SB 254 – Illinois

Status: Inactive / Dead
Year Introduced: 2021
Link: https://www.ilga.gov/legislation/BillStatus.asp?DocNum=254&GAID=16&DocTypeID=SB&LegId=131150&SessionID=110&GA=102

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning July 1, 2021, to receive the additional Long-Acting Injectable for Mental Health or Addiction Medicaid payment, a hospital shall submit a separate professional claim specifying “place of service 21 – Inpatient Hospital”. Provides that the professional claim shall include the hospital as the billing provider and list the practitioner performing the procedure as the rendering provider. Requires the hospital to use the appropriate Healthcare Common Procedure Coding System Level II procedure code and the National Drug Code. Requires facilities participating in the federal 340B Drug Pricing Program to continue to bill the 340B actual acquisition cost for the medication. Provides that long-acting injectable medications for mental health or addiction shall not be subject to prior authorization under the medical assistance program or under any Medicaid managed-care plans when initiated at an inpatient hospital setting or when continued at an outpatient treatment facility. Effective July 1, 2021.

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