SB1851 Enrolled LRB100 10394 KTG 20591 b
1		AN ACT concerning public aid.
2		Be it enacted by the People of the State of Illinois,
3		represented in the General Assembly:
4		Section 1. Findings; intent. According to the
5		Congressional Research Service reporting, approximately 35% to
6		60% of children placed in foster care have at least one chronic
7		or acute physical health condition that requires treatment,
8		including growth failure, asthma, obesity, vision impairment,
9		hearing loss, neurological problems, and complex chronic
10		illnesses; as many as 50% to 75% show behavioral or social
11		competency issues that may warrant mental health services; many
12		of these physical and mental health care issues persist and,
13		relative to their peers in the general population, children who
14		leave foster care for adoption and those who age out of care
15		continue to have greater health needs.
16		Federal child welfare policy requires states to develop
17		strategies to address the health care needs of each child in
18		foster care and mandates coordination of state child welfare
19		and Medicaid agencies to ensure that the health care needs of
20		children in foster care are properly identified and treated.
21		The Department of Children and Family Services is
22		responsible for ensuring safety, family permanence, and
23		well-being for the children placed in its custody and
24		protecting these children from further trauma by ensuring

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1		timely access to appropriate placements and services,
2		especially those children with complex emotional and
3		behavioral needs who are at much greater risk for not achieving
4		the fundamental child welfare goals of safety, permanence, and
5		well-being.
6		The Department remains under federal court oversight
7		pursuant to the B.H. Consent Decree, in part, for failure to
8		provide constitutionally sufficient services and placements
9		for children with psychological, behavioral, or emotional
10		challenges; the 2015 court-appointed Expert Panel found too
11		many children in the class experience multiple disruptions of
12		placement, services, and relationships; these children and
13		their families endure indeterminate waits, month upon month,
14		for services the child and family need, without a concrete plan
15		or timeframe; these disruptions and delays and the inaction of
16		Department officials exacerbate children's already serious and
17		chronic mental health problems; the Department's approach to
18		treatment and its system of practice have been shaped by
19		crises, practitioner preferences, tradition, and system
20		expediency.
21		The American Academy of Pediatrics cautions that the
22		effects of managed care on children's access to services and
23		actual health outcomes are not yet clear; it outlines design
24		and implementation principles if managed care is to be
25		implemented for children.
26		It is the intent of the General Assembly to ensure that

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1		children are provided a system of health care with full and
2		inclusive access to physical and behavioral health services
3		necessary for them to thrive.
4		The General Assembly finds it necessary to protect youth in
5		care by requiring the Department to plan the use of managed
6		care services transparently, collaboratively, and deliberately
7		to ensure quality outcomes and accountable oversight.
8		Section 5. The Open Meetings Act is amended by changing
9		Section 2 as follows:
10		(5 ILCS 120/2) (from Ch. 102, par. 42)
11		Sec. 2. Open meetings.
12		(a) Openness required. All meetings of public bodies shall
13		be open to the public unless excepted in subsection (c) and
14		closed in accordance with Section 2a.
15		(b) Construction of exceptions. The exceptions contained
16		in subsection (c) are in derogation of the requirement that
17		public bodies meet in the open, and therefore, the exceptions
18		are to be strictly construed, extending only to subjects
19		clearly within their scope. The exceptions authorize but do not
20		require the holding of a closed meeting to discuss a subject
21		included within an enumerated exception.
22		(c) Exceptions. A public body may hold closed meetings to
23		consider the following subjects:
24		(1) The appointment, employment, compensation,

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1		discipline, performance, or dismissal of specific
2		employees of the public body or legal counsel for the
3		public body, including hearing testimony on a complaint
4		lodged against an employee of the public body or against
5		legal counsel for the public body to determine its
6		validity. However, a meeting to consider an increase in
7		compensation to a specific employee of a public body that
8		is subject to the Local Government Wage Increase
9		Transparency Act may not be closed and shall be open to the
10		public and posted and held in accordance with this Act.
11		(2) Collective negotiating matters between the public
12		body and its employees or their representatives, or
13		deliberations concerning salary schedules for one or more
14		classes of employees.
15		(3) The selection of a person to fill a public office,
16		as defined in this Act, including a vacancy in a public
17		office, when the public body is given power to appoint
18		under law or ordinance, or the discipline, performance or
19		removal of the occupant of a public office, when the public
20		body is given power to remove the occupant under law or
21		ordinance.
22		(4) Evidence or testimony presented in open hearing, or
23		in closed hearing where specifically authorized by law, to
24		a quasi-adjudicative body, as defined in this Act, provided
25		that the body prepares and makes available for public
26		inspection a written decision setting forth its

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1		determinative reasoning.
2		(5) The purchase or lease of real property for the use
3		of the public body, including meetings held for the purpose
4		of discussing whether a particular parcel should be
5		acquired.
6		(6) The setting of a price for sale or lease of
7		property owned by the public body.
8		(7) The sale or purchase of securities, investments, or
9		investment contracts. This exception shall not apply to the
10		investment of assets or income of funds deposited into the
11		Illinois Prepaid Tuition Trust Fund.
12		(8) Security procedures, school building safety and
13		security, and the use of personnel and equipment to respond
14		to an actual, a threatened, or a reasonably potential
15		danger to the safety of employees, students, staff, the
16		public, or public property.
17		(9) Student disciplinary cases.
18		(10) The placement of individual students in special
19		education programs and other matters relating to
20		individual students.
21		(11) Litigation, when an action against, affecting or
22		on behalf of the particular public body has been filed and
23		is pending before a court or administrative tribunal, or
24		when the public body finds that an action is probable or
25		imminent, in which case the basis for the finding shall be
26		recorded and entered into the minutes of the closed

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1		meeting.
2		(12) The establishment of reserves or settlement of
3		claims as provided in the Local Governmental and
4		Governmental Employees Tort Immunity Act, if otherwise the
5		disposition of a claim or potential claim might be
6		prejudiced, or the review or discussion of claims, loss or
7		risk management information, records, data, advice or
8		communications from or with respect to any insurer of the
9		public body or any intergovernmental risk management
10		association or self insurance pool of which the public body
11		is a member.
12		(13) Conciliation of complaints of discrimination in
13		the sale or rental of housing, when closed meetings are
14		authorized by the law or ordinance prescribing fair housing
15		practices and creating a commission or administrative
16		agency for their enforcement.
17		(14) Informant sources, the hiring or assignment of
18		undercover personnel or equipment, or ongoing, prior or
19		future criminal investigations, when discussed by a public
20		body with criminal investigatory responsibilities.
21		(15) Professional ethics or performance when
22		considered by an advisory body appointed to advise a
23		licensing or regulatory agency on matters germane to the
24		advisory body's field of competence.
25		(16) Self evaluation, practices and procedures or
26		professional ethics, when meeting with a representative of

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1		a statewide association of which the public body is a
2		member.
3		(17) The recruitment, credentialing, discipline or
4		formal peer review of physicians or other health care
5		professionals, or for the discussion of matters protected
6		under the federal Patient Safety and Quality Improvement
7		Act of 2005, and the regulations promulgated thereunder,
8		including 42 C.F.R. Part 3 (73 FR 70732), or the federal
9		Health Insurance Portability and Accountability Act of
10		1996, and the regulations promulgated thereunder,
11		including 45 C.F.R. Parts 160, 162, and 164, by a hospital,
12		or other institution providing medical care, that is
13		operated by the public body.
14		(18) Deliberations for decisions of the Prisoner
15		Review Board.
16		(19) Review or discussion of applications received
17		under the Experimental Organ Transplantation Procedures
18		Act.
19		(20) The classification and discussion of matters
20		classified as confidential or continued confidential by
21		the State Government Suggestion Award Board.
22		(21) Discussion of minutes of meetings lawfully closed
23		under this Act, whether for purposes of approval by the
24		body of the minutes or semi-annual review of the minutes as
25		mandated by Section 2.06.
26		(22) Deliberations for decisions of the State

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1		Emergency Medical Services Disciplinary Review Board.
2		(23) The operation by a municipality of a municipal
3		utility or the operation of a municipal power agency or
4		municipal natural gas agency when the discussion involves
5		(i) contracts relating to the purchase, sale, or delivery
6		of electricity or natural gas or (ii) the results or
7		conclusions of load forecast studies.
8		(24) Meetings of a residential health care facility
9		resident sexual assault and death review team or the
10		Executive Council under the Abuse Prevention Review Team
11		Act.
12		(25) Meetings of an independent team of experts under
13		Brian's Law.
14		(26) Meetings of a mortality review team appointed
15		under the Department of Juvenile Justice Mortality Review
16		Team Act.
17		(27) (Blank).
18		(28) Correspondence and records (i) that may not be
19		disclosed under Section 11-9 of the Illinois Public Aid
20		Code or (ii) that pertain to appeals under Section 11-8 of
21		the Illinois Public Aid Code.
22		(29) Meetings between internal or external auditors
23		and governmental audit committees, finance committees, and
24		their equivalents, when the discussion involves internal
25		control weaknesses, identification of potential fraud risk
26		areas, known or suspected frauds, and fraud interviews

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1		conducted in accordance with generally accepted auditing
2		standards of the United States of America.
3		(30) Those meetings or portions of meetings of a
4		fatality review team or the Illinois Fatality Review Team
5		Advisory Council during which a review of the death of an
6		eligible adult in which abuse or neglect is suspected,
7		alleged, or substantiated is conducted pursuant to Section
8		15 of the Adult Protective Services Act.
9		(31) Meetings and deliberations for decisions of the
10		Concealed Carry Licensing Review Board under the Firearm
11		Concealed Carry Act.
12		(32) Meetings between the Regional Transportation
13		Authority Board and its Service Boards when the discussion
14		involves review by the Regional Transportation Authority
15		Board of employment contracts under Section 28d of the
16		Metropolitan Transit Authority Act and Sections 3A.18 and
17		3B.26 of the Regional Transportation Authority Act.
18		(33) Those meetings or portions of meetings of the
19		advisory committee and peer review subcommittee created
20		under Section 320 of the Illinois Controlled Substances Act
21		during which specific controlled substance prescriber,
22		dispenser, or patient information is discussed.
23		(34) Meetings of the Tax Increment Financing Reform
24		Task Force under Section 2505-800 of the Department of
25		Revenue Law of the Civil Administrative Code of Illinois.
26		(35) Meetings of the group established to discuss

