summary
Introduced
02/04/2026
02/04/2026
In Committee
02/17/2026
02/17/2026
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law of the Illinois Public Aid Code. Provides that the Article applies to a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Adds to the definition of "Demonstration Project", a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly facility-specific nursing component (instead of RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Effective immediately.
AI Summary
This bill expands the scope of the Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law to include fully integrated dual eligible special needs plans and any managed care plan for individuals who are eligible for both Medicare and Medicaid, which are now explicitly included in the definition of a "Demonstration Project." The Department of Healthcare and Family Services will now provide managed care organizations with specific quarterly per diem rates for nursing care, including any additional payments for enhanced services, as well as per diem rates for support and capital costs for each nursing home under contract with the organization, replacing the previous system that used RUG-IV nursing component per diem rates. This change aims to better align payments with the actual care provided to dually eligible individuals in nursing homes and is effective immediately.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Senate Health and Human Services Committee Hearing (16:00:00 3/3/2026 Room 400) (on 03/03/2026)
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