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Aaron Winters | Executive Director, Healthcare Council | 847-334-6411
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The 2019 regular session of the Illinois General Assembly is in the books, and it has been a busy year in the healthcare space. There is still lots to unpack from the last week of session, but in the meantime we hope everyone is able to take breath and start enjoying the summer. On to the update!
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Budget Bills Move and Session Ends
After a whirlwind of activity, the General Assembly passed a laundry list of budget and big-ticket items in the final days of session. The House adjourned on Saturday and the Senate completed work yesterday.
SB262, the appropriations package for Fiscal Year 2020 was passed on a bipartisan roll call through both Chambers last week. The legislation authorizes approximately $40 billion in state spending (a 2 percent increase over the previous fiscal year).
SB689 was the operational revenue package that included the MCO tax.
We'll do a deeper dive on the healthcare-related changes in the Budget Implementation bill and healthcare-related capital items in our next update, but in the meantime, here is a summary of the big ticket items we tracked all year.
Session in Review
MCO Tax Passes General Assembly
Since the first weeks of session, we've been tracking a proposed health insurance tax that members of the General Assembly wanted to pass in order to obtain additional federal Medicaid funds. Originally modeled on Michigan's onerous and now defunct Health Insurance Claims Assessment which taxed 1% of paid claims, the recently passed budget includes a paired down version that impacts Medicaid managed care organizations and HMO commercial insurance plans. Self-insured plans and PPO plans are not impacted by the tax. Commercial HMO plans will be taxed at $2.40 per member per month, with Medicaid plans agreeing to be taxed at much higher amounts in order to maximize federal matching funds, much like the hospital assessment.
Medicaid Omnibus Sent to Governor
After months of negotiations between the members of the bicameral and bipartisan Medicaid Working Group, negotiated language passed the legislation this week making several reforms to the state's Medicaid program. SB1321 places additional requirements on MCOs regarding timely payments to providers, requires HFS create a dispute resolution process and portal regarding provider claims complaints, requires additional MCO reporting including medical loss ratio data and BEP efforts and includes additional requirements to speed Medicaid eligibility redeterminations. The legislation also instructs HFS and DHS to explore value-based payment model for behavioral health providers.
Heat But No Pharmaceutical Fire
Despite a variety of anti-pharmaceutical legislation this session including a stand-alone House Committee to address drug pricing, significant anti-manufacturer legislation failed to advance. In the final week of session Sen. Andy Manar introduced an amendment that sought to cap health insurance copays for insulin and empowered the Attorney General to investigate drug pricing, but the amendment was not called for a vote in committee.
On the pharmacy benefit manager front after an incredibly problematic first draft, the General Assembly did pass a negotiated PBM regulatory bill (HB465) unanimously. The Chamber originally opposed but went neutral following agreed-to amendments.
Nurse Staffing Ratio Bill Fails to Advance
Rep. Crespo's HB2604 (setting nurse staffing ratios) received a tremendous amount of behind-the-scenes attention in the final week of session, but ultimately the bill was never called due to a lack of votes. Additionally, threats about a scaled-down pilot program impacting two hospitals did not manifest. The Chamber strongly opposes dictating a one-size-fits all staffing requirement for hospitals.
Live to Die Another Day on Rate Review
After Sen. Fine and Rep. Morgan's legislation creating rate review for health insurance plans was bottled up in the Senate Insurance Committee, Sen. Fine reintroduced her language on a different piece of legislation (SB665) and got the bill assigned to Senate Human Services where it passed out easily. However, in large part due to a floor speech from Senate Insurance Chairman Napoleon Harris objecting to the move, the legislation did not receive the required 30 votes. The sponsors have made it clear that they will continue to pursue this anti-market legislation and we will continue to oppose future efforts.
Odds and Ends
In a last-minute move, an amendment was introduced last week in the House that impacts health insurance plans. SB 653 was an attempt by physical therapy providers to halt a change in how time-based billing is measured. The Chamber was opposed to this legislation as it legislates items that are best left to private contract negotiations. The legislation passed both Chambers in the final week of session.
HB2154 passed the House last week, and was the vehicle for insurance coverage mandates for first episode psychosis and assertive community treatment. The Chamber was opposed as no other jurisdiction in the country requires commercial services to cover these types of services.
SB1909 was never called for a vote in the House. The legislation, among other items, required insurers to cover behavioral health treatments without medical necessity review for two days and created a new appeal process. The Chamber submitted alternate appeal language that would have brought processes in line with other treatment models that would have made us neutral.
Want a full list of the bills that have passed both chambers? Click here.
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