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1		Medicaid capitation rates under Section 5-30.8 of the
2		Illinois Public Aid Code.
3		(d) Definitions. For purposes of this Section:
4		"Employee" means a person employed by a public body whose
5		relationship with the public body constitutes an
6		employer-employee relationship under the usual common law
7		rules, and who is not an independent contractor.
8		"Public office" means a position created by or under the
9		Constitution or laws of this State, the occupant of which is
10		charged with the exercise of some portion of the sovereign
11		power of this State. The term "public office" shall include
12		members of the public body, but it shall not include
13		organizational positions filled by members thereof, whether
14		established by law or by a public body itself, that exist to
15		assist the body in the conduct of its business.
16		"Quasi-adjudicative body" means an administrative body
17		charged by law or ordinance with the responsibility to conduct
18		hearings, receive evidence or testimony and make
19		determinations based thereon, but does not include local
20		electoral boards when such bodies are considering petition
21		challenges.
22		(e) Final action. No final action may be taken at a closed
23		meeting. Final action shall be preceded by a public recital of
24		the nature of the matter being considered and other information
25		that will inform the public of the business being conducted.
26		(Source: P.A. 99-78, eff. 7-20-15; 99-235, eff. 1-1-16; 99-480,

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1		eff. 9-9-15; 99-642, eff. 7-28-16; 99-646, eff. 7-28-16;
2		99-687, eff. 1-1-17; 100-201, eff. 8-18-17; 100-465, eff.
3		8-31-17.)
4		Section 10. The Freedom of Information Act is amended by
5		changing Section 7.5 as follows:
6		(5 ILCS 140/7.5)
7		(Text of Section before amendment by P.A. 100-512 and
8		100-517)
9		Sec. 7.5. Statutory exemptions. To the extent provided for
10		by the statutes referenced below, the following shall be exempt
11		from inspection and copying:
12		(a) All information determined to be confidential
13		under Section 4002 of the Technology Advancement and
14		Development Act.
15		(b) Library circulation and order records identifying
16		library users with specific materials under the Library
17		Records Confidentiality Act.
18		(c) Applications, related documents, and medical
19		records received by the Experimental Organ Transplantation
20		Procedures Board and any and all documents or other records
21		prepared by the Experimental Organ Transplantation
22		Procedures Board or its staff relating to applications it
23		has received.
24		(d) Information and records held by the Department of

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1		Public Health and its authorized representatives relating
2		to known or suspected cases of sexually transmissible
3		disease or any information the disclosure of which is
4		restricted under the Illinois Sexually Transmissible
5		Disease Control Act.
6		(e) Information the disclosure of which is exempted
7		under Section 30 of the Radon Industry Licensing Act.
8		(f) Firm performance evaluations under Section 55 of
9		the Architectural, Engineering, and Land Surveying
10		Qualifications Based Selection Act.
11		(g) Information the disclosure of which is restricted
12		and exempted under Section 50 of the Illinois Prepaid
13		Tuition Act.
14		(h) Information the disclosure of which is exempted
15		under the State Officials and Employees Ethics Act, and
16		records of any lawfully created State or local inspector
17		general's office that would be exempt if created or
18		obtained by an Executive Inspector General's office under
19		that Act.
20		(i) Information contained in a local emergency energy
21		plan submitted to a municipality in accordance with a local
22		emergency energy plan ordinance that is adopted under
23		Section 11-21.5-5 of the Illinois Municipal Code.
24		(j) Information and data concerning the distribution
25		of surcharge moneys collected and remitted by carriers
26		under the Emergency Telephone System Act.

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1		(k) Law enforcement officer identification information
2		or driver identification information compiled by a law
3		enforcement agency or the Department of Transportation
4		under Section 11-212 of the Illinois Vehicle Code.
5		(l) Records and information provided to a residential
6		health care facility resident sexual assault and death
7		review team or the Executive Council under the Abuse
8		Prevention Review Team Act.
9		(m) Information provided to the predatory lending
10		database created pursuant to Article 3 of the Residential
11		Real Property Disclosure Act, except to the extent
12		authorized under that Article.
13		(n) Defense budgets and petitions for certification of
14		compensation and expenses for court appointed trial
15		counsel as provided under Sections 10 and 15 of the Capital
16		Crimes Litigation Act. This subsection (n) shall apply
17		until the conclusion of the trial of the case, even if the
18		prosecution chooses not to pursue the death penalty prior
19		to trial or sentencing.
20		(o) Information that is prohibited from being
21		disclosed under Section 4 of the Illinois Health and
22		Hazardous Substances Registry Act.
23		(p) Security portions of system safety program plans,
24		investigation reports, surveys, schedules, lists, data, or
25		information compiled, collected, or prepared by or for the
26		Regional Transportation Authority under Section 2.11 of

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1		the Regional Transportation Authority Act or the St. Clair
2		County Transit District under the Bi-State Transit Safety
3		Act.
4		(q) Information prohibited from being disclosed by the
5		Personnel Records Review Act.
6		(r) Information prohibited from being disclosed by the
7		Illinois School Student Records Act.
8		(s) Information the disclosure of which is restricted
9		under Section 5-108 of the Public Utilities Act.
10		(t) All identified or deidentified health information
11		in the form of health data or medical records contained in,
12		stored in, submitted to, transferred by, or released from
13		the Illinois Health Information Exchange, and identified
14		or deidentified health information in the form of health
15		data and medical records of the Illinois Health Information
16		Exchange in the possession of the Illinois Health
17		Information Exchange Authority due to its administration
18		of the Illinois Health Information Exchange. The terms
19		"identified" and "deidentified" shall be given the same
20		meaning as in the Health Insurance Portability and
21		Accountability Act of 1996, Public Law 104-191, or any
22		subsequent amendments thereto, and any regulations
23		promulgated thereunder.
24		(u) Records and information provided to an independent
25		team of experts under Brian's Law.
26		(v) Names and information of people who have applied

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1		for or received Firearm Owner's Identification Cards under
2		the Firearm Owners Identification Card Act or applied for
3		or received a concealed carry license under the Firearm
4		Concealed Carry Act, unless otherwise authorized by the
5		Firearm Concealed Carry Act; and databases under the
6		Firearm Concealed Carry Act, records of the Concealed Carry
7		Licensing Review Board under the Firearm Concealed Carry
8		Act, and law enforcement agency objections under the
9		Firearm Concealed Carry Act.
10		(w) Personally identifiable information which is
11		exempted from disclosure under subsection (g) of Section
12		19.1 of the Toll Highway Act.
13		(x) Information which is exempted from disclosure
14		under Section 5-1014.3 of the Counties Code or Section
15		8-11-21 of the Illinois Municipal Code.
16		(y) Confidential information under the Adult
17		Protective Services Act and its predecessor enabling
18		statute, the Elder Abuse and Neglect Act, including
19		information about the identity and administrative finding
20		against any caregiver of a verified and substantiated
21		decision of abuse, neglect, or financial exploitation of an
22		eligible adult maintained in the Registry established
23		under Section 7.5 of the Adult Protective Services Act.
24		(z) Records and information provided to a fatality
25		review team or the Illinois Fatality Review Team Advisory
26		Council under Section 15 of the Adult Protective Services

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1		Act.
2		(aa) Information which is exempted from disclosure
3		under Section 2.37 of the Wildlife Code.
4		(bb) Information which is or was prohibited from
5		disclosure by the Juvenile Court Act of 1987.
6		(cc) Recordings made under the Law Enforcement
7		Officer-Worn Body Camera Act, except to the extent
8		authorized under that Act.
9		(dd) Information that is prohibited from being
10		disclosed under Section 45 of the Condominium and Common
11		Interest Community Ombudsperson Act.
12		(ee) Information that is exempted from disclosure
13		under Section 30.1 of the Pharmacy Practice Act.
14		(ff) Information that is exempted from disclosure
15		under the Revised Uniform Unclaimed Property Act.
16		(gg) (ff) Information that is prohibited from being
17		disclosed under Section 7-603.5 of the Illinois Vehicle
18		Code.
19		(hh) (ff) Records that are exempt from disclosure under
20		Section 1A-16.7 of the Election Code.
21		(ii) (ff) Information which is exempted from
22		disclosure under Section 2505-800 of the Department of
23		Revenue Law of the Civil Administrative Code of Illinois.
24		(ll) Information the disclosure of which is restricted
25		and exempted under Section 5-30.8 of the Illinois Public
26		Aid Code.

