HB 5778

Abstract

Amends the Comprehensive Health Insurance Plan Act, the Children's Health Insurance Program Act, the Covering ALL KIDS Health Insurance Act, and the Illinois Public Aid Code to require the health insurance programs created by those Acts to use fee schedules that are competitive with those of non-governmental, third-party health insurance programs. Requires that reimbursement for any service must not be lower than Medicare reimbursement in effect on July 1, 2006. Provides that the fee schedule must be increased or decreased annually corresponding to the decrease or increase in total State tax revenue in the prior fiscal year. Requires payment for services to be made within 30 days after receipt of a bill or claim for payment. Further amends the Covering ALL KIDS Health Insurance Act. Provides that there shall be no co-payment or coinsurance for any services under the Covering ALL KIDS Health Insurance Program. Provides that the study conducted by the Department of Healthcare and Family Services must measure the effect of the Program on access to care by review of all available data, including identifying the number of physicians serving in the primary care case management program by county and, for counties with a population of 100,000 or greater, by geozip. Requires the Department to consult with stakeholders on the rules for healthcare professional participation in the Program. Sets forth provisions for healthcare professional participation and Program standards and provides that the Medicaid Advisory Committee must approve any rules implementing these provisions. Effective July 1, 2006.