Clark Kaericher | Executive Director, Healthcare Council & Sr. VP of Government Affairs | 618-806-1501
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May 26, 2023
The purpose of the Healthcare Council is to develop and take actions to achieve affordable, accessible, efficient, high-quality healthcare options for the employers and residents of our state. We advocate for market-based solutions that encourage innovation in healthcare delivery – and work against costly mandates and burdensome regulations. Through quarterly meetings, the Council brings together the diverse voices of the healthcare community and provides a forum to interact with government and private sector leaders at the highest levels.
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They’ve been saying it for awhile now, but I’m very confident that TODAY is finally adjournment day. Ok, well a little after midnight tonight/tomorrow, but you get the point…
Rate Review One Step Closer to Law
HB 2296, Health Insurance Rate Review passed the Senate 38-19-0. This bill provides that beginning before or on May 1, 2026, and each May 1 thereafter, the Department of Insurance shall report to the Governor and the General Assembly on health insurance coverage, affordability, and cost trends.
In a win for the insurance community, any forms and rates filed for large employer group accident and health insurance shall be automatically deemed approved after 90 days after filing. Beginning plan year 2026, rate increases for all individual and small group accident and health insurance policies must be filed with the Department for approval. So-called unreasonable rate increases or inadequate rates shall be modified or disapproved.
Beginning plan year 2025, the Department shall post all insurers' rate filings and summaries on the Department's website. The Department shall open a 30-day public comment period on the date that a rate filing is posted on the website. After the close of the public comment period, the Department shall issue a decision to approve, disapprove, or modify a rate filing within 60 days, and post the decision on the Department's website.
Senator Fine pushed very hard for this bill and as of (very) late Thursday evening, it appears she is going to be successful. Frankly, I have real doubts about the Department’s ability to find and hire adequate staff to implement this and I fear their cost estimates are woefully short. For this reason, the insertion of the automatic approval was critically important. It will be interesting to watch whether this language creates a political issue as the minority party will likely be quick to blame the majority for any future increases to voters’ premiums.
Note that the annual Budget Implementation Bill (known as the bill) provides for up to $10 million annually from the Insurance Producer Administration Fund to administer the exchange.
First Medicaid Rate Increase in 28 Years
A long overdue Medicaid increase was passed late yesterday by the General Assembly. Providers will see their first increase since 1995. For perspective on how long ago this really is- during the last increase Coolio, TLC, Seal and Boyz II Men topped the Billboard charts.
While providers only received half the increase they requested, 10% as opposed to 20%, this represents much needed relief. As Senate Republicans pointed out on the floor, it rates had kept up with inflation over this time budgeteers would need to fund a 96% increase.
True story- every time my dad wants to complain about paying for something he’ll say “Do you know how much Medicaid pays me per hour with a patient?” Somehow I doubt my family will be hearing this ten percent less in the future.
State Based Exchange Passes Senate- Back to House on Concurrence Today
HB 579, State-Based Exchange passed the Senate 37-19-0. The Department of Insurance shall operate the Illinois Health Benefits Exchange as a State-based exchange using the federal platform by plan year 2025 and as a State-based exchange by plan year 2026. The Director of Insurance may elect to add a small business health options program to the Illinois Health Benefits Exchange. Provides that the General Assembly shall appropriate funds to establish the Illinois Health Benefits Exchange. Issuers must remit an assessment in monthly installments to the Department. Through the adoption of rules, the Director of Insurance may require that plans offered on the exchange conform with standardized plan designs.
Note that the assessment rate was lowered in the Senate by a half point to 3.5% from 4% as it passed the House. This is not an insignificant savings.
I fully expect the House to pass this bill today and for the Governor to sign. Whether we see any of the benefits materialize for small businesses as the proponents claim…I have my doubts.
Close Only Counts in Horseshoes…Another Year Without BIPA Reform
Nobody that’s read a single newsletter from the Illinois Chamber would doubt that BIPA reform has been a major priority of ours for several years now. We started this year with a list of seven reforms to the state’s misguided law, the major ones remain a retroactive limit to nuclear damages and a security exception like the one in the two other states to have followed us down this path.
It’s been a long road but this year we were very close to a deal. It fell apart at the last minute when neither retroactivity or a security exception was offered. A limitation on future suits is, genuinely, appreciated as a step in the right direction but ultimately the Chamber and our partners couldn’t agree. For me, it was a practical question. Had we agreed, I could picture the dozens of you that I’d have to call or text and known you’d be disappointed. On the other hand, without a crystal ball there was no way to know if any of you would be helped with prospective damage limitations. That last offer was later filed in HB 3811, Senate Amendment 4.
The Chamber partnered with a coalition that included the IMA, IRMA, NFIB, the Illinois Railroads, Hotel Association, Chicagoland Chamber, and the Illinois Truckers. When it became obvious that we’d have to wait a little longer for real reform, the group released the following statement:
“We thank Senate President Pro Tempore Bill Cunningham for his tireless and patient leadership in attempting to negotiate changes to the state’s ambiguous Biometric Information Privacy Act. Our goal through this process was to provide compliance clarity for entities operating in Illinois while maintaining strong privacy protections for individuals. While we are disappointed an agreement was not reached this Spring, we are hopeful a path remains to provide clarity surrounding the law, as requested in recent decisions by the Illinois Supreme Court. We continue to believe it is possible to implement a solution that balances personal security and common-sense application.”
