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Pritzker signs major new Medicaid bill into law

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* Tribune

Illinois residents on Medicaid will have access to more services and some families with children in a state health insurance program may no longer have to pay premiums, thanks to a bill Gov. J.B. Pritzker signed into law Tuesday.

The new law puts into place an array of measures aimed at improving access to health care and affordability for those on Medicaid, which is a state and federally funded health insurance program for low-income people. More than 3 million people in Illinois were on Medicaid as of fiscal year 2020.

The law will give those on Medicaid access to marriage therapy and smoking cessation counseling, as well as require that every patient experiencing an opioid-related overdose or withdrawal be admitted to hospitals overnight when medically necessary. It increases the rates Medicaid will pay providers for certain services and will provide community-based support for veterans.

It will also require coverage of kidney transplant medications for undocumented people, among other things.

* Capitol News Illinois

Among many provisions, the bill provides that people covered under Medicaid will continue to be eligible throughout the COVID-19 public health emergency and for up to 12 months after the emergency expires.

It also calls on the Department of Healthcare and Family Services to establish a program for implementation of certified community behavioral health clinics by Jan. 1, 2022, and to develop a “comprehensive behavioral health strategy” that is to be submitted to the governor and General Assembly by July 1, 2022.

Other provisions include recognizing veteran support specialists as mental health professionals under the state’s Medicaid plan; coverage of both individual and group tobacco cessation programs; requiring in-patient treatment for anyone experiencing an opioid overdose or withdrawal if it’s determined to be medically necessary; coverage of kidney transplant medications regardless of a patient’s U.S. residency status; and providing a 10 percent increase, through March 31, 2022, in reimbursement rates for supportive living facilities, to be paid for with federal funds from the American Rescue Plan Act.

House Majority Leader Greg Harris, a Chicago Democrat and member of the Medicaid working group, said this year’s bill is aimed at addressing many of the health care disparities that have existed in Illinois for years but which were exacerbated by the COVID-19 pandemic.

* Center Square

Stephanie Altman, with Shriver Center on Poverty Law, said the new law ensures more people impacted by the pandemic are covered, despite their income and employment status, with a provision that continues Medicaid eligibility up to a year after the COVID-19 emergency is lifted by the governor.

“This legislation will also make health care coverage for children under the All Kids or CHIP program guaranteed under Medicaid without monthly premiums and reduce the harmful turning on and off of health care coverage permanently in Illinois,” Altman said at the signing ceremony in Downers Grove Tuesday.

The Illinois Health and Hospital Association praised aspects of the new law, including allowing inpatient detox services more than once in 60 days and requiring inpatient coverage for opioid withdrawal treatment, if medically necessary.

“There are other notable provisions in the Medicaid Omnibus legislation including a provision to require reimbursement for vaccinations at 70% of the median regional maximum rate; inpatient reimbursement for long-acting injectable medication for mental health and substance use disorders; a pilot program to prevent ‘lock-out’ kids who are staying beyond medical necessity; and reimbursement for immunosuppressive drugs for kidney transplants covered for noncitizens who meet residency and income criteria,” the group said in a policy position last month.

The bill passed both chambers without any opposition.

posted by Rich Miller
Wednesday, Jul 7, 21 @ 3:20 am

Comments

  1. The bill is here, it’s a big one if anyone wants to dig into it: https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2294&GAID=16&DocTypeID=SB&LegID=&SessionID=110&SpecSess=&Session=&GA=102

    The part I don’t understand is why the bill wants to ask the Feds to move all of the CHIP recipients into Medicaid (moving from Title XXI to XIX). My understanding is that the state gets more federal matching money for CHIP than non-ACA Title XIX (70% instead of 57%), so wouldn’t this be leaving money on the table? I know the hospital association put out a statement saying this would help them get more money, because some supplemental payments to hospitals get calculated differently for the two eligibility groups, but I don’t understand how the state doesn’t lose money if we make that switch.

    Comment by Perrid Wednesday, Jul 7, 21 @ 8:42 am

  2. - Perrid - Wednesday, Jul 7, 21 @ 8:42 am:

    Currently there is a combination CHIP here and this moves it to a Medicaid expansion CHIP.

    https://www.medicaid.gov/chip/state-program-information/index.html

    Comment by Shield Wednesday, Jul 7, 21 @ 8:46 am

  3. This bill should lower crime as it addresses mental health, substance abuse and even helps keep marriages intact.

    Crime being lowered should save the state money in the long run.

    Comment by 17% Solution Wednesday, Jul 7, 21 @ 10:45 am

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