305 Ill. Comp. Stat. § 5/5-30.3. Empowering meaningful patient choice in Medicaid Managed Care: Medical Assistance – Illinois
Status: Enacted Year Enacted: 2016
Each medicaid managed care entity shall have an updated provider directory. Medicaid Managed Care Entities shall publish on their respective websites a formulary for each plan offered and make the formularies easily understandable and publicly …
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305 Ill. Comp. Stat. § 5/5-30.5. Managed care; automatic assignment: Medical Assistance – Illinois
Status: Enacted Year Enacted: 2017
Medicaid enrollees shall be automatically enrolled in plans thought an algorithm which is designed to preserveexisting provider-beneficiary relationships that takes into account quality scores and other operational proficiency criteria developed, defined, and adopted by the …
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305 Ill. Comp. Stat. § 5/5-30.8. Managed care organization rate transparency: Medical Assistance – Illinois
Status: Enacted Year Enacted: 2018
Department of Healthcare and Family Services shall implement a capitation base rate setting process beginning on the effective date of this amendatory Act of the 100th General Assembly which shall include all of the following …
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305 Ill. Comp. Stat. § 5/5-5.19. Reimbursement request records: Medical Assistance – Illinois
Status: Enacted Year Enacted: 1994
Reimbursement request records. The Illinois Department shall file all requests for reimbursement for medical services provided under this Article according to both (i) the name of the service provider and (ii) the name of the …
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305 Ill. Comp. Stat. §§ 5/14-1 through 5/14-13: Hospital Services Trust Fund – Illinois
Status: Enacted Year Enacted: 1991
The Department may, by rule, implement the All Patient Refined Diagnosis Related Groups (APR-DRG) payment system for inpatient services provided on or after July 1, 2013, in a manner consistent with the actions authorized in …
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305 Ill. Comp. Stat. §§ 5/5A-12.2 through 12.5: Hospital Provider Funding – Illinois
Status: Enacted Year Enacted: 2008
To preserve and improve access to hospital services, for hospital services rendered on or after July 1, 2008, the Illinois Department shall, except for hospitals described in subsection (b) of Section 5A-3, make payments to …
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305 Ill. Comp. Stat. §§ 65/1 through 65/10: Early Mental Health and Addictions Treatment Act – Illinois
Status: Enacted Year Enacted: 2018
In order to address the opiod epidemic, Illinois shall create the Assertive Engagement and Community-Based Clinical Treatment Pilot Program for early treatment of an opioid or other drug addiction. The Department of Healthcare and Family …
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35 Pa. Cons. Stat. § 448.802a. Definitions: Health Care Facilities Act – Pennsylvania
Status: Enacted Year Enacted: 1980
The following words and phrases when used in this chapter shall have, unless the context clearly indicates otherwise, the meanings given them in this section.
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35 Pa. Cons. Stat. § 448.804. Administration: Health Care Facilities Act – Pennsylvania
Status: Enacted Year Enacted: 1980
The department shall administer this chapter so as to encourage innovation and experimentation in health care and health care facilities consistent with the provisions of this chapter and shall encourage contributions of private funds and …
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35 Pa. Cons. Stat. § 448.806c. Consumer protections: Health Care Facilities Act – Pennsylvania
Status: Enacted Year Enacted: 2006
Each consumer or the consumer’s legal representative or responsible family member shall receive an information packet from the home care agency or home care registry prior to the commencement of services which includes the specified …
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35 Pa. Cons. Stat. § 449.10 – Pennsylvania
Status: Enacted
Providers that information collected by the PHC4 is for the benefit of the public and public officials, and that determinations on whether the information should be released under the states Right-to-Know Law should be made …
35 Pa. Cons. Stat. § 449.11 – Pennsylvania
Status: Enacted
Allows any Pennsylvanian agency “to study and report on the short-term and long-term fiscal and programmatic impact on the health care consumer of changes in ownership of hospitals from nonprofit to profit, whether through purchase, …
35 Pa. Cons. Stat. § 449.6 – Pennsylvania
Status: Enacted
Authorizes the PHC4 to collect data on provider quality and provider services under the Uniform Claims and Billing Form that the PHC4 maintains. The Council is required to collect, among other things, patient demographic information, …
35 Pa. Cons. Stat. § 449.7 – Pennsylvania
Status: Enacted
Requires that the PHC4 issue certain public reports (see here) using the data collected under § 449.6 (see above). The reports must contain information on provider quality and service effectiveness ranked against performance and cost …
35 Pa. Cons. Stat. § 449.9 – Pennsylvania
Status: Enacted
Creates a Mandated Benefits Review Panel to review mandated benefits proposals in the legislature to determine the fiscal, economic, and social impact of such initiatives based on data submitted by proponents and opponents of the …
35 Pa. Cons. Stat. §§ 449.1-449.19 – Pennsylvania
Status: Enacted
The “Health Care Cost Containment Act,” implements a number of cost containment, transparency, and health care reform measures designed to study and increase consumer access to quality and affordable care. The Act was set to …