Sen. Mattie Hunter
Filed: 4/11/2008
 
 

 




 

 		












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AMENDMENT TO SENATE BILL 1938




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    AMENDMENT NO. ______. Amend Senate Bill 1938, AS AMENDED, 
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by replacing everything after the enacting clause with the 
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following:

 
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    "Section 5. The Illinois Public Aid Code is amended  by 
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adding Section 5-5.26 as follows:
 
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    (305 ILCS 5/5-5.26  new)
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    Sec. 5-5.26. Cost-reporting mechanism for child and adult 
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psychiatric services.
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    (a) The General Assembly finds that direct access to 
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psychiatric mental health services for children and adults 
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suffering from mental illness will improve the quality of life 
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for these individuals and will reduce health care costs by 
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avoiding the need for more costly inpatient hospitalization.  
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Thus, it is the intent of the General Assembly to develop 
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policy aimed at ensuring that psychiatrists providing child and 
 


 






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adult psychiatric services on an outpatient basis are 
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adequately reimbursed for the cost of providing these services.  
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Therefore, in order to determine the actual costs, the 
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Department of Healthcare and Family Services shall develop a 
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cost-reporting mechanism for service providers as defined in 
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this Section by no later than January 1, 2009.  The Department 
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of Healthcare and Family Services shall consult with service 
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providers as defined in this Section to assist with the 
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development of the cost-reporting mechanism.  By no later than 
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March 1, 2009, the Department of Healthcare and Family Services 
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shall report to the Governor and the General Assembly on the 
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results of the cost-reporting mechanism.  This report shall 
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include, but need not be limited to, details on the development 
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of the cost-reporting mechanism and its accurate reflection of 
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the actual costs to service providers for providing child and 
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adult psychiatric services.  The Department of Healthcare and 
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Family Services shall, subject to appropriation, establish a 
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separate cost-based reimbursement rate based on the 
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cost-reporting mechanism for psychiatrists who provide child 
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and adult psychiatric services on an outpatient basis for 
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service providers  as defined by this Section.
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    (b) This Section applies only to psychiatrists who provide 
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child and adult psychiatric services on an outpatient basis for 
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service providers as defined in this Section.
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    (c) For purposes of this Section:
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    "Cost-based reimbursement rate" means a rate of 
 


 






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reimbursement equal to the allowable and audited reasonable 
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costs reported.
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    "Psychiatrist" means a psychiatrist as defined in Section 
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1-121 of the Mental Health and Developmental Disabilities Code.
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    "Service provider" means any of the following that 
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demonstrates a combined Medicaid, poverty, and uninsured 
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patient population penetration rate of 60% or greater:
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        (1) An entity certified by the Illinois Department of 
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    Human Services under the Medicaid Community Mental Health 
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    Services Program under 59 Ill. Adm. Code 132.
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        (2) A person, corporation, or entity that furnishes 
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    medical, educational, psychiatric, vocational, or 
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    rehabilitative services to a recipient under this Code and 
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    enters into a contract or agreement with one or more of the 
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    following State agencies to provide such services:
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            (A) The Department of Human Services.
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            (B) The Department of Children and Family 
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        Services.
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            (C) The Department of Corrections.
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            (D) The Department of Juvenile Justice. 
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        (3) A community mental health board established under 
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    the Community Mental Health Act.
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    "Service provider" does not include an employee of a State 
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agency or county agency.
 

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    Section 99. Effective date. This Act takes effect upon 
 


 






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becoming law.".