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1		(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
2		eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
3		99-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
4		100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
5		8-28-17; 100-465, eff. 8-31-17; revised 11-2-17.)
6		(Text of Section after amendment by P.A. 100-517 but before
7		amendment by P.A. 100-512)
8		Sec. 7.5. Statutory exemptions. To the extent provided for
9		by the statutes referenced below, the following shall be exempt
10		from inspection and copying:
11		(a) All information determined to be confidential
12		under Section 4002 of the Technology Advancement and
13		Development Act.
14		(b) Library circulation and order records identifying
15		library users with specific materials under the Library
16		Records Confidentiality Act.
17		(c) Applications, related documents, and medical
18		records received by the Experimental Organ Transplantation
19		Procedures Board and any and all documents or other records
20		prepared by the Experimental Organ Transplantation
21		Procedures Board or its staff relating to applications it
22		has received.
23		(d) Information and records held by the Department of
24		Public Health and its authorized representatives relating
25		to known or suspected cases of sexually transmissible

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1		disease or any information the disclosure of which is
2		restricted under the Illinois Sexually Transmissible
3		Disease Control Act.
4		(e) Information the disclosure of which is exempted
5		under Section 30 of the Radon Industry Licensing Act.
6		(f) Firm performance evaluations under Section 55 of
7		the Architectural, Engineering, and Land Surveying
8		Qualifications Based Selection Act.
9		(g) Information the disclosure of which is restricted
10		and exempted under Section 50 of the Illinois Prepaid
11		Tuition Act.
12		(h) Information the disclosure of which is exempted
13		under the State Officials and Employees Ethics Act, and
14		records of any lawfully created State or local inspector
15		general's office that would be exempt if created or
16		obtained by an Executive Inspector General's office under
17		that Act.
18		(i) Information contained in a local emergency energy
19		plan submitted to a municipality in accordance with a local
20		emergency energy plan ordinance that is adopted under
21		Section 11-21.5-5 of the Illinois Municipal Code.
22		(j) Information and data concerning the distribution
23		of surcharge moneys collected and remitted by carriers
24		under the Emergency Telephone System Act.
25		(k) Law enforcement officer identification information
26		or driver identification information compiled by a law

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1		enforcement agency or the Department of Transportation
2		under Section 11-212 of the Illinois Vehicle Code.
3		(l) Records and information provided to a residential
4		health care facility resident sexual assault and death
5		review team or the Executive Council under the Abuse
6		Prevention Review Team Act.
7		(m) Information provided to the predatory lending
8		database created pursuant to Article 3 of the Residential
9		Real Property Disclosure Act, except to the extent
10		authorized under that Article.
11		(n) Defense budgets and petitions for certification of
12		compensation and expenses for court appointed trial
13		counsel as provided under Sections 10 and 15 of the Capital
14		Crimes Litigation Act. This subsection (n) shall apply
15		until the conclusion of the trial of the case, even if the
16		prosecution chooses not to pursue the death penalty prior
17		to trial or sentencing.
18		(o) Information that is prohibited from being
19		disclosed under Section 4 of the Illinois Health and
20		Hazardous Substances Registry Act.
21		(p) Security portions of system safety program plans,
22		investigation reports, surveys, schedules, lists, data, or
23		information compiled, collected, or prepared by or for the
24		Regional Transportation Authority under Section 2.11 of
25		the Regional Transportation Authority Act or the St. Clair
26		County Transit District under the Bi-State Transit Safety

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1		Act.
2		(q) Information prohibited from being disclosed by the
3		Personnel Records Review Act.
4		(r) Information prohibited from being disclosed by the
5		Illinois School Student Records Act.
6		(s) Information the disclosure of which is restricted
7		under Section 5-108 of the Public Utilities Act.
8		(t) All identified or deidentified health information
9		in the form of health data or medical records contained in,
10		stored in, submitted to, transferred by, or released from
11		the Illinois Health Information Exchange, and identified
12		or deidentified health information in the form of health
13		data and medical records of the Illinois Health Information
14		Exchange in the possession of the Illinois Health
15		Information Exchange Authority due to its administration
16		of the Illinois Health Information Exchange. The terms
17		"identified" and "deidentified" shall be given the same
18		meaning as in the Health Insurance Portability and
19		Accountability Act of 1996, Public Law 104-191, or any
20		subsequent amendments thereto, and any regulations
21		promulgated thereunder.
22		(u) Records and information provided to an independent
23		team of experts under Brian's Law.
24		(v) Names and information of people who have applied
25		for or received Firearm Owner's Identification Cards under
26		the Firearm Owners Identification Card Act or applied for

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1		or received a concealed carry license under the Firearm
2		Concealed Carry Act, unless otherwise authorized by the
3		Firearm Concealed Carry Act; and databases under the
4		Firearm Concealed Carry Act, records of the Concealed Carry
5		Licensing Review Board under the Firearm Concealed Carry
6		Act, and law enforcement agency objections under the
7		Firearm Concealed Carry Act.
8		(w) Personally identifiable information which is
9		exempted from disclosure under subsection (g) of Section
10		19.1 of the Toll Highway Act.
11		(x) Information which is exempted from disclosure
12		under Section 5-1014.3 of the Counties Code or Section
13		8-11-21 of the Illinois Municipal Code.
14		(y) Confidential information under the Adult
15		Protective Services Act and its predecessor enabling
16		statute, the Elder Abuse and Neglect Act, including
17		information about the identity and administrative finding
18		against any caregiver of a verified and substantiated
19		decision of abuse, neglect, or financial exploitation of an
20		eligible adult maintained in the Registry established
21		under Section 7.5 of the Adult Protective Services Act.
22		(z) Records and information provided to a fatality
23		review team or the Illinois Fatality Review Team Advisory
24		Council under Section 15 of the Adult Protective Services
25		Act.
26		(aa) Information which is exempted from disclosure

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1		under Section 2.37 of the Wildlife Code.
2		(bb) Information which is or was prohibited from
3		disclosure by the Juvenile Court Act of 1987.
4		(cc) Recordings made under the Law Enforcement
5		Officer-Worn Body Camera Act, except to the extent
6		authorized under that Act.
7		(dd) Information that is prohibited from being
8		disclosed under Section 45 of the Condominium and Common
9		Interest Community Ombudsperson Act.
10		(ee) Information that is exempted from disclosure
11		under Section 30.1 of the Pharmacy Practice Act.
12		(ff) Information that is exempted from disclosure
13		under the Revised Uniform Unclaimed Property Act.
14		(gg) (ff) Information that is prohibited from being
15		disclosed under Section 7-603.5 of the Illinois Vehicle
16		Code.
17		(hh) (ff) Records that are exempt from disclosure under
18		Section 1A-16.7 of the Election Code.
19		(ii) (ff) Information which is exempted from
20		disclosure under Section 2505-800 of the Department of
21		Revenue Law of the Civil Administrative Code of Illinois.
22		(jj) (ff) Information and reports that are required to
23		be submitted to the Department of Labor by registering day
24		and temporary labor service agencies but are exempt from
25		disclosure under subsection (a-1) of Section 45 of the Day
26		and Temporary Labor Services Act.

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1		(ll) Information the disclosure of which is restricted
2		and exempted under Section 5-30.8 of the Illinois Public
3		Aid Code.
4		(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
5		eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
6		99-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
7		100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
8		8-28-17; 100-465, eff. 8-31-17; 100-517, eff. 6-1-18; revised
9		11-2-17.)
10		(Text of Section after amendment by P.A. 100-512)
11		Sec. 7.5. Statutory exemptions. To the extent provided for
12		by the statutes referenced below, the following shall be exempt
13		from inspection and copying:
14		(a) All information determined to be confidential
15		under Section 4002 of the Technology Advancement and
16		Development Act.
17		(b) Library circulation and order records identifying
18		library users with specific materials under the Library
19		Records Confidentiality Act.
20		(c) Applications, related documents, and medical
21		records received by the Experimental Organ Transplantation
22		Procedures Board and any and all documents or other records
23		prepared by the Experimental Organ Transplantation
24		Procedures Board or its staff relating to applications it
25		has received.

SB1851 Enrolled - 24 - LRB100 10394 KTG 20591 b
1		(d) Information and records held by the Department of
2		Public Health and its authorized representatives relating
3		to known or suspected cases of sexually transmissible
4		disease or any information the disclosure of which is
5		restricted under the Illinois Sexually Transmissible
6		Disease Control Act.
7		(e) Information the disclosure of which is exempted
8		under Section 30 of the Radon Industry Licensing Act.
9		(f) Firm performance evaluations under Section 55 of
10		the Architectural, Engineering, and Land Surveying
11		Qualifications Based Selection Act.
12		(g) Information the disclosure of which is restricted
13		and exempted under Section 50 of the Illinois Prepaid
14		Tuition Act.
15		(h) Information the disclosure of which is exempted
16		under the State Officials and Employees Ethics Act, and
17		records of any lawfully created State or local inspector
18		general's office that would be exempt if created or
19		obtained by an Executive Inspector General's office under
20		that Act.
21		(i) Information contained in a local emergency energy
22		plan submitted to a municipality in accordance with a local
23		emergency energy plan ordinance that is adopted under
24		Section 11-21.5-5 of the Illinois Municipal Code.
25		(j) Information and data concerning the distribution
26		of surcharge moneys collected and remitted by carriers

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1		under the Emergency Telephone System Act.
2		(k) Law enforcement officer identification information
3		or driver identification information compiled by a law
4		enforcement agency or the Department of Transportation
5		under Section 11-212 of the Illinois Vehicle Code.
6		(l) Records and information provided to a residential
7		health care facility resident sexual assault and death
8		review team or the Executive Council under the Abuse
9		Prevention Review Team Act.
10		(m) Information provided to the predatory lending
11		database created pursuant to Article 3 of the Residential
12		Real Property Disclosure Act, except to the extent
13		authorized under that Article.
14		(n) Defense budgets and petitions for certification of
15		compensation and expenses for court appointed trial
16		counsel as provided under Sections 10 and 15 of the Capital
17		Crimes Litigation Act. This subsection (n) shall apply
18		until the conclusion of the trial of the case, even if the
19		prosecution chooses not to pursue the death penalty prior
20		to trial or sentencing.
21		(o) Information that is prohibited from being
22		disclosed under Section 4 of the Illinois Health and
23		Hazardous Substances Registry Act.
24		(p) Security portions of system safety program plans,
25		investigation reports, surveys, schedules, lists, data, or
26		information compiled, collected, or prepared by or for the

SB1851 Enrolled - 26 - LRB100 10394 KTG 20591 b
1		Regional Transportation Authority under Section 2.11 of
2		the Regional Transportation Authority Act or the St. Clair
3		County Transit District under the Bi-State Transit Safety
4		Act.
5		(q) Information prohibited from being disclosed by the
6		Personnel Records Review Act.
7		(r) Information prohibited from being disclosed by the
8		Illinois School Student Records Act.
9		(s) Information the disclosure of which is restricted
10		under Section 5-108 of the Public Utilities Act.
11		(t) All identified or deidentified health information
12		in the form of health data or medical records contained in,
13		stored in, submitted to, transferred by, or released from
14		the Illinois Health Information Exchange, and identified
15		or deidentified health information in the form of health
16		data and medical records of the Illinois Health Information
17		Exchange in the possession of the Illinois Health
18		Information Exchange Authority due to its administration
19		of the Illinois Health Information Exchange. The terms
20		"identified" and "deidentified" shall be given the same
21		meaning as in the Health Insurance Portability and
22		Accountability Act of 1996, Public Law 104-191, or any
23		subsequent amendments thereto, and any regulations
24		promulgated thereunder.
25		(u) Records and information provided to an independent
26		team of experts under Brian's Law.

