MMAI-PAYMENT CLAIMS-MEDIATION Senate SponsorsSen. David Koehler, John G. Mulroe-Patricia Van Pelt and Mattie Hunter 1/10/2017SenateSession Sine Die 305 ILCS 5/5F-32305 ILCS 5/5F-33 newAmends the Illinois Public Aid Code. In a provision concerning non-emergency prior approvals and appeals under the Medicare-Medicaid Alignment Initiative Demonstration Project, requires Managed Care Organizations (MCOs) to have a method of receiving prior approval requests 24 hours a day, 7 days a week, 365 days a year from (rather than for) nursing home residents, physicians, or providers (rather than nursing home residents). Provides that in a non-emergency situation, in the event a resident's physician orders a service, treatment, or test that is not approved by the MCO, the enrollee, physician, or provider may utilize an expedited appeal to the MCO (rather than the physician and the provider may utilize an expedited appeal to the MCO). Requires the MCO to notify all individuals who file an expedited appeal of the MCO's decision within 24 hours after receipt of all required information. Adds provisions concerning payment of claims submitted by a provider to a MCO, including: (i) the time period within which a claim must be reviewed and paid; (ii) MCO notification regarding the corrective action needed to permit payment of a rejected or denied claim; (iii) MCO notification on coding and documentation requirements; and (iv) the establishment of a claims mediation process to mediate rejected or denied claims. 2/18/2016SenateFiled with Secretary by Sen. David Koehler 2/18/2016SenateFirst Reading 2/18/2016SenateReferred to Assignments 3/2/2016SenateAssigned to Public Health 3/9/2016SenatePostponed - Public Health 3/16/2016SenatePostponed - Public Health 4/6/2016SenateDo Pass Public Health; 009-000-000 4/6/2016SenatePlaced on Calendar Order of 2nd Reading April 7, 2016 4/14/2016SenateSenate Floor Amendment No. 1 Filed with Secretary by Sen. David Koehler 4/14/2016SenateSenate Floor Amendment No. 1 Referred to Assignments 4/18/2016SenateSenate Floor Amendment No. 2 Filed with Secretary by Sen. David Koehler 4/18/2016SenateSenate Floor Amendment No. 2 Referred to Assignments 4/18/2016SenateAdded as Co-Sponsor Sen. John G. Mulroe 4/19/2016SenateSenate Floor Amendment No. 1 Assignments Refers to Public Health 4/19/2016SenateSenate Floor Amendment No. 2 Assignments Refers to Public Health 4/19/2016SenateSenate Floor Amendment No. 1 Postponed - Public Health 4/19/2016SenateSenate Floor Amendment No. 2 Recommend Do Adopt Public Health; 009-000-000 4/21/2016SenateAdded as Chief Co-Sponsor Sen. Patricia Van Pelt 4/22/2016SenateRule 2-10 Committee/3rd Reading Deadline Established As May 13, 2016 5/12/2016SenateAdded as Co-Sponsor Sen. Mattie Hunter 5/13/2016SenateRule 2-10 Committee/3rd Reading Deadline Established As May 27, 2016 5/27/2016SenateRule 2-10 Committee/3rd Reading Deadline Established As May 31, 2016 7/31/2016SenatePursuant to Senate Rule 3-9(b) / Referred to Assignments 7/31/2016SenateSenate Floor Amendment No. 1 Pursuant to Senate Rule 3-9(b) / Referred to Assignments 7/31/2016SenateSenate Floor Amendment No. 2 Pursuant to Senate Rule 3-9(b) / Referred to Assignments 1/10/2017SenateSession Sine Die