Other Floor Votes
HB 2450, Healthcare Licensing/Education passed the House 103-1-0. This bill provides that for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional who has continuing education requirements must complete at least a one-hour course in training on cultural competency. A health care professional may count this one hour for completion of this course toward meeting the minimum credit hours required for continuing education. Provides that, notwithstanding any other provision of law, for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional whose license or registration renewal occurs every 2 years must complete all statutorily mandated topics within 3 renewal periods. Provides that if any additional statutorily mandated topics are added by law after the effective date of the amendatory Act, a health care professional whose license or registration renewal occurs every 2 years must complete all statutorily mandated topics within 4 renewal periods. Provides that, notwithstanding any other provision of law, for health care professional license or registration renewals occurring on or after January 1, 2025, a health care professional whose license or registration renewal occurs every 3 years must complete all statutorily mandated topics within 2 renewal periods. Provides that if any additional statutorily mandated topics are added by law after the effective date of the amendatory Act, then a health care professional whose license or registration renewal occurs every 3 years must complete all statutorily mandated topics within 3 renewal periods. Provides that the Department of Financial and Professional Regulation shall maintain on its website information regarding the current specific statutorily mandated training topics. Provides that each license or permit application or renewal form the Department provides to a health care professional must include a notification regarding the current requirements for the specific statutorily mandated topics. Amends the Illinois Controlled Substances Act. Provides that in accordance with the requirement for prescribers of controlled substances to undergo training under the federal Consolidated Appropriations Act, 2023 every prescriber who is licensed to prescribe controlled substances shall, during the pre-renewal period, complete one hour (rather than 3 hours) of continuing education on safe opioid prescribing practices offered or accredited by a professional association, State government agency, or federal government agency.
SB 1298, Medicaid Omnibus passed the House 72-31-0 and passed the Senate 44-0-2. This bill Creates the Substance Use Disorder Residential and Detox Rate Equity Act. Requires the General Assembly to appropriate sufficient funds to the Department of Human Services, for State Fiscal Year 2024 and for each State fiscal year thereafter, to ensure reimbursement rates will be increased and subsequently adjusted upward by an amount equal to the Consumer Price Index-U from the previous year, not to exceed 5% in any State fiscal year, for licensed or certified community-based substance use disorder treatment providers under community service grant programs for persons with substance use disorders, including, but not limited to, certain residential and withdrawal management services provided in accordance with criteria established by the American Society of Addiction Medicine. Amends the Illinois Public Aid Code. In the Medical Assistance Article of the Code, provides that on and after January 1, 2024, the inpatient, per diem rate to be paid to a hospital for inpatient psychiatric services shall be not less than 90% of the per diem rate established under a specified provision of the Code. Makes changes to provisions concerning funding to the human poison control center designated under the Poison Control System Act; hospital reimbursement rates for specified inpatient and outpatient services; medical assistance coverage for cognitive assessment and care planning services provided to a person who experiences signs or symptoms of cognitive impairment; the supportive living program rate for dementia care; and Prospective Payment System rates increases for federally qualified health centers. Amends the Specialized Mental Health Rehabilitation Act of 2013. Provides that beginning July 1, 2023, for improving the quality of life and the quality of care at specialized mental health rehabilitation facilities, a payment of no less than $10.50 per day, per single room occupancy shall be added to the existing $15 additional per day, per single room occupancy rate for a total of at least $25.50 per day, per single room occupancy. Sets forth a rate increase for each Medicaid-occupied bed in dual-occupancy rooms. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that, subject to federal approval, on and after July 1, 2023, the reimbursement rates paid to providers of private duty nursing services for medically fragile and technology dependent children shall be at a specified percentage rate higher than the reimbursement rates in effect for nursing services on June 30, 2023. Amends the Medical Assistance Article of the Illinois Public Aid Code. Increases the reimbursement rate for ventilator services, speech therapy services, physical therapy services, and occupational therapy services. Establishes a $60 personal needs allowance for nursing home residents who are eligible for medical assistance. Amends the Rebuild Illinois Mental Health Workforce Act. Increases the Mobile Crisis Response Medicaid Payment rate, the Crisis Intervention Medicaid Payment rate, and other specified rates. In a provision concerning reimbursement rates for ambulance services, provides that ambulance services includes medical transportation services provided by means of air ambulance. Provides for an increase in the base rate for both base charges and mileage charges for medical transportation services provided by means of an air ambulance. In a provision concerning the tiered exceptional care per diem rates for medically complex for the developmentally disabled facilities, provides that, subject to federal approval, each tier rate shall be increased 6% over the amount in effect on the effective date of the amendatory Act. Provides that, subject to federal approval, the Department of Healthcare and Family Services shall increase the base rate of reimbursement for both base charges and mileage charges for ground ambulance service providers not participating in the Ground Emergency Medical Transportation (GEMT) Program for medical transportation services provided by means of a ground ambulance to a level not lower than 140% (rather than 112%) of the base rate in effect as of January 1, 2023 (rather than July 30, 2018).
Rulemaking
No rulemaking of note in the May 19th report.
Articles of Interest
Don’t Forget to Register for the Women in Business Conference
June 21, 2023
8:30 am – 2:30 pm
NIU Center | 1120 E. Diehl Road Naperville, IL 60563
The Illinois Chamber welcomes you to our women's conference as we come together to discuss and further dreams of our already strong women for a stronger Illinois. This year's theme is "Celebrate Success." The robust agenda will provide time for networking and connecting with professionals, and topics providing takeaways for all to take back to the office or home. Sponsorships now available, more information here.
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