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1		(v) Names and information of people who have applied
2		for or received Firearm Owner's Identification Cards under
3		the Firearm Owners Identification Card Act or applied for
4		or received a concealed carry license under the Firearm
5		Concealed Carry Act, unless otherwise authorized by the
6		Firearm Concealed Carry Act; and databases under the
7		Firearm Concealed Carry Act, records of the Concealed Carry
8		Licensing Review Board under the Firearm Concealed Carry
9		Act, and law enforcement agency objections under the
10		Firearm Concealed Carry Act.
11		(w) Personally identifiable information which is
12		exempted from disclosure under subsection (g) of Section
13		19.1 of the Toll Highway Act.
14		(x) Information which is exempted from disclosure
15		under Section 5-1014.3 of the Counties Code or Section
16		8-11-21 of the Illinois Municipal Code.
17		(y) Confidential information under the Adult
18		Protective Services Act and its predecessor enabling
19		statute, the Elder Abuse and Neglect Act, including
20		information about the identity and administrative finding
21		against any caregiver of a verified and substantiated
22		decision of abuse, neglect, or financial exploitation of an
23		eligible adult maintained in the Registry established
24		under Section 7.5 of the Adult Protective Services Act.
25		(z) Records and information provided to a fatality
26		review team or the Illinois Fatality Review Team Advisory

SB1851 Enrolled - 28 - LRB100 10394 KTG 20591 b
1		Council under Section 15 of the Adult Protective Services
2		Act.
3		(aa) Information which is exempted from disclosure
4		under Section 2.37 of the Wildlife Code.
5		(bb) Information which is or was prohibited from
6		disclosure by the Juvenile Court Act of 1987.
7		(cc) Recordings made under the Law Enforcement
8		Officer-Worn Body Camera Act, except to the extent
9		authorized under that Act.
10		(dd) Information that is prohibited from being
11		disclosed under Section 45 of the Condominium and Common
12		Interest Community Ombudsperson Act.
13		(ee) Information that is exempted from disclosure
14		under Section 30.1 of the Pharmacy Practice Act.
15		(ff) Information that is exempted from disclosure
16		under the Revised Uniform Unclaimed Property Act.
17		(gg) (ff) Information that is prohibited from being
18		disclosed under Section 7-603.5 of the Illinois Vehicle
19		Code.
20		(hh) (ff) Records that are exempt from disclosure under
21		Section 1A-16.7 of the Election Code.
22		(ii) (ff) Information which is exempted from
23		disclosure under Section 2505-800 of the Department of
24		Revenue Law of the Civil Administrative Code of Illinois.
25		(jj) (ff) Information and reports that are required to
26		be submitted to the Department of Labor by registering day

SB1851 Enrolled - 29 - LRB100 10394 KTG 20591 b
1		and temporary labor service agencies but are exempt from
2		disclosure under subsection (a-1) of Section 45 of the Day
3		and Temporary Labor Services Act.
4		(kk) (ff) Information prohibited from disclosure under
5		the Seizure and Forfeiture Reporting Act.
6		(ll) Information the disclosure of which is restricted
7		and exempted under Section 5-30.8 of the Illinois Public
8		Aid Code.
9		(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
10		eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
11		99-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
12		100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
13		8-28-17; 100-465, eff. 8-31-17; 100-512, eff. 7-1-18; 100-517,
14		eff. 6-1-18; revised 11-2-17.)
15		Section 15. The Children and Family Services Act is amended
16		by adding Section 5.45 as follows:
17		(20 ILCS 505/5.45 new)
18		Sec. 5.45. Managed care plan services.
19		(a) As used in this Section:
20		"Caregiver" means an individual or entity directly
21		providing the day-to-day care of a child ensuring the child's
22		safety and well-being.
23		"Child" means a child placed in the care of the Department
24		pursuant to the Juvenile Court Act of 1987.

SB1851 Enrolled - 30 - LRB100 10394 KTG 20591 b
1		"Department" means the Department of Children and Family
2		Services, or any successor State agency.
3		"Director" means the Director of Children and Family
4		Services.
5		"Managed care organization" has the meaning ascribed to
6		that term in Section 5-30.1 of the Illinois Public Aid Code.
7		"Medicaid managed care plan" means a health care plan
8		operated by a managed care organization under the Medical
9		Assistance Program established in Article V of the Illinois
10		Public Aid Code.
11		"Workgroup" means the Child Welfare Medicaid Managed Care
12		Implementation Advisory Workgroup.
13		(b) Every child who is in the care of the Department
14		pursuant to the Juvenile Court Act of 1987 shall receive the
15		necessary services required by this Act and the Juvenile Court
16		Act of 1987, including any child enrolled in a Medicaid managed
17		care plan.
18		(c) The Department shall not relinquish its authority or
19		diminish its responsibility to determine and provide necessary
20		services that are in the best interest of a child even if those
21		services are directly or indirectly:
22		(1) provided by a managed care organization, another
23		State agency, or other third parties;
24		(2) coordinated through a managed care organization,
25		another State agency, or other third parties; or
26		(3) paid for by a managed care organization, another

SB1851 Enrolled - 31 - LRB100 10394 KTG 20591 b
1		State agency, or other third parties.
2		(d) The Department shall:
3		(1) implement and enforce measures to ensure that a
4		child's enrollment in Medicaid managed care supports
5		continuity of treatment and does not hinder service
6		delivery;
7		(2) establish a single point of contact for health care
8		coverage inquiries and dispute resolution systemwide
9		without transferring this responsibility to a third party
10		such as a managed care coordinator;
11		(3) not require any child to participate in Medicaid
12		managed care if the child would otherwise be exempt from
13		enrolling in a Medicaid managed care plan under any rule or
14		statute of this State; and
15		(4) make recommendations regarding managed care
16		contract measures, quality assurance activities, and
17		performance delivery evaluations in consultation with the
18		Workgroup; and
19		(5) post on its website:
20		(A) a link to any rule adopted or procedures
21		changed to address the provisions of this Section, if
22		applicable;
23		(B) each managed care organization's contract,
24		enrollee handbook, and directory;
25		(C) the notification process and timeframe
26		requirements used to inform managed care plan

SB1851 Enrolled - 32 - LRB100 10394 KTG 20591 b
1		enrollees, enrollees' caregivers, and enrollees' legal
2		representation of any changes in health care coverage
3		or change in a child's managed care provider;
4		(D) defined prior authorization requirements for
5		prescriptions, goods, and services in emergency and
6		non-emergency situations;
7		(E) the State's current Health Care Oversight and
8		Coordination Plan developed in accordance with federal
9		requirements; and
10		(F) the transition plan required under subsection
11		(f), including:
12		(i) the public comments submitted to the
13		Department, the Department of Healthcare and
14		Family Services, and the Workgroup for
15		consideration in development of the transition
16		plan;
17		(ii) a list and summary of recommendations of
18		the Workgroup that the Director or Director of
19		Healthcare and Family Services declined to adopt
20		or implement; and
21		(iii) the Department's attestation that the
22		transition plan will not impede the Department's
23		ability to timely identify the service needs of
24		youth in care and the timely and appropriate
25		provision of services to address those identified
26		needs.

SB1851 Enrolled - 33 - LRB100 10394 KTG 20591 b
1		(e) The Child Welfare Medicaid Managed Care Implementation
2		Advisory Workgroup is established to advise the Department on
3		the transition and implementation of managed care for children.
4		The Director of Children and Family Services and the Director
5		of Healthcare and Family Services shall serve as
6		co-chairpersons of the Workgroup. The Directors shall jointly
7		appoint members to the Workgroup who are stakeholders from the
8		child welfare community, including:
9		(1) employees of the Department of Children and Family
10		Services who have responsibility in the areas of (i)
11		managed care services, (ii) performance monitoring and
12		oversight, (iii) placement operations, and (iv) budget
13		revenue maximization;
14		(2) employees of the Department of Healthcare and
15		Family Services who have responsibility in the areas of (i)
16		managed care contracting, (ii) performance monitoring and
17		oversight, (iii) children's behavioral health, and (iv)
18		budget revenue maximization;
19		(3) 2 representatives of youth in care;
20		(4) one representative of managed care organizations
21		serving youth in care;
22		(5) 4 representatives of child welfare providers;
23		(6) one representative of parents of children in
24		out-of-home care;
25		(7) one representative of universities or research
26		institutions;

SB1851 Enrolled - 34 - LRB100 10394 KTG 20591 b
1		(8) one representative of pediatric physicians;
2		(9) one representative of the juvenile court;
3		(10) one representative of caregivers of youth in care;
4		(11) one practitioner with expertise in child and
5		adolescent psychiatry;
6		(12) one representative of substance abuse and mental
7		health providers with expertise in serving children
8		involved in child welfare and their families;
9		(13) at least one member of the Medicaid Advisory
10		Committee;
11		(14) one representative of a statewide organization
12		representing hospitals;
13		(15) one representative of a statewide organization
14		representing child welfare providers;
15		(16) one representative of a statewide organization
16		representing substance abuse and mental health providers;
17		and
18		(17) other child advocates as deemed appropriate by the
19		Directors.
20		To the greatest extent possible, the co-chairpersons shall
21		appoint members who reflect the geographic diversity of the
22		State and include members who represent rural service areas.
23		Members shall serve 2-year terms or until the Workgroup
24		dissolves. If a vacancy occurs in the Workgroup membership, the
25		vacancy shall be filled in the same manner as the original
26		appointment for the remainder of the unexpired term. The

