Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the supportive living facilities program, provides that sites for the operation of the program shall be selected by the Department of Healthcare and Family Services based upon criteria that may include the need for services in a geographic area, the availability of funding, the site's ability to meet the standards, and a need to increase access for Medicaid enrollees who need an alternative to nursing home care. Requires the Department to determine need utilizing the most recently available statewide report every 3 years, and to also consider the occupancy rates, vacancies, and waiting lists in surrounding operational supportive living program sites, and public comments. Provides that based on need, the Department shall make the final determination to establish geographic areas utilizing county or zip code-based geographic areas within a rate setting region as the basis for opening a competitive application process. Contains provisions on the analysis and other information required in the statewide report; primary market areas for supportive living program sites; and other matters. Effective immediately.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that any person who was initially determined to be eligible for medical assistance and is receiving institutional services or home and community-based services as authorized under the Article shall be presumed eligible for a continuation of coverage for such services during any redetermination process, unless the person experiences a material change in financial circumstances that results in the loss of eligibility. Requires any person who experiences a material change in financial circumstances that results in the loss of eligibility to notify the Department of Healthcare and Family Services. Permits the Department to conduct a redetermination of eligibility. Requires the Department to notify the person before the commencement of any redetermination and after the redetermination is concluded along with the results of the redetermination and the effective date of any eligibility change. Requires the Department to seek federal authorization, no later than January 1, 2028, to exempt persons with disabilities who are otherwise eligible for medical assistance from annual eligibility redeterminations, except that a full redetermination shall be conducted at least once every 5 years, regardless of whether a material change in financial circumstances has occurred.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to authorize coverage for screening by low-dose mammography for the presence of occult breast cancer for individuals 25 (rather than 35) years of age or older who are otherwise eligible for medical assistance. Requires the Department to convene 2 separate expert panels to review quality standards for mammography and establish quality standards for breast cancer treatment. Provides that subject to Department approval, rate methodology for screening and diagnostic mammography shall be based on the quality standards established by the expert panels and State qualified ACR Designated Comprehensive Breast Imaging Centers (formerly known as Breast Imaging Centers of Excellence). Requires the expert panels to establish a comprehensive and clinical methodology to inform women who are age-appropriate for screening mammography, but who have not received a mammogram within the previous 18 months, of the importance and benefits of screening mammography. Provides that within 2 years after the completion of a pilot program providing case-managing or patient navigation services for women diagnosed with breast cancer, the Department shall establish as a permanent initiative the Patient Assistance for Beneficiaries Diagnosed with Breast Cancer. Requires the Department to submit annual reports to the General Assembly detailing program outcomes, financial expenditures, and any recommendations for adjustments to maintain or enhance the program's effectiveness. Requires the Department to establish or facilitate training and continuing education opportunities specific to breast health and mammography for radiologists. Makes other changes. Effective immediately.
Amends the Rebuild Illinois Mental Health Workforce Act. Provides that, subject to federal approval, for dates of service on and after July 1, 2026, the Medicaid reimbursement rates for Assertive Community Treatment and Community Support Team services shall be increased by an amount appropriated for the purposes enumerated in the Act. Effective July 1, 2026.
Amends the Medical Assistance Article of the Illinois Public Aid Code. Expands medical assistance coverage to certain categories of lawfully present noncitizens. Sets income guidelines for qualifying persons age 19 through 64 and income guidelines for persons 65 years of age or older. Removes a provision permitting medical assistance coverage for up to 24 continuous months from the initial eligibility date, if otherwise eligible.
Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Allows the Department of Public Health to contract for a statewide mobile pregnancy application to promote awareness of maternal and infant health programs for Medicaid participants, eligible individuals, and the uninsured. Sets application requirements, data reporting standards, and payment terms. Provides for nondigital outreach. Directs the Department to issue a request for proposals within 180 days.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the Medicaid Access Adjustment payments to nursing facilities, provides that for dates of service beginning January 1, 2027, the Medicaid Access Adjustment shall be increased by $5.75 to $10.50 per diem. Provides that beginning January 1, 2027, facilities located outside of Rate Areas 6, 7, and 8 shall have the Medicaid percent of occupied bed days to be at least 60% of all occupied bed days adjusted quarterly to qualify for the Medicaid Access Adjustment. Provides that the remaining facilities shall have their threshold remain at 70%.
Amends the Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law of the Illinois Public Aid Code. Provides that the Article applies to a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Adds to the definition of "Demonstration Project", a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly facility-specific nursing component (instead of RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Effective immediately.
Provides that the Act may be referred to as the Illinois Newborn Equity Support Transfer (NEST) Program Act. Amends the Department of Human Services Act. Requires the Department of Human Services to establish and administer, subject to appropriations, the Illinois Newborn Equity Support Transfer (NEST) Program to provide direct cash assistance to eligible participants by July 1, 2026. Defines "participant" to mean any individual who gives birth in Illinois while enrolled in or eligible for Medicaid through Moms and Babies. Permits the Department to adopt any rules necessary to implement the NEST Program. Provides that program participants shall receive a $1,500 lump sum payment in or around the third trimester of pregnancy, prior to delivery; and a $500 monthly cash payment for the first 6 months following delivery. Requires the Department to submit reports to the General Assembly on a biennial basis that summarizes (1) the number of program participants and distribution across the State, (2) outcomes related to maternal and child health, housing stability, and economic security, or other outcomes identified by the Department in collaboration with stakeholders, and (3) recommendations for program improvements or additional populations beyond Medicaid enrollment to include as participants. Provides that cash disbursements made to participants under the NEST Program shall be considered "guaranteed income" as described in the Hospital Uninsured Patient Discount Act for purposes of determining eligibility for assistance under the Illinois Public Aid Code. Effective immediately.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the supportive living facilities program, prohibits a supportive living dementia care setting from limiting a resident's access to the sink, microwave, or refrigerator located within the respective resident's room, provided a comprehensive safety assessment deems the resident's use of the appliances safe. Requires the comprehensive safety assessment to be conducted prior to any resident moving in and at least once per quarter thereafter. Requires social and recreational programming to be provided no less than 3 times daily, including at least one time and location separate from a meal service. Requires newly constructed supportive living dementia care settings to provide no less than 300 square feet for a single occupancy apartment or no less than 450 square feet for a double occupancy apartment, which may include the closets and bathroom. Requires each apartment to include a sink, microwave, and refrigerator within the unit. Provides that any newly constructed supportive living dementia care setting shall provide a common area completely separate from the dining area.
