MEDICAID-MCO PROMPT PAYMENT

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to adopt rules and policies within 90 days after the effective date of the amendatory Act for interest penalties to be imposed on managed care organizations for all delayed payments, as defined, to medical providers. Provides that if payment is not issued from the managed care organization to the medical provider within 30 days of receiving the funds from the State, it shall be considered a delayed payment and an interest penalty of 1.0% of any amount unpaid shall be added for each month or fraction thereof after the end of this 30-day period, until final payment is made. Provides that if payment is not issued from the managed care organization to the medical provider within 60 days of receiving the funds from the State, the interest penalty shall increase to 2.5% of any amount unpaid, until final payment is made. Provides that if payment is not issued from the managed care organization to the medical provider within 90 days of receiving the funds from the State, the interest penalty shall increase to 5% of any amount unpaid, until final payment is made. Requires managed care organizations to review in a timely manner each claim made to it and provide the Department with a quarterly report indicating certain information, including, but not limited to: (i) the number of claims and dollar amount received by the managed care organization from providers for that quarter; (ii) the average length of time for that quarter it took the managed care organization to pay a provider claim from when it was first submitted; and (iii) the total number and dollar amount of interest penalty payments incurred for that quarter. Requires the Department to annually review managed care payment times and provide details of delays in the Department's annual report.

• Dave SyversonR
• Linda HolmesD
• Terri BryantR