summary
Introduced
02/04/2025
02/04/2025
In Committee
02/24/2026
02/24/2026
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to require Medicaid managed care organizations to reimburse at no less than 100% of the Medical Assistance program's Durable Medical Equipment fee schedule for the same service or item of durable medical equipment, complex rehab technology, prosthetics, orthotics, or supplies. Provides that the reimbursement requirement shall also apply to a Medicaid managed care organization's subcontractors and third-party administrators. Provides that the Department has the authority to implement the reimbursement requirement on and after July 1, 2025 and prior to the completion of any regulatory process undertaken in order to effect such change. Effective July 1, 2025.
AI Summary
This bill amends the Illinois Public Aid Code to require Medicaid managed care organizations (MCOs) to reimburse providers at 100% of the Medical Assistance program's Durable Medical Equipment (DME) fee schedule for specific medical items and services. The bill covers reimbursement for durable medical equipment, complex rehabilitation technology, prosthetics, orthotics, and related supplies. Importantly, this reimbursement requirement also extends to MCOs' subcontractors and third-party administrators, ensuring comprehensive coverage. The Illinois Department of Healthcare and Family Services is granted the authority to implement this reimbursement requirement starting July 1, 2025, and can do so even before completing any necessary regulatory processes. This legislation aims to ensure fair and consistent reimbursement rates for medical equipment providers within the Medicaid managed care system, potentially improving access to essential medical equipment for Illinois Medicaid recipients.
Committee Categories
Budget and Finance
Sponsors (1)
Last Action
Assigned to Appropriations-Health and Human Services Committee (on 02/24/2026)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2713&GAID=18&DocTypeID=HB&SessionID=114&GA=104 |
| BillText | https://www.ilga.gov/legislation/104/HB/10400HB2713.htm |
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