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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | |||||||||||||||||||
5 | changing Section 5-18.5 as follows: | |||||||||||||||||||
6 | (305 ILCS 5/5-18.5) | |||||||||||||||||||
7 | Sec. 5-18.5. Perinatal doula and evidence-based home | |||||||||||||||||||
8 | visiting services. | |||||||||||||||||||
9 | (a) As used in this Section: | |||||||||||||||||||
10 | "Home visiting" means a voluntary, evidence-based strategy | |||||||||||||||||||
11 | used to support pregnant people, infants, and young children | |||||||||||||||||||
12 | and their caregivers to promote infant, child, and maternal | |||||||||||||||||||
13 | health, to foster educational development and school | |||||||||||||||||||
14 | readiness, and to help prevent child abuse and neglect. Home | |||||||||||||||||||
15 | visitors are trained professionals whose visits and activities | |||||||||||||||||||
16 | focus on promoting strong parent-child attachment to foster | |||||||||||||||||||
17 | healthy child development. | |||||||||||||||||||
18 | "Perinatal doula" means a trained provider who provides | |||||||||||||||||||
19 | regular, voluntary physical, emotional, and educational | |||||||||||||||||||
20 | support, but not medical or midwife care, to pregnant and | |||||||||||||||||||
21 | birthing persons before, during, and after childbirth, | |||||||||||||||||||
22 | otherwise known as the perinatal period. | |||||||||||||||||||
23 | "Perinatal doula training" means any doula training that |
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1 | focuses on providing support throughout the prenatal, labor | ||||||
2 | and delivery, or postpartum period, and reflects the type of | ||||||
3 | doula care that the doula seeks to provide. | ||||||
4 | (b) Notwithstanding any other provision of this Article, | ||||||
5 | perinatal doula services and evidence-based home visiting | ||||||
6 | services shall be covered under the medical assistance | ||||||
7 | program, subject to appropriation, for persons who are | ||||||
8 | otherwise eligible for medical assistance under this Article. | ||||||
9 | Perinatal doula services include regular visits beginning in | ||||||
10 | the prenatal period and continuing into the postnatal period, | ||||||
11 | inclusive of continuous support during labor and delivery, | ||||||
12 | that support healthy pregnancies and positive birth outcomes. | ||||||
13 | Perinatal doula services may be embedded in an existing | ||||||
14 | program, such as evidence-based home visiting. Perinatal doula | ||||||
15 | services provided during the prenatal period may be provided | ||||||
16 | weekly, services provided during the labor and delivery period | ||||||
17 | may be provided for the entire duration of labor and the time | ||||||
18 | immediately following birth, and services provided during the | ||||||
19 | postpartum period may be provided up to 12 months postpartum. | ||||||
20 | (b-5) Notwithstanding any other provision of this Article, | ||||||
21 | midwifery services shall be covered under the medical | ||||||
22 | assistance program, subject to appropriation, for persons who | ||||||
23 | are otherwise eligible for medical assistance under this | ||||||
24 | Article. The Department shall consult with midwives on | ||||||
25 | formulating rules concerning reimbursement rates for midwifery | ||||||
26 | services. The reimbursement rates for the following related |
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1 | services shall be increased by 6% for dates of service on and | ||||||
2 | after January 1, 2023: | ||||||
3 | 59409 Vaginal Delivery Only. | ||||||
4 | 59410 Obstetrical Care; Vaginal Delivery Only | ||||||
5 | Including Postpartum Care. | ||||||
6 | 59514 Cesarean Delivery Only. | ||||||
7 | 59515 Cesarean Delivery Postpartum. | ||||||
8 | 59612 Vaginal Delivery Only, After Previous Cesarean | ||||||
9 | Delivery. | ||||||
10 | 59614 Vaginal Delivery After Previous Cesarean | ||||||
11 | Section, Including Postpartum Care. | ||||||
12 | 59620 Cesarean Section Delivery After Attempted | ||||||
13 | Vaginal Delivery After Previous Cesarean Section. | ||||||
14 | 59622 Cesarean Section After Attempted Vaginal | ||||||
15 | Delivery Intravenous/Cesarean Section/Including | ||||||
16 | Postpartum Care. | ||||||
17 | 99201 Evaluation and Management Office/Other Health | ||||||
18 | Visit New Patient. | ||||||
19 | 99202 Evaluation and Management Office/Other Health | ||||||
20 | Visit New Patient. | ||||||
