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IL HB2050

IL HB2050
MEDICAID-ORTHODONTIC SERVICES


summary

Introduced
02/02/2023
In Committee
02/07/2023
Crossed Over
Passed
Dead
01/08/2025

Introduced Session

103rd General Assembly

Bill Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on and after July 1, 2023, medically necessary orthodontic services may be covered under the medical assistance program. Requires the Department of Healthcare and Family Services to use certain auto-qualifiers when determining whether an individual, who is otherwise eligible for medical assistance, is also eligible for coverage for a medically necessary orthodontic service. Provides that if the Department denies a claim for a medically necessary orthodontic service, the Department must, at a minimum, provide the following information to the provider of the orthodontic service: (i) the actual score of the orthodontic case; (ii) the name of the dentist or orthodontist who scored the orthodontic case; (iii) a detailed scoring sheet outlining the reasons for the score of the orthodontic case; and (iv) instructions on how to appeal the denied claim.

AI Summary

This bill proposes to amend the Illinois Public Aid Code to provide that, on and after July 1, 2023, medically necessary orthodontic services may be covered under the state's medical assistance program. The bill requires the Department of Healthcare and Family Services to use certain "auto-qualifiers" when determining whether an individual is eligible for coverage of medically necessary orthodontic services. The bill also requires the Department to provide specific information to the provider if it denies a claim for a medically necessary orthodontic service, such as the actual score of the orthodontic case, the name of the dentist or orthodontist who scored the case, a detailed scoring sheet, and instructions on how to appeal the denied claim.

Sponsors (2)

Last Action

Session Sine Die (on 01/07/2025)

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