SB1851 Enrolled - 35 - LRB100 10394 KTG 20591 b
1		Workgroup shall hold meetings, as it deems appropriate, in the
2		northern, central, and southern regions of the State to solicit
3		public comments to develop its recommendations. To ensure the
4		Department of Children and Family Services and the Department
5		of Healthcare and Family Services are provided time to confer
6		and determine their use of pertinent Workgroup recommendations
7		in the transition plan required under subsection (f), the
8		co-chairpersons shall convene at least 3 meetings. The
9		Department of Children and Family Services and the Department
10		of Healthcare and Family Services shall provide administrative
11		support to the Workgroup. Workgroup members shall serve without
12		compensation. The Workgroup shall dissolve 5 years after the
13		Department of Children and Family Services' implementation of
14		managed care.
15		(f) Prior to transitioning any child to managed care, the
16		Department of Children and Family Services and the Department
17		of Healthcare and Family Services, in consultation with the
18		Workgroup, must develop and post publicly, a transition plan
19		for the provision of health care services to children enrolled
20		in Medicaid managed care plans. Interim transition plans must
21		be posted to the Department's website by July 15, 2018. The
22		transition plan shall be posted at least 28 days before the
23		Department's implementation of managed care. The transition
24		plan shall address, but is not limited to, the following:
25		(1) an assessment of existing network adequacy, plans
26		to address gaps in network, and ongoing network evaluation;

SB1851 Enrolled - 36 - LRB100 10394 KTG 20591 b
1		(2) a framework for preparing and training
2		organizations, caregivers, frontline staff, and managed
3		care organizations;
4		(3) the identification of administrative changes
5		necessary for successful transition to managed care, and
6		the timeframes to make changes;
7		(4) defined roles, responsibilities, and lines of
8		authority for care coordination, placement providers,
9		service providers, and each State agency involved in
10		management and oversight of managed care services;
11		(5) data used to establish baseline performance and
12		quality of care, which shall be utilized to assess quality
13		outcomes and identify ongoing areas for improvement;
14		(6) a process for stakeholder input into managed care
15		planning and implementation;
16		(7) a dispute resolution process, including the rights
17		of enrollees and representatives of enrollees under the
18		dispute process and timeframes for dispute resolution
19		determinations and remedies;
20		(8) the process for health care transition for youth
21		exiting the Department's care through emancipation or
22		achieving permanency; and
23		(9) protections to ensure the continued provision of
24		health care services if a child's residence or legal
25		guardian changes.
26		(g) Reports.

SB1851 Enrolled - 37 - LRB100 10394 KTG 20591 b
1		(1) On or before February 1, 2019, and on or before
2		each February 1 thereafter, the Department shall submit a
3		report to the House and Senate Human Services Committees,
4		or to any successor committees, on measures of access to
5		and the quality of health care services for children
6		enrolled in Medicaid managed care plans, including, but not
7		limited to, data showing whether:
8		(A) children enrolled in Medicaid managed care
9		plans have continuity of care across placement types,
10		geographic regions, and specialty service needs;
11		(B) each child is receiving the early periodic
12		screening, diagnosis, and treatment services as
13		required by federal law, including, but not limited to,
14		regular preventative care and timely specialty care;
15		(C) children are assigned to health homes;
16		(D) each child has a health care oversight and
17		coordination plan as required by federal law;
18		(E) there exist complaints and grievances
19		indicating gaps or barriers in service delivery; and
20		(F) the Workgroup and other stakeholders have and
21		continue to be engaged in quality improvement
22		initiatives.
23		The report shall be prepared in consultation with the
24		Workgroup and other agencies, organizations, or
25		individuals the Director deems appropriate in order to
26		obtain comprehensive and objective information about the

SB1851 Enrolled - 38 - LRB100 10394 KTG 20591 b
1		managed care plan operation.
2		(2) During each legislative session, the House and
3		Senate Human Services Committees shall hold hearings to
4		take public testimony about managed care implementation
5		for children in the care of, adopted from, or placed in
6		guardianship by the Department. The Department shall
7		present testimony, including information provided in the
8		report required under paragraph (1), the Department's
9		compliance with the provisions of this Section, and any
10		recommendations for statutory changes to improve health
11		care for children in the Department's care.
12		(h) If any provision of this Section or its application to
13		any person or circumstance is held invalid, the invalidity of
14		that provision or application does not affect other provisions
15		or applications of this Section that can be given effect
16		without the invalid provision or application.
17		Section 16. The Nursing Home Care Act is amended by
18		changing Section 2-217 as follows:
19		(210 ILCS 45/2-217)
20		Sec. 2-217. Order for transportation of resident by an
21		ambulance service provider. If a facility orders medi-car,
22		service car, or ground ambulance transportation of a resident
23		of the facility by an ambulance service provider, the facility
24		must maintain a written record that shows (i) the name of the

SB1851 Enrolled - 39 - LRB100 10394 KTG 20591 b
1		person who placed the order for that transportation and (ii)
2		the medical reason for that transportation. Additionally, the
3		facility must provide the ambulance service provider with a
4		Physician Certification Statement on a form prescribed by the
5		Department of Healthcare and Family Services in accordance with
6		subsection (g) of Section 5-4.2 of the Illinois Public Aid
7		Code. The facility shall provide a copy of the Physician
8		Certification Statement to the ambulance service provider
9		prior to or at the time of transport. The Physician
10		Certification Statement is not required prior to the transport
11		if a delay in transport can be expected to negatively affect
12		the patient outcome; however, the facility shall provide a copy
13		of the Physician Certification Statement to the ambulance
14		service provider at no charge within 10 days after the request.
15		A facility shall, upon request, furnish assistance to the
16		transportation provider in the completion of the form if the
17		Physician Certification Statement is incomplete. The facility
18		must maintain the record for a period of at least 3 years after
19		the date of the order for transportation by ambulance.
20		(Source: P.A. 94-1063, eff. 1-31-07.)
21		Section 17. The Specialized Mental Health Rehabilitation
22		Act of 2013 is amended by adding Section 5-104 as follows:
23		(210 ILCS 49/5-104 new)
24		Sec. 5-104. Therapeutic visit rates. For a facility

SB1851 Enrolled - 40 - LRB100 10394 KTG 20591 b
1		licensed under this Act by June 1, 2018 or provisionally
2		licensed under this Act by June 1, 2018, a payment shall be
3		made for therapeutic visits that have been indicated by an
4		interdisciplinary team as therapeutically beneficial. Payment
5		under this Section shall be at a rate of 75% of the facility's
6		rate on the effective date of this amendatory Act of the 100th
7		General Assembly and may not exceed 20 days in a fiscal year
8		and shall not exceed 10 days consecutively.
9		Section 18. The Hospital Licensing Act is amended by
10		changing Section 6.22 as follows:
11		(210 ILCS 85/6.22)
12		Sec. 6.22. Arrangement for transportation of patient by an
13		ambulance service provider.
14		(a) In this Section:
15		"Ambulance service provider" means a Vehicle Service
16		Provider as defined in the Emergency Medical Services (EMS)
17		Systems Act who provides non-emergency transportation
18		services by ambulance.
19		"Patient" means a person who is transported by an
20		ambulance service provider.
21		(b) If a hospital arranges for medi-car, service car, or
22		ground ambulance transportation of a patient of the hospital by
23		ambulance, the hospital must provide the ambulance service
24		provider, at or prior to transport, a Physician Certification

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1		Statement formatted and completed in compliance with federal
2		regulations or an equivalent form developed by the hospital.
3		Each hospital shall develop a policy requiring a physician or
4		the physician's designee to complete the Physician
5		Certification Statement. The Physician Certification Statement
6		shall be maintained as part of the patient's medical record. A
7		hospital shall, upon request, furnish assistance to the
8		ambulance service provider in the completion of the form if the
9		Physician Certification Statement is incomplete. The Physician
10		Certification Statement or equivalent form is not required
11		prior to transport if a delay in transport can be expected to
12		negatively affect the patient outcome; however, a hospital
13		shall provide a copy of the Physician Certification Statement
14		to the ambulance service provider at no charge within 10 days
15		after the request.
16		(c) If a hospital is unable to provide a Physician
17		Certification Statement or equivalent form, then the hospital
18		shall provide to the patient a written notice and a verbal
19		explanation of the written notice, which notice must meet all
20		of the following requirements:
21		(1) The following caption must appear at the beginning
22		of the notice in at least 14-point type: Notice to Patient
23		Regarding Non-Emergency Ambulance Services.
24		(2) The notice must contain each of the following
25		statements in at least 14-point type:
26		(A) The purpose of this notice is to help you make

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1		an informed choice about whether you want to be
2		transported by ambulance because your medical
3		condition does not meet medical necessity for
4		transportation by an ambulance.
5		(B) Your insurance may not cover the charges for
6		ambulance transportation.
7		(C) You may be responsible for the cost of
8		ambulance transportation.
9		(D) The estimated cost of ambulance transportation
10		is $(amount).
11		(3) The notice must be signed by the patient or by the
12		patient's authorized representative. A copy shall be given
13		to the patient and the hospital shall retain a copy.
14		(d) The notice set forth in subsection (c) of this Section
15		shall not be required if a delay in transport can be expected
16		to negatively affect the patient outcome.
17		(e) If a patient is physically or mentally unable to sign
18		the notice described in subsection (c) of this Section and no
19		authorized representative of the patient is available to sign
20		the notice on the patient's behalf, the hospital must be able
21		to provide documentation of the patient's inability to sign the
22		notice and the unavailability of an authorized representative.
23		In any case described in this subsection (e), the hospital
24		shall be considered to have met the requirements of subsection
25		(c) of this Section.
26		(Source: P.A. 94-1063, eff. 1-31-07.)