21 | 99203 Office or Other Outpatient Visit for the | ||||||
22 | Evaluation and Management of a New Patient. | ||||||
23 | 99204 Office or Other Outpatient Visit for the | ||||||
24 | Evaluation and Management of a New Patient. | ||||||
25 | 99205 Office or Other Outpatient Visit for the | ||||||
26 | Evaluation and Management of a New Patient. |
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1 | 99211 Face-to-Face Encounter With a Patient Consisting | ||||||
2 | of Elements of Both Evaluation. | ||||||
3 | 99212 Office or Other Outpatient Visit for the | ||||||
4 | Evaluation and Management of an Established Patient. | ||||||
5 | 99213 Office or Other Outpatient Visit for the | ||||||
6 | Evaluation and Management of an Established Patient. | ||||||
7 | 99214 Office or Other Outpatient Visit for the | ||||||
8 | Evaluation and Management of an Established Patient. | ||||||
9 | 99215 Office or Other Outpatient Visit for the | ||||||
10 | Evaluation and Management of an Established Patient. | ||||||
11 | 99381 Initial Comprehensive Preventive Medicine | ||||||
12 | Evaluation and Management of an Individual Including an | ||||||
13 | Age and Gender Appropriate History. | ||||||
14 | 99382 Initial Comprehensive Preventive Medicine | ||||||
15 | Evaluation and Management of an Individual Including an | ||||||
16 | Age and Gender Appropriate History, Examination, | ||||||
17 | Counseling/Anticipatory Guidance/Risk Factor Reduction | ||||||
18 | Interventions. | ||||||
19 | 99383 Initial Comprehensive Preventive Medicine | ||||||
20 | Evaluation and Management of an Individual Including an | ||||||
21 | Age and Gender Appropriate History. | ||||||
22 | 99384 New Patient Preventive Medicine Services. | ||||||
23 | 99385 Initial Comprehensive Preventive Medicine | ||||||
24 | Evaluation and Management of an Individual Including an | ||||||
25 | Age and Gender Appropriate History, Examination, | ||||||
26 | Counseling/Anticipatory Guidance/Risk Factor Reduction |
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1 | Interventions. | ||||||
2 | 99386 Initial Comprehensive Preventive Medicine | ||||||
3 | Evaluation and Management of an Individual Including an | ||||||
4 | Age and Gender Appropriate History, Examination. | ||||||
5 | 99387 New Patient Preventive Medicine Services. | ||||||
6 | 99391 Periodic Comprehensive Preventive Medicine | ||||||
7 | Reevaluation and Management of an Individual Including an | ||||||
8 | Age and Gender Appropriate History. | ||||||
9 | 99392 Periodic Reevaluation Healthy Child. | ||||||
10 | 99393 Periodic Reevaluation Healthy Child. | ||||||
11 | 99394 Periodic Reevaluation Healthy Adolescent. | ||||||
12 | 99395 Periodic Reevaluation/Management 18-39 Years. | ||||||
13 | 99396 Periodic Reevaluation/Management 40-64 Years. | ||||||
14 | 99397 Periodic Reevaluation/Management 65 Years and | ||||||
15 | Greater. | ||||||
16 | (c) The Department of Healthcare and Family Services shall | ||||||
17 | adopt rules to administer this Section. In this rulemaking, | ||||||
18 | the Department shall consider the expertise of and consult | ||||||
19 | with doula program experts, doula training providers, | ||||||
20 | practicing doulas, and home visiting experts, along with State | ||||||
21 | agencies implementing perinatal doula services and relevant | ||||||
22 | bodies under the Illinois Early Learning Council. This body of | ||||||
23 | experts shall inform the Department on the credentials | ||||||
24 | necessary for perinatal doula and home visiting services to be | ||||||
25 | eligible for Medicaid reimbursement and the rate of | ||||||
26 | reimbursement for home visiting and perinatal doula services |
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1 | in the prenatal, labor and delivery, and postpartum periods. | ||||||
2 | Every 2 years, the Department shall assess the rates of | ||||||
3 | reimbursement for perinatal doula and home visiting services | ||||||
4 | and adjust rates accordingly. | ||||||
5 | (d) The Department shall seek such State plan amendments | ||||||
6 | or waivers as may be necessary to implement this Section and | ||||||
7 | shall secure federal financial participation for expenditures | ||||||
8 | made by the Department in accordance with this Section.
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9 | (Source: P.A. 102-4, eff. 4-27-21.)
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10 | Section 99. Effective date. This Act takes effect upon | ||||||
11 | becoming law.
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