Medicaid Transparency Bill Becomes Law!

by Kristina Rasmussen The Medicaid transparency bill championed by Rep. Patti Bellock and the Illinois Policy Institute was signed into law by Governor Pat Quinn! The bill authorizes the Director of the Department of Healthcare and Family Services to create an online transparency portal like South Carolina’s website — let’s ask the Director to build onsunshine.illinois.gov and create one without delay. Director Julie...

by Kristina Rasmussen

The Medicaid transparency bill championed by Rep. Patti Bellock and the Illinois Policy Institute was signed into law by Governor Pat Quinn!

The bill authorizes the Director of the Department of Healthcare and Family Services to create an online transparency portal like South Carolina’s website — let’s ask the Director to build onsunshine.illinois.gov and create one without delay. Director Julie Hamos can be reached at 217-782-1200 or 312-793-4792.

For your reading pleasure, here’s the full text of the law:

Public Act 096-0941

HB5241 Enrolled    LRB096 16158 KTG 31409 b

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois,
represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by
adding Section 5-2.01 as follows:

(305 ILCS 5/5-2.01 new)
Sec. 5-2.01. Medicaid accountability through transparency
program.
(a) Internet-based transparency program. The Director of
the Department of Healthcare and Family Services shall be
authorized to implement a program under which the Director
shall make available through the Department’s public Internet
website information on medical claims reimbursed under the
State’s medical assistance program insofar as such information
has been de-identified in accordance with regulations
promulgated pursuant to the Illinois Health Insurance
Portability and Accountability Act. In implementing the
program, the Director shall ensure the following:
(1) The information made so available shall be in a
format that is easily accessible, useable, and
understandable to the public, including individuals
interested in improving the quality of care provided to
individuals eligible for items and services under this
Article, researchers, health care providers, and
individuals interested in reducing the prevalence of waste
and fraud under this Article.
(2) The information made so available shall be as
current as deemed practical by the Director and shall be
updated at least once per calendar quarter.
(3) The information made so available shall be
aggregated to a level to ensure patient confidentiality,
but shall, to the extent feasible, allow for posting of
information by provider or vendor name and county, number
of individuals served, total patient visits, payment for
bills submitted, average cost for bills submitted,
adjustments to payments, and total amounts paid.
(4) The Director periodically solicits comments from a
sampling of individuals who access the information through
the program on how to best improve the utility of the
program.
(b) Use of contractor. For purposes of implementing the
program under subsection (a) of this Section and ensuring the
information made available through the program is periodically
updated, the Director may select and enter into a contract with
a public or private entity meeting the criteria and
qualifications the Director determines appropriate.
(c) Annual Reports. Not later than 12 months after the
effective date of this amendatory Act of the 96th General
Assembly and annually thereafter, the Director shall submit to
the General Assembly a report on the status of the program
authorized under subsection (a). The report shall include
details including, but not limited to, the estimated or actual
costs of developing and maintaining the reporting system, the
actual or potential benefit or adverse consequences associated
with the system, and, if applicable, the extent to which
information made available through the program is accessed and
the extent to which comments received under paragraph (4) of
subsection (a) of this Section were used to improve the utility
of the program.

Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 06/25/2010