HB 4663

Abstract

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to be responsible for and actively oversee managed care organization compliance and shall immediately modify all contractual arrangements with each of the managed care organizations in conflict with the provisions of the amendatory Act. Provides that a managed care organization's failure to agree to all necessary amendments to its contract with the State shall constitute the company's notice of withdrawal from the medical assistance program. Requires the Department to attest to each managed care organization's compliance with all provisions of the amendatory Act within 60 days after the effective date of the amendatory Act. Provides that if the Department cannot attest to each managed care organization's compliance by the end of the 60 days or after any of the audits required under the amendatory Act, then the Department shall prohibit the managed care organization from managing skilled nursing facilities patients under the medical assistance managed care program. Contains provisions concerning the transition of network residents to managed care organizations in good standing; quarterly audits of each managed care organization's business practices; monthly audits of each managed care organization's information technology and systems; Medicaid fee-for-service reimbursement rates for nursing facilities under contract with managed care organizations; fines for non-compliance; and other matters.