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Illinois Statutes Chapter 305. Public Aid § 5/5H-3. Managed care assessment

Current as of January 01, 2025 | Updated by Findlaw Staff

§ 5H-3. Managed care assessment.

(a) There is imposed upon managed care organization member months an assessment, calculated on base year data, as set forth below for the appropriate tier:

(1) Tier 1: $78.90 per member month.

(2) Tier 2: $1.40 per member month.

(3) Tier 3: $2.40 per member month.

(b) The tiers are established as follows:

(1) Tier 1 includes the first 4,195,000 member months in a Medicaid managed care organization for the base year;

(2) Tier 2 includes member months over 4,195,000 in a Medicaid managed care organization during the base year; and

(3) Tier 3 includes member months during the base year in a managed care organization that is not a Medicaid managed care organization.

(c) For State fiscal year 2020, and for each State fiscal year thereafter, the Department may adjust rates or tier parameters or both in order to maximize the revenue generated by the assessment consistent with federal regulations and to meet federal statistical tests necessary for federal financial participation. Any upward adjustment to the Tier 3 rate shall be the minimum necessary to meet federal statistical tests.

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Cite this article: FindLaw.com - Illinois Statutes Chapter 305. Public Aid § 5/5H-3. Managed care assessment - last updated January 01, 2025 | https://codes.findlaw.com/il/chapter-305-public-aid/il-st-sect-305-5-5h-3/

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