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1		Section 20. The Illinois Public Aid Code is amended by
2		changing Sections 5-4.2, 5-5.4h, and 5A-16 and by adding
3		Sections 5-5.07 and 5-30.8 as follows:
4		(305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)
5		Sec. 5-4.2. Ambulance services payments.
6		(a) For ambulance services provided to a recipient of aid
7		under this Article on or after January 1, 1993, the Illinois
8		Department shall reimburse ambulance service providers at
9		rates calculated in accordance with this Section. It is the
10		intent of the General Assembly to provide adequate
11		reimbursement for ambulance services so as to ensure adequate
12		access to services for recipients of aid under this Article and
13		to provide appropriate incentives to ambulance service
14		providers to provide services in an efficient and
15		cost-effective manner. Thus, it is the intent of the General
16		Assembly that the Illinois Department implement a
17		reimbursement system for ambulance services that, to the extent
18		practicable and subject to the availability of funds
19		appropriated by the General Assembly for this purpose, is
20		consistent with the payment principles of Medicare. To ensure
21		uniformity between the payment principles of Medicare and
22		Medicaid, the Illinois Department shall follow, to the extent
23		necessary and practicable and subject to the availability of
24		funds appropriated by the General Assembly for this purpose,

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1		the statutes, laws, regulations, policies, procedures,
2		principles, definitions, guidelines, and manuals used to
3		determine the amounts paid to ambulance service providers under
4		Title XVIII of the Social Security Act (Medicare).
5		(b) For ambulance services provided to a recipient of aid
6		under this Article on or after January 1, 1996, the Illinois
7		Department shall reimburse ambulance service providers based
8		upon the actual distance traveled if a natural disaster,
9		weather conditions, road repairs, or traffic congestion
10		necessitates the use of a route other than the most direct
11		route.
12		(c) For purposes of this Section, "ambulance services"
13		includes medical transportation services provided by means of
14		an ambulance, medi-car, service car, or taxi.
15		(c-1) For purposes of this Section, "ground ambulance
16		service" means medical transportation services that are
17		described as ground ambulance services by the Centers for
18		Medicare and Medicaid Services and provided in a vehicle that
19		is licensed as an ambulance by the Illinois Department of
20		Public Health pursuant to the Emergency Medical Services (EMS)
21		Systems Act.
22		(c-2) For purposes of this Section, "ground ambulance
23		service provider" means a vehicle service provider as described
24		in the Emergency Medical Services (EMS) Systems Act that
25		operates licensed ambulances for the purpose of providing
26		emergency ambulance services, or non-emergency ambulance

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1		services, or both. For purposes of this Section, this includes
2		both ambulance providers and ambulance suppliers as described
3		by the Centers for Medicare and Medicaid Services.
4		(c-3) For purposes of this Section, "medi-car" means
5		transportation services provided to a patient who is confined
6		to a wheelchair and requires the use of a hydraulic or electric
7		lift or ramp and wheelchair lockdown when the patient's
8		condition does not require medical observation, medical
9		supervision, medical equipment, the administration of
10		medications, or the administration of oxygen.
11		(c-4) For purposes of this Section, "service car" means
12		transportation services provided to a patient by a passenger
13		vehicle where that patient does not require the specialized
14		modes described in subsection (c-1) or (c-3).
15		(d) This Section does not prohibit separate billing by
16		ambulance service providers for oxygen furnished while
17		providing advanced life support services.
18		(e) Beginning with services rendered on or after July 1,
19		2008, all providers of non-emergency medi-car and service car
20		transportation must certify that the driver and employee
21		attendant, as applicable, have completed a safety program
22		approved by the Department to protect both the patient and the
23		driver, prior to transporting a patient. The provider must
24		maintain this certification in its records. The provider shall
25		produce such documentation upon demand by the Department or its
26		representative. Failure to produce documentation of such

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1		training shall result in recovery of any payments made by the
2		Department for services rendered by a non-certified driver or
3		employee attendant. Medi-car and service car providers must
4		maintain legible documentation in their records of the driver
5		and, as applicable, employee attendant that actually
6		transported the patient. Providers must recertify all drivers
7		and employee attendants every 3 years.
8		Notwithstanding the requirements above, any public
9		transportation provider of medi-car and service car
10		transportation that receives federal funding under 49 U.S.C.
11		5307 and 5311 need not certify its drivers and employee
12		attendants under this Section, since safety training is already
13		federally mandated.
14		(f) With respect to any policy or program administered by
15		the Department or its agent regarding approval of non-emergency
16		medical transportation by ground ambulance service providers,
17		including, but not limited to, the Non-Emergency
18		Transportation Services Prior Approval Program (NETSPAP), the
19		Department shall establish by rule a process by which ground
20		ambulance service providers of non-emergency medical
21		transportation may appeal any decision by the Department or its
22		agent for which no denial was received prior to the time of
23		transport that either (i) denies a request for approval for
24		payment of non-emergency transportation by means of ground
25		ambulance service or (ii) grants a request for approval of
26		non-emergency transportation by means of ground ambulance

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1		service at a level of service that entitles the ground
2		ambulance service provider to a lower level of compensation
3		from the Department than the ground ambulance service provider
4		would have received as compensation for the level of service
5		requested. The rule shall be filed by December 15, 2012 and
6		shall provide that, for any decision rendered by the Department
7		or its agent on or after the date the rule takes effect, the
8		ground ambulance service provider shall have 60 days from the
9		date the decision is received to file an appeal. The rule
10		established by the Department shall be, insofar as is
11		practical, consistent with the Illinois Administrative
12		Procedure Act. The Director's decision on an appeal under this
13		Section shall be a final administrative decision subject to
14		review under the Administrative Review Law.
15		(f-5) Beginning 90 days after July 20, 2012 (the effective
16		date of Public Act 97-842), (i) no denial of a request for
17		approval for payment of non-emergency transportation by means
18		of ground ambulance service, and (ii) no approval of
19		non-emergency transportation by means of ground ambulance
20		service at a level of service that entitles the ground
21		ambulance service provider to a lower level of compensation
22		from the Department than would have been received at the level
23		of service submitted by the ground ambulance service provider,
24		may be issued by the Department or its agent unless the
25		Department has submitted the criteria for determining the
26		appropriateness of the transport for first notice publication

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1		in the Illinois Register pursuant to Section 5-40 of the
2		Illinois Administrative Procedure Act.
3		(g) Whenever a patient covered by a medical assistance
4		program under this Code or by another medical program
5		administered by the Department, including a patient covered
6		under the State's Medicaid managed care program, is being
7		transported discharged from a facility and requires
8		non-emergency transportation including ground ambulance,
9		medi-car, or service car transportation, a Physician
10		Certification Statement , a physician discharge order as
11		described in this Section shall be required for each patient
12		whose discharge requires medically supervised ground ambulance
13		services. Facilities shall develop procedures for a licensed
14		medical professional physician with medical staff privileges
15		to provide a written and signed Physician Certification
16		Statement physician discharge order. The Physician
17		Certification Statement physician discharge order shall
18		specify the level of transportation ground ambulance services
19		needed and complete a medical certification establishing the
20		criteria for approval of non-emergency ambulance
21		transportation, as published by the Department of Healthcare
22		and Family Services, that is met by the patient. This order and
23		the medical certification shall be completed prior to ordering
24		the transportation an ambulance service and prior to patient
25		discharge. The Physician Certification Statement is not
26		required prior to transport if a delay in transport can be

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1		expected to negatively affect the patient outcome. discharge.
2		The medical certification specifying the level and type of
3		non-emergency transportation needed shall be in the form of the
4		Physician Certification Statement on a standardized form
5		prescribed by the Department of Healthcare and Family Services.
6		Within 75 days after the effective date of this amendatory Act
7		of the 100th General Assembly, the Department of Healthcare and
8		Family Services shall develop a standardized form of the
9		Physician Certification Statement specifying the level and
10		type of transportation services needed in consultation with the
11		Department of Public Health, Medicaid managed care
12		organizations, a statewide association representing ambulance
13		providers, a statewide association representing hospitals, 3
14		statewide associations representing nursing homes, and other
15		stakeholders. The Physician Certification Statement shall
16		include, but is not limited to, the criteria necessary to
17		demonstrate medical necessity for the level of transport needed
18		as required by (i) the Department of Healthcare and Family
19		Services and (ii) the federal Centers for Medicare and Medicaid
20		Services as outlined in the Centers for Medicare and Medicaid
21		Services' Medicare Benefit Policy Manual, Pub. 100-02, Chap.
22		10, Sec. 10.2.1, et seq. The use of the Physician Certification
23		Statement shall satisfy the obligations of hospitals under
24		Section 6.22 of the Hospital Licensing Act and nursing homes
25		under Section 2-217 of the Nursing Home Care Act.
26		Implementation and acceptance of the Physician Certification

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1		Statement shall take place no later than 90 days after the
2		issuance of the Physician Certification Statement by the
3		Department of Healthcare and Family Services.
4		Pursuant to subsection (E) of Section 12-4.25 of this Code,
5		the Department is entitled to recover overpayments paid to a
6		provider or vendor, including, but not limited to, from the
7		discharging physician, the discharging facility, and the
8		ground ambulance service provider, in instances where a
9		non-emergency ground ambulance service is rendered as the
10		result of improper or false certification.
11		Beginning October 1, 2018, the Department of Healthcare and
12		Family Services shall collect data from Medicaid managed care
13		organizations and transportation brokers, including the
14		Department's NETSPAP broker, regarding denials and appeals
15		related to the missing or incomplete Physician Certification
16		Statement forms and overall compliance with this subsection.
17		The Department of Healthcare and Family Services shall publish
18		quarterly results on its website within 15 days following the
19		end of each quarter.
20		(h) On and after July 1, 2012, the Department shall reduce
21		any rate of reimbursement for services or other payments or
22		alter any methodologies authorized by this Code to reduce any
23		rate of reimbursement for services or other payments in
24		accordance with Section 5-5e.
25		(Source: P.A. 97-584, eff. 8-26-11; 97-689, eff. 6-14-12;
26		97-842, eff. 7-20-12; 98-463, eff. 8-16-13.)

