reglab/housing_qa huggingface dataset:
305 ILCS 5/5-16.12
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-16.12.     Managed Care Reform and Patient Rights Act.     The medical  assistance  program and other programs administered by the Department are subject to the  provisions of the Managed Care Reform and Patient Rights Act.  The  Department may adopt rules  to  implement those provisions.  These rules shall require compliance with  that Act in  the medical assistance managed care programs and other programs administered by  the Department.  The medical assistance  fee-for-service program is not subject to the provisions of the Managed Care  Reform and Patient Rights Act.Nothing in the Managed Care Reform and Patient Rights Act shall be  construed to mean that the Department is a health care plan as defined in that  Act simply because the Department enters into contractual relationships with  health care plans.    (Source: P.A. 91-617, eff. 1-1-00.)
305 ILCS 5/5-16.13
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-16.13. (Repealed).(Source: P.A. 93-674, eff. 6-10-04. Repealed internally, eff. 12-31-04.)
305 ILCS 5/5-17
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-17)Sec. 5-17. Programs to improve access to hospital care.(a) (1) The General Assembly finds:(A) That while hospitals have traditionally         provided charitable care to indigent patients, this burden is not equally borne by all hospitals operating in this State.  Some hospitals continue to provide significant amounts of care to low-income persons while others provide very little such care; and(B) That access to hospital care in this State by         the indigent citizens of Illinois would be seriously impaired by the closing of hospitals that provide significant amounts of care to low-income persons.(2) To help expand the availability of hospital care     for all citizens of this State, it is the policy of the State to implement programs that more equitably distribute the burden of providing hospital care to Illinois' low-income population and that improve access to health care in Illinois.(3) The Illinois Department may develop and implement     a program that lessens the burden of providing hospital care to Illinois' low-income population, taking into account the costs that must be incurred by hospitals providing significant amounts of care to low-income persons, and may develop adjustments to increase rates to improve access to health care in Illinois. The Illinois Department shall prescribe by rule the criteria, standards and procedures for effecting such adjustments in the rates of hospital payments for services provided to eligible low-income persons (under Articles V, VI and VII of this Code) under this Article.(b) The Illinois Department shall require hospitals certified to  participate in the federal Medicaid program to:(1) provide equal access to available services to     low-income persons who are eligible for assistance under Articles V, VI and VII of this Code;(2) provide data and reports on the provision of     uncompensated care.(c) From the effective date of this amendatory Act of 1992 until July  1, 1992, nothing in this Section 5-17 shall be construed as creating a  private right of action on behalf of any individual.(d) On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e. (Source: P.A. 97-689, eff. 6-14-12.)
305 ILCS 5/5-18
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

 (from Ch. 23, par. 5-18)Sec. 5-18.     (Repealed).     (Source: P.A. 87-895. Repealed by P.A. 92-275, eff. 8-7-01.)
305 ILCS 5/5-18.10
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-18.10. Reimbursement for postpartum visits.(a) In this Section:"Certified lactation counselor" means a health care professional in lactation counseling who has demonstrated the necessary skills, knowledge, and attitudes to provide clinical breastfeeding counseling and management support to families who are thinking about breastfeeding or who have questions or problems during the course of breastfeeding."Certified nurse midwife" means a person who exceeds the competencies for a midwife contained in the Essential Competencies for Midwifery Practice, published by the International Confederation of Midwives, and who qualifies as an advanced practice registered nurse."Community health worker" means a frontline public health worker who is a trusted member or has an unusually close understanding of the community served. This trusting relationship enables the community health worker to serve as a liaison, link, and intermediary between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery."International board-certified lactation consultant" means a health care professional who is certified by the International Board of Lactation Consultant Examiners and specializes in the clinical management of breastfeeding."Medical caseworker" means a health care professional who assists in the planning, coordination, monitoring, and evaluation of medical services for a patient with emphasis on quality of care, continuity of services, and affordability."Perinatal doula" means a trained provider of regular and voluntary physical, emotional, and educational support, but not medical or midwife care, to pregnant and birthing persons before, during, and after childbirth, otherwise known as the perinatal period."Public health nurse" means a registered nurse who promotes and protects the health of populations using knowledge from nursing, social, and public health sciences.(b) The Illinois Department shall establish a medical assistance program to cover a universal postpartum visit within the first 3 weeks after childbirth and a comprehensive visit within 4 to 12 weeks postpartum for persons who are otherwise eligible for medical assistance under this Article. In addition, postpartum care services rendered by perinatal doulas, certified lactation counselors, international board-certified lactation consultants, public health nurses, certified nurse midwives, community health workers, and medical caseworkers shall be covered under the medical assistance program.   (Source: P.A. 102-665, eff. 10-8-21.)
