SB 1965 – Illinois

Status: In Process
Year Introduced: 2023
Link: https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1965&GAID=17&DocTypeID=SB&SessionID=112&GA=103

In provisions requiring the Department of Healthcare and Family Services to implement a capitation base rate setting process for payments to managed care organizations (MCOs), removes the following requirements: (i) that any quality incentive or other incentive withholding of any portion of the actuarially certified capitation rates must be budget-neutral; (ii) that the entirety of any aggregate withheld amounts must be returned to the MCOs in proportion to their performance on the relevant performance metric; and (iii) that no amounts shall be returned to the Department if all performance measures are not achieved to the extent allowable by federal law and regulations.

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