Legislation


HB 5669 – Illinois

Status: Inactive / Dead
Year Introduced: 2018
Link: http://www.ilga.gov/legislation/BillStatus.asp?DocNum=5669&GAID=14&DocTypeID=HB&SessionID=91&GA=100

DHFS-MCO/MCE-CLAIMS RPTS: Requires the Department of Healthcare and Family Services to report each managed care organization’s operational performance concerning actual administrative costs incurred; the medical loss ratios for the previous 4 calendar years; all Medicaid provider payment data for all services; and the amount of denied claims. Requires each managed care entity to self-report the same information and publish it on a monthly basis on the managed care entity’s website as soon as practical but no later than July 1, 2018. Requires the Department to: (i) regularly monitor the actual administrative costs incurred by Medicaid Managed Care Entities to ensure that the administrative costs do not exceed what is allowed by contract; (ii) annually calculate the medical loss ratios for the previous 4 calendar years, and beginning no later than July 1, 2018, annually determine whether the State should be reimbursed by the Medicaid Managed Care Entities due to overpayment; (iii) require all Medicaid Managed Care Entities to regularly submit all Medicaid provider payment data for all.


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