305 ILCS 5/5-20
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-20. Electronic health care card. By December 31, 1994, the  Illinois Department may develop and implement by rule an electronic health  information system to process claims electronically and to electronically store  Medicare and Medicaid patient records, medical histories, and billing  information.  The Illinois Department may issue each Medicare and Medicaid  recipient a health card containing electronically coded information that will  access the system, verify their Medicare or Medicaid status, and display how  much the patient must pay in deductibles or copayments for a medical procedure.   The Illinois Department may also develop safeguards to protect recipients'  health information from misuse or unauthorized disclosure.On or before July 1, 2011, the Department shall cease issuing monthly MediPlan cards and shall instead issue permanent or semi-permanent member  cards to individuals enrolled for medical assistance.  Furthermore, the Department may employ any reasonable means by which providers may verify an individual's eligibility for medical assistance in place of MediPlan cards. (Source: P.A. 96-940, eff. 1-1-11.)
305 ILCS 5/5-21
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-21. Immunization. By July 1, 1994, the Illinois Department shall,  in cooperation with the Department of Public Health, establish and implement a  pilot program that will provide immunization services for children on a walk-in  basis at local public aid offices.  The Director shall determine the number and  location of the local public aid offices that will participate in the pilot  program.  The Illinois Department shall submit a report on the effectiveness  of the program to the General Assembly on or before December 31, 1995.  The Department of Healthcare and Family Services (formerly Department of Public Aid) and the Department of Human Services, in  cooperation with the Department of Public Health, shall continue to implement  the pilot program after the effective date of this amendatory Act of 1996.       (Source: P.A. 95-331, eff. 8-21-07.)
305 ILCS 5/5-22
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-22. (Repealed).        (Source: P.A. 90-655, eff. 7-30-98. Repealed by P.A. 96-1123, eff. 1-1-11.)
305 ILCS 5/5-23
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-23.     (Repealed).     (Source: P.A. 92-581, eff. 6-26-02. Repealed internally, eff. 7-1-03.)
305 ILCS 5/5-24
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-24. (Repealed).(Source: P.A. 97-689, eff. 6-14-12. Repealed internally, eff. 1-1-14.)
305 ILCS 5/5-25
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-25. Pediatric asthma initiative.(a) During fiscal year 2006, the Department of Public Aid shall evaluate current standards of treatment of asthma for its beneficiaries. The review may include state-of-the-art programs in asthma disease management as well as evidence-based best practices for the early diagnosis, treatment, and control of asthma, particularly in children. The Department's review may include asthma disease management as one component of a comprehensive disease management model. The Department shall consult with the Department of Public Health and other State agencies, advocates, and providers in conducting this review. The Department's review shall also seek to maximize collaborations between existing asthma programs in the State of Illinois. The review shall also assess the available methods of implementing and funding asthma disease management and treatment within the Medicaid program.(b) After completing the review under subsection (a), the Department of Public Aid shall develop a pilot asthma disease management program. The pilot program shall be targeted to an area or areas with the highest prevalence of asthma.    The Department shall consult with the Department of Public Health and other State agencies, federal health agencies, experts in asthma and immunology, providers, and consumers in developing the pilot program. The pilot program shall also seek to maximize collaborations between existing asthma programs in the State of Illinois. The pilot   program shall be subject to specific appropriations or budget savings derived from the program due to reduced asthma-related hospitalizations or emergency room visits.         (Source: P.A. 94-328, eff. 7-26-05.)
305 ILCS 5/5-26
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-26. Federal Family Opportunity Act.(a) As used in this Section, "the federal Act" means the federal Family Opportunity Act, enacted as part of the Deficit Reduction Act of 2005.(b) Subject to appropriations for program administration and services, the Department of Human Services, in conjunction with the Department of Healthcare and Family Services, shall implement the Medical Assistance provisions of the federal Act as soon as possible after the effective date of this amendatory Act of the 95th General Assembly.(c) As soon as possible after the effective date of this amendatory Act of the 95th General Assembly, the Department of Human Services, in conjunction with the Department of Healthcare and Family Services, shall take all necessary and appropriate steps to try to secure (i) any available federal funds for a demonstration project regarding home and community-based alternatives to psychiatric residential treatment facilities for children, as authorized by the federal Act, and (ii) the location in Illinois of a family-to-family health information center, as authorized by the federal Act.    (Source: P.A. 97-48, eff. 6-28-11.)
