. Senate Committee Amendment No. 1 Deletes reference to: 305 ILCS 5/5-30.1 Adds reference to: 305 ILCS 5/1-5 from Ch. 23, par. 1-5 Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning construction of the Code.
No votes to display
Rule 2-10 Third Reading/Passage Deadline Established As May 31, 2020
Rule 2-10 Third Reading Deadline Established As May 29, 2020
Rule 2-10 Third Reading Deadline Established As May 22, 2020
Rule 2-10 Third Reading Deadline Established As May 15, 2020
Pursuant to Senate Rule 3-9(b) / Referred to Assignments
Rule 2-10 Third Reading Deadline Established As May 7, 2020
Senate Committee Amendment No. 1 Adopted
Placed on Calendar Order of 2nd Reading March 5, 2020
Do Pass as Amended Executive; 016-000-000
Senate Committee Amendment No. 1 Assignments Refers to Executive
Senate Committee Amendment No. 1 Referred to Assignments
Re-referred to Executive
Senate Committee Amendment No. 1 Filed with Secretary by Sen. Don Harmon
Added as Co-Sponsor Sen. Elgie R. Sims, Jr.
Rule 3-9(a) / Re-referred to Assignments
Added as Chief Co-Sponsor Sen. Andy Manar
Added as Chief Co-Sponsor Sen. Kimberly A. Lightford
Assigned to Special Committee on Oversight of Medicaid Managed Care
Added as Chief Co-Sponsor Sen. Iris Y. Martinez
First Reading
Referred to Assignments
Filed with Secretary by Sen. Don Harmon
Bill Text Versions | Format |
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Introduced | HTML |
Document | Format |
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Senate Amendment 001 |
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