HB 66

Abstract

Amends the Illinois Public Aid Code. Provides that, on and after January 1, 2022, no recipient of medical assistance shall be required to enroll or transition to the State's managed care medical assistance program. Provides that any recipient enrolled in a managed care health plan on January 1, 2022 shall be given the option to disenroll from the State's managed care medical assistance program and receive coverage under the State's fee-for-service program. Provides that on and after January 1, 2022, the Department of Healthcare and Family Services shall not enter into any new contract or agreement with a managed care organization (MCO) to provide services where payment for medical services is made on a capitated basis. Provides that the Department shall not renew, renter, renegotiate, change orders, or amend any contract or agreement it entered into with an MCO that was solicited under a specified request for proposals. Provides that any recipient who is enrolled in a managed care health plan administered by an MCO that entered a contract with the Department under a specified request for proposals shall be transitioned to the State's fee-for-service program upon the expiration of the MCO's contract with the Department. Requires the Department to establish, by rule, an appeals and grievance process that includes: an expedited internal review of an appeal involving an adverse determination; a final adverse determination; and a standard external review. Requires the Department to notify a recipient in writing of the recipient's right to request an external review. Repeals a provision concerning procurement requirements for MCO contracts.