Signed by Governor Pat Quinn

Vote Smart's Synopsis:

Vote to concur with House amendments and pass a bill that reduces Medicaid funding, effective July 1, 2012.

Highlights:

• Requires a 3.5 percent reduction in Medicaid reimbursements for hospital services (Sec. 75).

• Exempts rural hospitals that are identified by the Department of Public Health as “critical access” hospitals from the reduction required by this bill (Sec. 75).

• Exempts safety-net hospitals from the reduction in reimbursement (Sec. 75).

• Defines “safety-net hospitals" as those with a Medicaid Inpatient Utilization rate of at least 40 percent and a charity percent of at least 4 percent, or with a Medicaid Inpatient Utilization rate of at least 50 percent (Sec. 75).

• Defines “Medicaid Inpatient Utilization rate” as the ratio of a hospital's inpatient days that qualify for Medicaid to the total number of the hospital's inpatient days from the fiscal year ending 3 years prior to the year the rate is to be used (Sec. 75).

• Defines the “charity percent” as the ratio of a hospital's services provided charitably for individuals without health insurance to a hospital's total charges (Sec. 75).

• Requires a 2.7 percent reduction in Medicaid reimbursements for facilities and institutions for mental diseases (Sec. 75).

• Repeals the Illinois Senior Citizens and Disabled Persons Pharmaceutical Assistance Program (Sec. 90).

• Limits medical assistance for “medically fragile” or technology dependent children from families with an income of up to 500 percent of the federal poverty level (Sec. 75).

• Requires medical assistance for “medically fragile” children to maximize federal reimbursement and family cost-sharing, including co-pays, premiums, or other family contributions (Sec. 75).

• Requires a caretaker relative to have an income below 134 percent of the federal poverty level to qualify for the Family Care program, whereas existing law requires an income below 186 percent of the federal poverty level (Sec. 75).

• Requires the Department of Healthcare and Family Services to hire a contractor to determine which individuals on the Medicaid rolls are ineligible based on Medicaid requirements (Sec. 75).

• Limits reimbursements from the Department of Public Aid for prescription refills to 4 times a month, including 3 name brand prescriptions (Sec. 75).

• Exempts the following kinds of prescriptions from the monthly limit (Sec. 75):
• Immunosuppressant drugs;
• Onclytic drugs; and
• Anti-retroviral drugs.

• Repeals Medicaid reimbursements for group psychotherapy in nursing homes and adult chiropractic services (Sec. 75).

• Limits Medicaid reimbursements for adult eyeglasses to 1 pair every 2 years and adult dental services to emergencies (Sec. 75).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that reduces Medicaid funding, effective July 1, 2012.

Highlights:

• Requires a 3.5 percent reduction in Medicaid reimbursements for hospital services (Sec. 75).

• Exempts rural hospitals that are identified by the Department of Public Health as “critical access” hospitals from the reduction required by this bill (Sec. 75).

• Exempts safety-net hospitals from the reduction in reimbursement (Sec. 75).

• Defines “safety-net hospitals" as those with a Medicaid Inpatient Utilization rate of at least 40 percent and a charity percent of at least 4 percent, or with a Medicaid Inpatient Utilization rate of at least 50 percent (Sec. 75).

• Defines “Medicaid Inpatient Utilization rate” as the ratio of a hospital's inpatient days that qualify for Medicaid to the total number of the hospital's inpatient days from the fiscal year ending 3 years prior to the year the rate is to be used (Sec. 75).

• Defines the “charity percent” as the ratio of a hospital's services provided charitably for individuals without health insurance to a hospital's total charges (Sec. 75).

• Requires a 2.7 percent reduction in Medicaid reimbursements for facilities and institutions for mental diseases (Sec. 75).

• Repeals the Illinois Senior Citizens and Disabled Persons Pharmaceutical Assistance Program (Sec. 90).

• Limits medical assistance for “medically fragile” or technology dependent children from families with an income of up to 500 percent of the federal poverty level (Sec. 75).

• Requires medical assistance for “medically fragile” children to maximize federal reimbursement and family cost-sharing, including co-pays, premiums, or other family contributions (Sec. 75).

• Requires a caretaker relative to have an income below 134 percent of the federal poverty level to qualify for the Family Care program, whereas existing law requires an income below 186 percent of the federal poverty level (Sec. 75).

• Requires the Department of Healthcare and Family Services to hire a contractor to determine which individuals on the Medicaid rolls are ineligible based on Medicaid requirements (Sec. 75).

• Limits reimbursements from the Department of Public Aid for prescription refills to 4 times a month, including 3 name brand prescriptions (Sec. 75).

• Exempts the following kinds of prescriptions from the monthly limit (Sec. 75):
• Immunosuppressant drugs;
• Onclytic drugs; and
• Anti-retroviral drugs.

• Repeals Medicaid reimbursements for group psychotherapy in nursing homes and adult chiropractic services (Sec. 75).

• Limits Medicaid reimbursements for adult eyeglasses to 1 pair every 2 years and adult dental services to emergencies (Sec. 75).

Full Bill Text