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1		(305 ILCS 5/5-5.4h)
2		Sec. 5-5.4h. Medicaid reimbursement for medically complex
3		for the developmentally disabled facilities licensed under the
4		MC/DD Act long-term care facilities for persons under 22 years
5		of age.
6		(a) Facilities licensed as medically complex for the
7		developmentally disabled facilities long-term care facilities
8		for persons under 22 years of age that serve severely and
9		chronically ill pediatric patients shall have a specific
10		reimbursement system designed to recognize the characteristics
11		and needs of the patients they serve.
12		(b) For dates of services starting July 1, 2013 and until a
13		new reimbursement system is designed, medically complex for the
14		developmentally disabled facilities long-term care facilities
15		for persons under 22 years of age that meet the following
16		criteria:
17		(1) serve exceptional care patients; and
18		(2) have 30% or more of their patients receiving
19		ventilator care;
20		shall receive Medicaid reimbursement on a 30-day expedited
21		schedule.
22		(c) Subject to federal approval of changes to the Title XIX
23		State Plan, for dates of services starting July 1, 2014 through
24		March 31, 2019, medically complex for the developmentally
25		disabled facilities and until a new reimbursement system is

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1		designed, long-term care facilities for persons under 22 years
2		of age which meet the criteria in subsection (b) of this
3		Section shall receive a per diem rate for clinically complex
4		residents of $304. Clinically complex residents on a ventilator
5		shall receive a per diem rate of $669. Subject to federal
6		approval of changes to the Title XIX State Plan, for dates of
7		services starting April 1, 2019, medically complex for the
8		developmentally disabled facilities must be reimbursed an
9		exceptional care per diem rate, instead of the base rate, for
10		services to residents with complex or extensive medical needs.
11		Exceptional care per diem rates must be paid for the conditions
12		or services specified under subsection (f) at the following per
13		diem rates: Tier 1 $326, Tier 2 $546, and Tier 3 $735.
14		(d) For To qualify for the per diem rate of $669 for
15		clinically complex residents on a ventilator pursuant to
16		subsection (c) or subsection (f), facilities shall have a
17		policy documenting their method of routine assessment of a
18		resident's weaning potential with interventions implemented
19		noted in the resident's medical record.
20		(e) For services provided prior to April 1, 2019 and for
21		For the purposes of this Section, a resident is considered
22		clinically complex if the resident requires at least one of the
23		following medical services:
24		(1) Tracheostomy care with dependence on mechanical
25		ventilation for a minimum of 6 hours each day.
26		(2) Tracheostomy care requiring suctioning at least

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1		every 6 hours, room air mist or oxygen as needed, and
2		dependence on one of the treatment procedures listed under
3		paragraph (4) excluding the procedure listed in
4		subparagraph (A) of paragraph (4).
5		(3) Total parenteral nutrition or other intravenous
6		nutritional support and one of the treatment procedures
7		listed under paragraph (4).
8		(4) The following treatment procedures apply to the
9		conditions in paragraphs (2) and (3) of this subsection:
10		(A) Intermittent suctioning at least every 8 hours
11		and room air mist or oxygen as needed.
12		(B) Continuous intravenous therapy including
13		administration of therapeutic agents necessary for
14		hydration or of intravenous pharmaceuticals; or
15		intravenous pharmaceutical administration of more than
16		one agent via a peripheral or central line, without
17		continuous infusion.
18		(C) Peritoneal dialysis treatments requiring at
19		least 4 exchanges every 24 hours.
20		(D) Tube feeding via nasogastric or gastrostomy
21		tube.
22		(E) Other medical technologies required
23		continuously, which in the opinion of the attending
24		physician require the services of a professional
25		nurse.
26		(f) Complex or extensive medical needs for exceptional care

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1		reimbursement. The conditions and services used for the
2		purposes of this Section have the same meanings as ascribed to
3		those conditions and services under the Minimum Data Set (MDS)
4		Resident Assessment Instrument (RAI) and specified in the most
5		recent manual. Instead of submitting minimum data set
6		assessments to the Department, medically complex for the
7		developmentally disabled facilities must document within each
8		resident's medical record the conditions or services using the
9		minimum data set documentation standards and requirements to
10		qualify for exceptional care reimbursement.
11		(1) Tier 1 reimbursement is for residents who are
12		receiving at least 51% of their caloric intake via a
13		feeding tube.
14		(2) Tier 2 reimbursement is for residents who are
15		receiving tracheostomy care without a ventilator.
16		(3) Tier 3 reimbursement is for residents who are
17		receiving tracheostomy care and ventilator care.
18		(g) For dates of services starting April 1, 2019,
19		reimbursement calculations and direct payment for services
20		provided by medically complex for the developmentally disabled
21		facilities are the responsibility of the Department of
22		Healthcare and Family Services instead of the Department of
23		Human Services. Appropriations for medically complex for the
24		developmentally disabled facilities must be shifted from the
25		Department of Human Services to the Department of Healthcare
26		and Family Services. Nothing in this Section prohibits the

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1		Department of Healthcare and Family Services from paying more
2		than the rates specified in this Section. The rates in this
3		Section must be interpreted as a minimum amount. Any
4		reimbursement increases applied to providers licensed under
5		the ID/DD Community Care Act must also be applied in an
6		equivalent manner to medically complex for the developmentally
7		disabled facilities.
8		(h) The Department of Healthcare and Family Services shall
9		pay the rates in effect on March 31, 2019 until the changes
10		made to this Section by this amendatory Act of the 100th
11		General Assembly have been approved by the Centers for Medicare
12		and Medicaid Services of the U.S. Department of Health and
13		Human Services.
14		(i) The Department of Healthcare and Family Services may
15		adopt rules as allowed by the Illinois Administrative Procedure
16		Act to implement this Section; however, the requirements of
17		this Section must be implemented by the Department of
18		Healthcare and Family Services even if the Department of
19		Healthcare and Family Services has not adopted rules by the
20		implementation date of April 1, 2019.
21		(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14.)
22		(305 ILCS 5/5-5.07 new)
23		Sec. 5-5.07. Inpatient psychiatric stay; DCFS per diem
24		rate. The Department of Children and Family Services shall pay
25		the DCFS per diem rate for inpatient psychiatric stay at a

SB1851 Enrolled - 56 - LRB100 10394 KTG 20591 b
1		free-standing psychiatric hospital effective the 11th day when
2		a child is in the hospital beyond medical necessity, and the
3		parent or caregiver has denied the child access to the home and
4		has refused or failed to make provisions for another living
5		arrangement for the child or the child's discharge is being
6		delayed due to a pending inquiry or investigation by the
7		Department of Children and Family Services. This Section is
8		repealed 6 months after the effective date of this amendatory
9		Act of the 100th General Assembly.
10		(305 ILCS 5/5-30.8 new)
11		Sec. 5-30.8. Managed care organization rate transparency.
12		(a) For the establishment of managed care organization
13		(MCO) capitation base rate payments from the State, including,
14		but not limited to: (i) hospital fee schedule reforms and
15		updates, (ii) rates related to a single State-mandated
16		preferred drug list, (iii) rate updates related to the State's
17		preferred drug list, (iv) inclusion of coverage for children
18		with special needs, (v) inclusion of coverage for children
19		within the child welfare system, (vi) annual MCO capitation
20		rates, and (vii) any retroactive provider fee schedule
21		adjustments or other changes required by legislation or other
22		actions, the Department of Healthcare and Family Services shall
23		implement a capitation base rate setting process beginning on
24		the effective date of this amendatory Act of the 100th General
25		Assembly which shall include all of the following elements of

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1		transparency:
2		(1) The Department shall include participating MCOs
3		and a statewide trade association representing a majority
4		of participating MCOs in meetings to discuss the impact to
5		base capitation rates as a result of any new or updated
6		hospital fee schedules or other provider fee schedules.
7		Additionally, the Department shall share any data or
8		reports used to develop MCO capitation rates with
9		participating MCOs. This data shall be comprehensive
10		enough for MCO actuaries to recreate and verify the
11		accuracy of the capitation base rate build-up.
12		(2) The Department shall not limit the number of
13		experts that each MCO is allowed to bring to the draft
14		capitation base rate meeting or the final capitation base
15		rate review meeting. Draft and final capitation base rate
16		review meetings shall be held in at least 2 locations.
17		(3) The Department and its contracted actuary shall
18		meet with all participating MCOs simultaneously and
19		together along with consulting actuaries contracted with
20		statewide trade association representing a majority of
21		Medicaid health plans at the request of the plans.
22		Participating MCOs shall additionally, at their request,
23		be granted individual capitation rate development meetings
24		with the Department.
25		(4) Any quality incentive or other incentive
26		withholding of any portion of the actuarially certified

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1		capitation rates must be budget-neutral. The entirety of
2		any aggregate withheld amounts must be returned to the MCOs
3		in proportion to their performance on the relevant
4		performance metric. No amounts shall be returned to the
5		Department if all performance measures are not achieved to
6		the extent allowable by federal law and regulations.
7		(5) Upon request, the Department shall provide written
8		responses to questions regarding MCO capitation base
9		rates, the capitation base development methodology, and
10		MCO capitation rate data, and all other requests regarding
11		capitation rates from MCOs. Upon request, the Department
12		shall also provide to the MCOs materials used in
13		incorporating provider fee schedules into base capitation
14		rates.
15		(b) For the development of capitation base rates for new
16		capitation rate years:
17		(1) The Department shall take into account emerging
18		experience in the development of the annual MCO capitation
19		base rates, including, but not limited to, current-year
20		cost and utilization trends observed by MCOs in an
21		actuarially sound manner and in accordance with federal law
22		and regulations.
23		(2) No later than January 1 of each year, the
24		Department shall release an agreed upon annual calendar
25		that outlines dates for capitation rate setting meetings
26		for that year. The calendar shall include at least the

