summary
Introduced
02/06/2025
02/06/2025
In Committee
03/21/2025
03/21/2025
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Rebuild Illinois Mental Health Workforce Act. Provides that beginning January 1, 2026, for each State fiscal year, a monthly directed payment shall be paid to each community mental health provider of community support individual services based on the number of Medicaid users of community support individual services documented by Medicaid fee-for-service and managed care encounter claims delivered by the provider in the base year. Sets forth how the monthly directed payment shall be calculated. Requires the Department of Healthcare and Family Services to adjust and pay community mental health providers for any payments authorized for all services from a community mental health provider which have been paid by a Medicaid managed care organization but no encounter claim has been recorded in the Departments' Enterprise Data Warehouse. Provides that the Department must develop a process for community mental health providers to reconcile these payments and submit claims for which the Department has not used for making payments. Permits the Department to sanction Medicaid managed care organizations for services not received by the Department.
AI Summary
This bill amends the Rebuild Illinois Mental Health Workforce Act to expand Medicaid funding and payment structures for community mental health providers. Starting January 1, 2026, the bill introduces a new monthly directed payment for community mental health providers offering individual support services, calculated based on the number of Medicaid users who received at least 100 units of services in the previous base year. Each Medicaid user will generate a $2,400 annual payment, distributed in 12 equal monthly installments. The bill also requires the Department of Healthcare and Family Services (DHFS) to adjust payments for services that have been paid by Medicaid managed care organizations but not recorded in the department's data warehouse. Additionally, the department must develop a process for providers to reconcile these payments and submit claims, and it may sanction managed care organizations for unrecorded services. This legislation builds on previous efforts to improve mental health service reimbursement rates and support community mental health providers by ensuring more comprehensive and accurate payment mechanisms for services rendered to Medicaid recipients.
Committee Categories
Budget and Finance
Sponsors (1)
Last Action
Rule 19(a) / Re-referred to Rules Committee (on 03/21/2025)
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=2993&GAID=18&DocTypeID=HB&SessionID=114&GA=104 |
| BillText | https://www.ilga.gov/legislation/104/HB/10400HB2993.htm |
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