305 ILCS 5/5-27
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-27. (Repealed).(Source: P.A. 96-1372, eff. 7-29-10. Repealed internally, eff. 1-1-11.)
305 ILCS 5/5-28
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-28. Community transition resources.  The Department of Healthcare and Family Services, in collaboration with all relevant agencies,  shall develop a Community Transition Plan to allow nursing facility residents who are determined to be appropriate for transition to the community to access or acquire resources to support the transition.  These strategies may include, but need not be limited to, enhancement of the Community Home Maintenance Allowance, retention of income from work, and incorporation of community transition services into existing home and community-based waiver programs.  (Source: P.A. 96-1372, eff. 7-29-10.)
305 ILCS 5/5-29
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-29. Income Limits and Parental Responsibility. In light of the unprecedented fiscal crisis confronting the State, it is the intent of the General Assembly to explore whether the income limits and income counting methods established for children under  the  Covering  ALL KIDS  Health  Insurance  Act,  pursuant to this amendatory Act of the 96th General Assembly, should apply to medical assistance programs available to children made eligible under the Illinois Public Aid Code, including through home and community based services waiver programs authorized under Section 1915(c) of the Social Security Act, where parental income is currently not considered in determining a child's eligibility for medical assistance.  The Department of Healthcare and Family Services is hereby directed, with the participation of the Department of Human Services and stakeholders, to conduct an analysis of these programs to determine parental cost sharing opportunities, how these opportunities may impact the children currently in the programs, waivers and on the waiting list, and any other factors which may increase efficiencies and decrease State costs.  The Department is further directed to review how services under these programs and waivers may be provided by the use of a combination of skilled, unskilled, and uncompensated care and to advise as to what revisions to the Nurse Practice Act, and Acts regulating other relevant professions, are necessary to accomplish this combination of care.  The Department shall submit a written analysis on the children's programs and waivers as part of the Department's annual Medicaid reports due to the General Assembly in 2011 and 2012.   (Source: P.A. 96-1501, eff. 1-25-11.)
305 ILCS 5/5-30.2
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.2. Monthly reports; managed care enrollment.(a) As used in this Section, "Medicaid Managed Care Entity" means a Managed Care Organization (MCO), a Managed Care Community Network (MCCN), an Accountable Care Entity (ACE), or a  Care Coordination Entity (CCE) contracted by the Department.(b) As soon as practical if the data is reasonably available, but no later than January 1, 2017, the Department shall publish monthly reports on its website on the enrollment of persons in the State's medical assistance program. In addition,  as soon as practical if the data is reasonably available, but no later than January 1, 2017, the Department shall publish monthly reports on its website on the enrollment of recipients of medical assistance into a Medicaid Managed Care Entity contracted by the Department.  As soon as practical if the data is reasonably available, but no later than January 1, 2017, the monthly reports shall include all of the following information for the medical assistance program generally and, separately, for each Medicaid Managed Care Entity contracted by the Department:(1) Total enrollment.(2) The number of persons enrolled in the medical     assistance program under items 18 and 19 of Section 5-2.(3) The number of children enrolled.(4) The number of parents and caretakers of minor     children enrolled.(5) The number of women enrolled on the basis of     pregnancy.(6) The number of seniors enrolled.(7) The number of persons enrolled on the basis of     disability.(c)  As soon as practical if the data is reasonably available, but no later than January 1, 2017, the Department shall publish monthly reports on its website detailing the percentage of persons enrolled in each Medicaid Managed Care Entity that was assigned using an auto-assignment algorithm. This percentage should also report the type of enrollee who was assigned using an auto-assignment algorithm, including, but not limited to, persons enrolled in the medical assistance program in each of the groups listed in subsection (b) of this Section.(d)  As soon as practical if the data is reasonably available, but no later than January 1, 2017, monthly enrollment reports for each Medicaid Managed Care Entity shall include data on the 2 most recently available months and data comparing the most recently available month to that month in the prior year.(e)  As soon as practical if the data is reasonably available, but no later than January 1, 2017, monthly enrollment reports for each Medicaid Managed Care Entity shall include a breakdown of language preference for enrollees by English, Spanish, and the next 4 most commonly used languages.(f) The Department must annually publish on its website each Medicaid Managed Care Entity's quality metrics outcomes and must make public an independent annual quality review report on the State's Medicaid managed care delivery system.   (Source: P.A. 99-86, eff. 7-21-15.)
