summary
Introduced
02/05/2026
02/05/2026
In Committee
03/04/2026
03/04/2026
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Managed Care Organization Provider Assessment Article of the Illinois Public Aid Code. In provisions concerning tiered managed care assessment rates, provides that beginning July 1, 2026, the Department of Healthcare and Family Services may implement a tax that is based on uniform rates, determined at a level not to exceed limitations imposed by the federal Centers for Medicare and Medicaid Services, that may be set at either a percentage of premium revenue or on a per member per month basis. Removes a provision requiring any upward adjustment to the Tier 3 rate to be the minimum necessary to meet federal statistical tests. In the definition of "member months", removes language exempting enrollment in a Limited Health Services Organization, a Medicare Supplement Plan, or a Federal Employee Health Benefits Plan from the calculation of member months. Expands the definition of "managed care organization" to include an entity that operates as a preferred provider organization. Effective July 1, 2026.
AI Summary
This bill, effective July 1, 2026, amends the Illinois Public Aid Code concerning assessments on managed care organizations, which are entities that provide health services, now including preferred provider organizations. Beginning on that date, the Department of Healthcare and Family Services (DHFS), the state agency responsible for Medicaid, may implement a new tax on these organizations. This tax will be based on uniform rates, not exceeding limits set by the federal Centers for Medicare and Medicaid Services (CMS), and can be calculated either as a percentage of the organization's premium revenue or on a per-member-per-month basis. The bill also removes a previous requirement that any increase to a specific assessment rate, known as the Tier 3 rate, had to be the minimum necessary to meet federal statistical tests. Additionally, the definition of "member months," which is used to calculate the assessment and represents the total number of months individuals are enrolled in a managed care plan, will no longer exclude enrollment in certain plans like Medicare Advantage Plans, Medicare Supplement Plans, or Federal Employee Health Benefits Plans.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Assigned to Human Services Committee (on 03/04/2026)
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