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20 Ill. Comp. Stat. § 1305/1-40. Substance Use Disorders; Mental Health; provider payments: Department of Human Services Act – Illinois
Status: Enacted     Year Enacted: 2010
For authorized Medicaid services to enrolled individuals, Division of Substance Use Prevention and Recovery and Division of Mental Health providers shall receive payments for such authorized services, with payment occurring no later than in the …
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20 Ill. Comp. Stat. § 1705/15.3. Quality assurance for community mental health services: Mental Health and Developmental Disabilities Administrative Act – Illinois
Status: Enacted     Year Enacted: 1988
When the Department of Healthcare and Family Services or the Department of Human Services pays the cost, directly or indirectly, in whole or in part, for community mental health services and programs under the Medicaid …
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20 Ill. Comp. Stat. § 1705/54. Establishment of rates for purchase of service: Mental Health and Developmental Disabilities Administrative Act – Illinois
Status: Enacted     Year Enacted: 1983
Statute establishes procedures for the development, calculation, and communication of rates promulgated by the Department for the purchase of services for persons with a developmental disability and persons with mental illness. Statute requires that rates …
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20 Ill. Comp. Stat. § 1705/71a. Community Behavioral Health Care: Mental Health and Developmental Disabilities Administrative Act – Illinois
Status: Enacted     Year Enacted: 2011
The Department shall strive to guarantee that persons, including children, suffering from mental illness, substance abuse, and other behavioral disorders have access to locally accessible behavioral health care providers who have the ability to treat …
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20 Ill. Comp. Stat. § 301/55-30. Rate increase: Substance Use Disorder Act – Illinois
Status: Enacted     Year Enacted: 2017
Department shall by rule develop the increased rate methodology and annualize the increased rate beginning with the State fiscal year 2018 to licensed providers of community-based substance use disorder intervention and treatment, based on the …
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20 Ill. Comp. Stat. § 505/5.35. Residential services; rates: Children and Family Services Act – Illinois
Status: Enacted     Year Enacted: 2009
The Department has rate-setting authority to develop a performance-based model for residential services for children under the age of 22.
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210 Ill. Comp. Stat. §§ 155/1 through 155/45: Long Term Acute Care Hospital Quality Improvement Transfer Program Act – Illinois
Status: Enacted     Year Enacted: 2010
Act created as a method to improve health care outcomes of patients, which results in a more efficient use of resources needed to provide care. It is estimated this Act could save $10,000,000 annually. Statutes …
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215 Ill. Comp. Stat. § 125/1-2. Definitions: Health Maintenance Organization Act – Illinois
Status: Enacted     Year Enacted: 1974
Definitions for the Health Maintenance Organization Act.
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215 Ill. Comp. Stat. § 125/4.5-1. Point-of-service health service contracts: Health Maintenance Organization Act – Illinois
Status: Enacted     Year Enacted: 2002
HMOs may offer point-of-service contracts must abide by these limitations, including that the contract must include as in-plan covered services all services required by law to be provided by a health maintenance organization; must provide …
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215 Ill. Comp. Stat. § 130/1002. Definitions: Limited Health Service Organization Act – Illinois
Status: Enacted     Year Enacted: 1989
Statute includes definitions relevant to the Limited Health Service Organization Act including a definition of per capita prepayment for providers.
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215 Ill. Comp. Stat. § 134/25. Transition of services: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
Statute allows an enrollee to continue using a provider that moves out-of-network, but the physician must agree to accept reimbursement from the health care plan at rates established by the health care plan, the physician …
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215 Ill. Comp. Stat. § 134/70. Post-stabilization medical services: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
If prior authorization for covered post-stabilization services is required by the health care plan, the plan shall provide access 24 hours a day, 7 days a week to persons designated by the plan to make …
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215 Ill. Comp. Stat. § 170/56. Care coordination: Covering All Kids Health Insurance Act – Illinois
Status: Enacted     Year Enacted: 2011
Payment for such coordinated care shall be based on arrangements where the State pays for performance related to health care outcomes, the use of evidence-based practices, the use of primary care delivered through comprehensive medical …
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215 Ill. Comp. Stat. § 5/368a. Timely payment for health care services: Accident and Health Insurance – Illinois
Status: Enacted     Year Enacted: 1999
Statute regulates the payment for health care services by insurers, HMOs, managed care plans, health care plans, preferred provider organizations and third party administrators.
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215 Ill. Comp. Stat. § 5/368b. Contracting procedures: Accident and Health Insurance – Illinois
Status: Enacted     Year Enacted: 2004
The fee schedule, the capitation schedule, and the network provider administration manual constitute confidential, proprietary, and trade secret information and are subject to the provisions of the Illinois Trade Secrets Act.
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215 Ill. Comp. Stat. § 5/370b. Reimbursement on equal basis: Accident and Health Insurance – Illinois
Status: Enacted     Year Enacted: 1969
Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan or agreement for hospital or medical service or indemnity, wherever such policy, contract, …
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