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Bill > HB2558


IL HB2558

MEDICAID-MFTD-RATE STUDY


summary

Introduced
02/04/2025
In Committee
03/21/2025
Crossed Over
Passed
Dead

Introduced Session

104th General Assembly

Bill Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning provider reimbursement rates for services provided to medically fragile and technology dependent children, provides that by December 31, 2025, the Department of Healthcare and Family Services shall conduct a rate evaluation to study the soundness of the rate paid for private duty nursing services. Requires the Department to contract with an outside entity to conduct this study or utilize one of its existing contractors to conduct this evaluation. Provides that the contractor shall consult with Department-enrolled private duty providers to ensure the accuracy of this study as it is being created. Requires the study to include, at a minimum, a comparison of rates paid by other states for similar services and the cost of providing similar care in an institutional setting. Effective immediately.

AI Summary

This bill amends the Illinois Public Aid Code to require the Department of Healthcare and Family Services to conduct a comprehensive rate study for private duty nursing services by December 31, 2025. The study will evaluate the current reimbursement rates for nursing services provided to medically fragile and technology-dependent children who are eligible for medical assistance. The department must either contract with an outside entity or use an existing contractor to perform the study, and must ensure that Department-enrolled private duty nursing providers are consulted to guarantee the study's accuracy. The study must specifically compare nursing service rates across other states and analyze the cost of providing similar care in institutional settings. The bill builds upon existing provisions that have already increased nursing service reimbursement rates by 20% as of January 1, 2024, and plans an additional 7% increase as of January 1, 2025. By mandating this rate study, the bill aims to ensure that reimbursement rates for private duty nursing services are fair, competitive, and reflective of the actual costs of care for medically fragile children.

Committee Categories

Budget and Finance

Sponsors (2)

Last Action

Added Chief Co-Sponsor Rep. Elizabeth "Lisa" Hernandez (on 04/02/2025)

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