Chapter 305 — PUBLIC AID

(305 ILCS 5/5-30.9) Sec. 5-30.9. Disenrollment requirements; managed care organization. Disenrollment of a Medicaid enrollee from a managed care organization under contract with the Department shall be in accordance with the requirements of 42 CFR 438.56 whenever a contract is te…

(305 ILCS 5/5-30a) Sec. 5-30a. Exemptions from managed care enrollment; children. Notwithstanding any other provision of law, the Department shall not require any of the following children to enroll in or transition to the State's managed care medical assistance program: (1) Chil…

(305 ILCS 5/5-30b) Sec. 5-30b. Exemptions from managed care; ground ambulance services. Notwithstanding any other provision of law, beginning on the effective date of this amendatory Act of the 102nd General Assembly, the Department shall exempt ground ambulance services as descr…

(305 ILCS 5/5-30d) Sec. 5-30d. Increased funding for transportation services. Beginning no later than January 1, 2023 and subject to federal approval, the amount allocated to fund rates for medi-car, service car, and attendant services provided to adults and children under the me…

(305 ILCS 5/5-31) Sec. 5-31. (Repealed). (Source: P.A. 98-104, eff. 7-22-13. Repealed by P.A. 103-593, eff. 6-7-24.)

(305 ILCS 5/5-32) Sec. 5-32. (Repealed). (Source: P.A. 98-104, eff. 7-22-13. Repealed by P.A. 103-593, eff. 6-7-24.)

(305 ILCS 5/5-33) Sec. 5-33. (Repealed). (Source: P.A. 98-674, eff. 6-30-14. Repealed internally, eff. 1-1-16.)

(305 ILCS 5/5-34) Sec. 5-34. (Repealed). (Source: P.A. 98-674, eff. 6-30-14. Repealed internally, eff. 1-1-16.)

(305 ILCS 5/5-35) Sec. 5-35. Personal needs allowance. (a) For a person who is a resident in a facility licensed under the ID/DD Community Care Act, the Community-Integrated Living Arrangements Licensure and Certification Act, the Specialized Mental Health Rehabilitation Act of 2…

(305 ILCS 5/5-35.5) Sec. 5-35.5. Personal needs allowance; nursing home residents. Subject to federal approval, on and after January 1, 2024, for a person who is a resident in a facility licensed under the Nursing Home Care Act for whom payments are made under this Article throug…

(305 ILCS 5/5-36) Sec. 5-36. Pharmacy benefits. (a)(1) The Department may enter into a contract with a third party on a fee-for-service reimbursement model for the purpose of administering pharmacy benefits as provided in this Section for members not enrolled in a Medicaid manage…

(305 ILCS 5/5-36.1) Sec. 5-36.1. Earned income for residents of community-integrated living arrangements. (a) Beginning no later than July 1, 2021, residents of facilities licensed under the Community-Integrated Living Arrangements Licensure and Certification Act who are determin…

(305 ILCS 5/5-36.5) Sec. 5-36.5. Education on mental health and substance use treatment services for children and young adults. The Department of Healthcare and Family Services shall develop a layman's guide to the mental health and substance use treatment services available in I…

(305 ILCS 5/5-37) Sec. 5-37. Billing mechanism for preventive mental health services delivered to children. (a) The General Assembly finds: (1) It is common for children to have mental health needs but to not have a full-blown diagnosis of a mental illness. Examples include, but …

(305 ILCS 5/5-38) Sec. 5-38. Alignment of children's mental health treatment systems. The Governor's Office shall establish, convene, and lead a working group that includes the Director of Healthcare and Family Services, the Secretary of Human Services, the Director of Public Hea…

(305 ILCS 5/5-39) Sec. 5-39. Behavioral health services for children; diagnostic assessment system. Beginning on July 1, 2022, if it is necessary to provide a diagnostic code for behavioral health services for children ages 5 and under, providers shall utilize a developmentally a…

(305 ILCS 5/5-4) (from Ch. 23, par. 5-4) Sec. 5-4. Amount and nature of medical assistance. (a) The amount and nature of medical assistance shall be determined in accordance with the standards, rules, and regulations of the Department of Healthcare and Family Services, with due r…

(305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1) Sec. 5-4.1. Co-payments. The Department may by rule provide that recipients under any Article of this Code shall pay a federally approved fee as a co-payment for services. No co-payment requirement can exist for renal dialysis, radiati…