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1		following meetings and deadlines:
2		(A) An initial meeting for the Department to review
3		MCO data and draft rate assumptions to be used in the
4		development of capitation base rates for the following
5		year.
6		(B) A draft rate meeting after the Department
7		provides the MCOs with the draft capitation base rates
8		to discuss, review, and seek feedback regarding the
9		draft capitation base rates.
10		(3) Prior to the submission of final capitation rates
11		to the federal Centers for Medicare and Medicaid Services,
12		the Department shall provide the MCOs with a final
13		actuarial report including the final capitation base rates
14		for the following year and subsequently conduct a final
15		capitation base review meeting. Final capitation rates
16		shall be marked final.
17		(c) For the development of capitation base rates reflecting
18		policy changes:
19		(1) Unless contrary to federal law and regulation, the
20		Department must provide notice to MCOs of any significant
21		operational policy change no later than 60 days prior to
22		the effective date of an operational policy change in order
23		to give MCOs time to prepare for and implement the
24		operational policy change and to ensure that the quality
25		and delivery of enrollee health care is not disrupted.
26		"Operational policy change" means a change to operational

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1		requirements such as reporting formats, encounter
2		submission definitional changes, or required provider
3		interfaces made at the sole discretion of the Department
4		and not required by legislation with a retroactive
5		effective date. Nothing in this Section shall be construed
6		as a requirement to delay or prohibit implementation of
7		policy changes that impact enrollee benefits as determined
8		in the sole discretion of the Department.
9		(2) No later than 60 days after the effective date of
10		the policy change or program implementation, the
11		Department shall meet with the MCOs regarding the initial
12		data collection needed to establish capitation base rates
13		for the policy change. Additionally, the Department shall
14		share with the participating MCOs what other data is needed
15		to estimate the change and the processes for collection of
16		that data that shall be utilized to develop capitation base
17		rates.
18		(3) No later than 60 days after the effective date of
19		the policy change or program implementation, the
20		Department shall meet with MCOs to review data and the
21		Department's written draft assumptions to be used in
22		development of capitation base rates for the policy change,
23		and shall provide opportunities for questions to be asked
24		and answered.
25		(4) No later than 60 days after the effective date of
26		the policy change or program implementation, the

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1		Department shall provide the MCOs with draft capitation
2		base rates and shall also conduct a draft capitation base
3		rate meeting with MCOs to discuss, review, and seek
4		feedback regarding the draft capitation base rates.
5		(d) For the development of capitation base rates for
6		retroactive policy or fee schedule changes:
7		(1) The Department shall meet with the MCOs regarding
8		the initial data collection needed to establish capitation
9		base rates for the policy change. Additionally, the
10		Department shall share with the participating MCOs what
11		other data is needed to estimate the change and the
12		processes for collection of the data that shall be utilized
13		to develop capitation base rates.
14		(2) The Department shall meet with MCOs to review data
15		and the Department's written draft assumptions to be used
16		in development of capitation base rates for the policy
17		change. The Department shall provide opportunities for
18		questions to be asked and answered.
19		(3) The Department shall provide the MCOs with draft
20		capitation rates and shall also conduct a draft rate
21		meeting with MCOs to discuss, review, and seek feedback
22		regarding the draft capitation base rates.
23		(4) The Department shall inform MCOs no less than
24		quarterly of upcoming benefit and policy changes to the
25		Medicaid program.
26		(e) Meetings of the group established to discuss Medicaid

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1		capitation rates under this Section shall be closed to the
2		public and shall not be subject to the Open Meetings Act.
3		Records and information produced by the group established to
4		discuss Medicaid capitation rates under this Section shall be
5		confidential and not subject to the Freedom of Information Act.
6		(305 ILCS 5/5A-16)
7		Sec. 5A-16. State fiscal year 2019 implementation
8		protection.
9		(a) To preserve access to hospital services and to ensure
10		continuity of payments and stability of access to hospital
11		services, it is the intent of the General Assembly that there
12		not be a gap in payments to hospitals while the changes
13		authorized under Public Act 100-581 this amendatory Act of the
14		100th General Assembly are being reviewed by the federal
15		Centers for Medicare and Medicaid Services and implemented by
16		the Department. Therefore, pending the review and approval of
17		the changes to the assessment and hospital reimbursement
18		methodologies authorized under Public Act 100-581 this
19		amendatory Act of the 100th General Assembly by the federal
20		Centers for Medicare and Medicaid Services and the final
21		implementation of such program by the Department, the
22		Department shall take all actions necessary to continue the
23		reimbursement methodologies and payments to hospitals that are
24		changed under Public Act 100-581 this amendatory Act of the
25		100th General Assembly, as they are in effect on June 30, 2018,

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1		until the first day of the second month after the new and
2		revised methodologies and payments authorized under Public Act
3		100-581 this amendatory Act of the 100th General Assembly are
4		effective and implemented by the Department. Such actions by
5		the Department shall include, but not be limited to, requesting
6		prior to June 15, 2018 the extension of any federal approval of
7		the currently approved payment methodologies contained in
8		Illinois' Medicaid State Plan while the federal Centers for
9		Medicare and Medicaid Services reviews the proposed changes
10		authorized under Public Act 100-581 this amendatory Act of the
11		100th General Assembly.
12		(b) Notwithstanding any other provision of this Code, if
13		the federal Centers for Medicare and Medicaid Services should
14		approve the continuation of the reimbursement methodologies
15		and payments to hospitals under Sections 5A-12.2, 5A-12.4,
16		5A-12.5 and , and Section 14-12, as they are in effect on June
17		30, 2018, until the new and revised methodologies and payments
18		authorized under Sections 5A-12.6 and Section 14-12 of this
19		Code amendatory Act of the 100th General Assembly are federally
20		approved, then the reimbursement methodologies and payments to
21		hospitals under Sections 5A-12.2, 5A-12.4, 5A-12.5, and 14-12,
22		and the assessments imposed under Section 5A-2, as they are in
23		effect on June 30, 2018, shall continue until the effective
24		date of the new and revised methodologies and payments, which
25		shall be the first day of the second month following the date
26		of approval by the federal Centers for Medicare and Medicaid

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1		Services.
2		(c) Notwithstanding any other provision of this Code, if by
3		July 11, 2018 the federal Centers for Medicare and Medicaid
4		Services has neither approved the changes authorized under
5		Public Act 100-581 nor has formally approved an extension of
6		the reimbursement methodologies and payments to hospitals
7		under Sections 5A-12.5 and 14-12 as they are in effect on June
8		30, 2018, then the following shall apply:
9		(1) All reimbursement methodologies and payments for
10		hospital services authorized under Sections 5A-12.2,
11		5A-12.4, and 5A-12.5 in effect on June 30, 2018 shall
12		continue subject to the availability of federal matching
13		funds for such expenditures and subject to the provisions
14		of subsection (c) of Section 5A-15.
15		(2) All supplemental payments to hospitals authorized
16		in Illinois' Medicaid State Plan in effect on June 30,
17		2018, which are scheduled to terminate under Illinois'
18		Medicaid State Plan on June 30, 2018, shall continue
19		subject to the availability of federal matching funds for
20		such expenditures.
21		(3) All assessments imposed under Section 5A-2, as they
22		are in effect on June 30, 2018, shall continue.
23		(4) Notwithstanding any other provision in this
24		subsection (c), the Department shall make monthly advance
25		payments to any safety-net hospital or critical access
26		hospital requesting such advance payments in an amount, as

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1		requested by the hospital, provided that the total monthly
2		payments to the hospital under this subsection shall not
3		exceed 1/12th of the payments the hospital would have
4		received under Sections 5A-12.2, 5A-12.4, and 5A-12.5 and
5		subsections (d) and (f) of Section 14-12.
6		Notwithstanding any other provision in this subsection
7		(c), the Department may make monthly advance payments to a
8		hospital requesting such advance payments in an amount, as
9		requested by the hospital, provided that the total monthly
10		payments to the hospital under this subsection shall not
11		exceed 1/12th of the payments the hospital would have
12		received under Sections 5A-12.2, 5A-12.4, and 5A-12.5 and
13		subsections (d) and (f) of Section 14-12.
14		Advance payments under this paragraph (4) shall be made
15		regardless of federal approval for federal financial
16		participation under Title XIX or XXI of the federal Social
17		Security Act.
18		As used in this paragraph (4), "safety-net hospital"
19		means a hospital as defined in Section 5-5e.1 for Rate Year
20		2017 or an Illinois hospital that meets the criteria in
21		paragraphs (2) and (3) of subsection (a) of Section 5-5e.1
22		for Rate Year 2017.
23		As used in this paragraph (4), "critical access
24		hospital" means a hospital that has such status as of June
25		30, 2018.
26		(5) The changes authorized under this subsection (c)

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1		shall continue, on the same time schedule as otherwise
2		authorized under this Article, until the effective date of
3		the new and revised methodologies and payments under Public
4		Act 100-581, which shall be the first day of the second
5		month following the date of approval by the federal Centers
6		for Medicare and Medicaid Services.
7		(Source: P.A. 100-581, eff. 3-12-18.)
8		Section 95. No acceleration or delay. Where this Act makes
9		changes in a statute that is represented in this Act by text
10		that is not yet or no longer in effect (for example, a Section
11		represented by multiple versions), the use of that text does
12		not accelerate or delay the taking effect of (i) the changes
13		made by this Act or (ii) provisions derived from any other
14		Public Act.