305 ILCS 5/5-30.4
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.4. Provider inquiry portal. The Department shall establish, no later than January 1, 2018, a web-based portal to accept inquiries and requests for assistance from managed care organizations under contract with the State and providers under contract with managed care organizations to provide direct care.   (Source: P.A. 99-719, eff. 1-1-17; 100-201, eff. 8-18-17.)
305 ILCS 5/5-30.5
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.5. Managed care; automatic assignment. The  Department shall, within a reasonable period of time after  relevant data from managed care entities has been collected and  analyzed, but no earlier than January 1, 2017, seek input from the managed care entities and other stakeholders and develop and  implement within each enrollment region an algorithm preserving existing provider-beneficiary relationships that takes  into account quality scores and other operational proficiency  criteria developed, defined, and adopted by the Department, to  automatically assign Medicaid enrollees served under the  Family Health Plan and the Integrated Care Program and those  Medicaid enrollees eligible for medical assistance pursuant to  the Patient Protection and Affordable Care Act (Public Law  111-148) into managed care entities, including Accountable  Care Entities, Managed Care Community Networks, and Managed  Care Organizations. The quality metrics used shall be  measurable for all entities. The algorithm shall not use the  quality and proficiency metrics to reassign enrollees out of  any plan in which they are enrolled at the time and shall only  be used if the client has not voluntarily selected a primary  care physician and a managed care entity or care coordination  entity. Clients shall have one opportunity within 90 calendar  days after auto-assignment by algorithm to select a different  managed care entity. The algorithm developed and implemented  shall favor assignment into managed care entities with the  highest quality scores and levels of compliance with the  operational proficiency criteria established, taking into consideration existing provider-beneficiary relationship as defined by 42 CFR 438.50(f)(3) if one exists.  (Source: P.A. 99-898, eff. 1-1-17; 100-201, eff. 8-18-17.)
305 ILCS 5/5-30.6
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.6. Managed care organization contracts procurement requirement. Beginning on March 12, 2018 (the effective date of Public Act 100-580), any new contract between the Department and a managed care organization as defined in Section 5-30.1 shall be procured in accordance with the Illinois Procurement Code.(a) Application.(1) This Section does not apply to the State of     Illinois Medicaid Managed Care Organization Request for Proposals (2018-24-001) or any agreement, regardless of what it may be called, related to or arising from this procurement, including, but not limited to, contracts, renewals, renegotiated contracts, amendments, and change orders.(2) This Section does not apply to Medicare-Medicaid     Alignment Initiative contracts executed under Article V-F of this  Code.(b) In the event any provision of this Section or of the Illinois Procurement Code is inconsistent with applicable federal law or would have the effect of foreclosing the use, potential use, or receipt of federal financial participation, the applicable federal law or funding condition shall prevail, but only to the extent of such inconsistency.   (Source: P.A. 100-580, eff. 3-12-18; 101-81, eff. 7-12-19.)
305 ILCS 5/5-30.7
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.7. Encounter data guidelines; provider fee schedule.(a) No later than 60 days after the effective date of this amendatory Act of the 100th General Assembly, the Department shall publish on its website comprehensive written guidance on the submission of encounter data by managed care organizations. This information shall be updated and published as needed, but at least quarterly. The Department shall inform providers and managed care organizations of any updates via provider notices.(b) The Department shall publish on its website provider fee schedules on both a portable document format (PDF) and EXCEL format. The portable document format shall serve as the ultimate source if there is a discrepancy.   (Source: P.A. 100-580, eff. 3-12-18.)
305 ILCS 5/5-30.9
2021 Illinois Compiled Statutes|Chapter 305 - PUBLIC AID|305 ILCS 5/ - Illinois Public Aid Code.|Article V - Medical Assistance

Sec. 5-30.9. Disenrollment requirements; managed care organization. Disenrollment of a Medicaid enrollee from a managed care organization under contract with the Department shall be in accordance with the requirements of 42 CFR 438.56 whenever a contract is terminated between a Medicaid managed care health plan and a primary care provider that results in a disruption to the Medicaid enrollee's provider-beneficiary relationship.  (Source: P.A. 100-950, eff. 8-19-18; 101-81, eff. 7-12-19.)