(305 ILCS 5/5-4.2) Sec. 5-4.2. Ambulance services payments. (a) For ambulance services provided to a recipient of aid under this Article on or after January 1, 1993, the Illinois Department shall reimburse ambulance service providers at rates calculated in accordance with this Se…

(305 ILCS 5/5-4.20) Sec. 5-4.20. (Repealed). (Source: P.A. 88-380. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.21) Sec. 5-4.21. (Repealed). (Source: P.A. 90-372, eff. 7-1-98. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.22) Sec. 5-4.22. (Repealed). (Source: P.A. 87-861. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.23) Sec. 5-4.23. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.24) Sec. 5-4.24. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.25) Sec. 5-4.25. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.26) Sec. 5-4.26. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.27) Sec. 5-4.27. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.28) Sec. 5-4.28. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.29) Sec. 5-4.29. (Repealed). (Source: P.A. 87-861. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.30) Sec. 5-4.30. (Repealed). (Source: P.A. 88-380. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.31) Sec. 5-4.31. (Repealed). (Source: P.A. 90-372, eff. 7-1-98. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.32) Sec. 5-4.32. (Repealed). (Source: P.A. 87-861. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.33) Sec. 5-4.33. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.34) Sec. 5-4.34. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.35) Sec. 5-4.35. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.36) Sec. 5-4.36. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.37) Sec. 5-4.37. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.38) Sec. 5-4.38. (Repealed). (Source: P.A. 87-13. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-4.39) Sec. 5-4.39. (Repealed). (Source: P.A. 87-861. Repealed by P.A. 96-1530, eff. 2-16-11.)

(305 ILCS 5/5-40) Sec. 5-40. Human breast milk coverage. (a) Notwithstanding any other provision of this Act, pasteurized donated human breast milk, which may include human milk fortifiers if indicated by a prescribing licensed medical practitioner, shall be covered under a healt…

(305 ILCS 5/5-41) Sec. 5-41. Inpatient hospitalization for opioid-related overdose or withdrawal patients. Due to the disproportionately high opioid-related fatality rates among African Americans in under-resourced communities in Illinois, the lack of community resources, the com…

(305 ILCS 5/5-42) Sec. 5-42. Tobacco cessation coverage; managed care. Notwithstanding any other provision of this Article, a managed care organization under contract with the Department to provide services to recipients of medical assistance shall provide coverage for all tobacc…

(305 ILCS 5/5-43) Sec. 5-43. Supports Waiver Program for Young Adults with Developmental Disabilities. (a) The Department of Human Services' Division of Developmental Disabilities, in partnership with the Department of Healthcare and Family Services and stakeholders, shall study …

(305 ILCS 5/5-44) Sec. 5-44. Screening, Brief Intervention, and Referral to Treatment. As used in this Section, "SBIRT" means a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons who are at risk of developing…

(305 ILCS 5/5-45) Sec. 5-45. Reimbursement rates; substance use disorder treatment providers and facilities. Beginning on July 1, 2022, the Department of Human Services' Division of Substance Use Prevention and Recovery in conjunction with the Department of Healthcare and Family …

(305 ILCS 5/5-46) Sec. 5-46. General acute care hospitals. A general acute care hospital is authorized to file a notice with the Department of Public Health and the Health Facilities and Services Review Board to establish an acute mental illness category of service in accordance …

(305 ILCS 5/5-47) Sec. 5-47. Medicaid reimbursement rates; substance use disorder treatment providers and facilities. (a) Beginning on January 1, 2024, subject to federal approval, the Department of Healthcare and Family Services, in conjunction with the Department of Human Servi…

(305 ILCS 5/5-48) Sec. 5-48. Increasing behavioral health service capacity in federally qualified health centers. The Department of Healthcare and Family Services shall develop policies and procedures with the goal of increasing the capacity of behavioral health services provided…

(305 ILCS 5/5-49) Sec. 5-49. Long-acting reversible contraception. Subject to federal approval, the Department shall adopt policies and rates for long-acting reversible contraception by January 1, 2024 to ensure that reimbursement is not reduced by 4.4% below list price. The Depa…

(305 ILCS 5/5-5) Sec. 5-5. Medical services. The Illinois Department, by rule, shall determine the quantity and quality of and the rate of reimbursement for the medical assistance for which payment will be authorized, and the medical services to be provided, which may include all…