HB 5248

  • Illinois House Bill
  • 101st Regular Session
  • Introduced in House
  • House
  • Senate
  • Governor

Medicaid-Managed Care-Rates


Amends the Illinois Public Aid Code. In provisions concerning payment rates for nursing facilities, provides that a benchmark rate equal to the facility's fee-for-service rate shall be established for any facility receiving payment from a managed care entity for services. Provides that on and after July 1, 2020, no managed care entity shall pay a facility less than the established benchmark rate unless the managed care entity and the facility contractually agree upon a rate different than the established benchmark rate. Requires the benchmark rate to be updated quarterly by the Department of Healthcare and Family Services to recognize any rate adjustments to each facility's fee-for-service rate. Provides that until the State is in compliance with federal deadlines for Medicaid eligibility determinations, the Department must not expand the Medicare-Medicaid Alignment Initiative. Provides that beginning July 1, 2020, or upon federal approval, any enrollee who resides in a facility for more than 90 consecutive days shall no longer be required to enroll with a managed care organization and shall revert to having his or her services covered through a fee-for-service arrangement between the facility and the Department for any services received after 90 consecutive days of service. Effective immediately.

Bill Sponsors (3)


No votes to display


Mar 10, 2020


Added Co-Sponsor Rep. Camille Y. Lilly

Mar 04, 2020


Added Co-Sponsor Rep. Elizabeth Hernandez

Feb 18, 2020


First Reading


Referred to Rules Committee

Feb 14, 2020


Filed with the Clerk by Rep. Yehiel M. Kalish

Bill Text

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