SB 192

Abstract

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that if the Governor declares a statewide disaster due to a public health emergency and issues an executive order regarding the same disaster that orders hospitals and health care facilities to cancel or suspend elective or nonemergent surgeries or procedures, then the Department of Healthcare and Family Services must conduct an audit on each managed care organization under contract with the Department to determine if the managed care organization has maintained a minimum medical loss ratio of 85% during the disaster period established by the gubernatorial disaster proclamation. Requires the audit to be conducted no later than 90 days after the expiration of the proclaimed disaster. Requires each managed care organization, upon request, to submit to the Department all relevant data and other information in a form and manner prescribed by the Department to assist the Department in carrying out its duties concerning the audit. Provides that the Department shall recoup any overpayment made to a managed care organization during the disaster period established by a gubernatorial disaster proclamation if, upon completion of an audit, the Department determines that the managed care organization failed to maintain the minimum medical loss ratio of 85% during the disaster period established by the gubernatorial disaster proclamation. Provides that nothing under the amendatory Act shall be construed to alter the terms of any contract between the Department and a managed care organization.