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92_SB0165
LRB9203947DJpc
1 AN ACT in relation to public aid.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Public Aid Code is amended by
5 adding Section 5-23 as follows:
6 (305 ILCS 5/5-23 new)
7 Sec. 5-23. Disease management programs and services for
8 chronic conditions; pilot project.
9 (a) In this Section, "disease management programs and
10 services" means services administered to patients in order to
11 improve their overall health and to prevent clinical
12 exacerbations and complications, using cost-effective,
13 evidence-based practice guidelines and patient
14 self-management strategies. Disease management programs and
15 services include all of the following:
16 (1) A population identification process.
17 (2) Evidence-based or consensus-based clinical
18 practice guidelines, risk identification, and matching of
19 interventions with clinical need.
20 (3) Patient self-management and disease education.
21 (4) Process and outcomes measurement, evaluation,
22 management, and reporting.
23 (b) Subject to appropriations, the Department may
24 undertake a pilot project to study patient outcomes, for
25 patients with chronic diseases, associated with the use of
26 disease management programs and services for chronic
27 condition management. "Chronic diseases" include, but are not
28 limited to, diabetes, congestive heart failure, and chronic
29 obstructive pulmonary disease.
30 (c) The disease management programs and services pilot
31 project shall examine whether chronic disease management
-2- LRB9203947DJpc
1 programs and services for patients with specific chronic
2 conditions do any or all of the following:
3 (1) Improve the patient's overall health in a more
4 expeditious manner.
5 (2) Lower costs in other aspects of the medical
6 assistance program, such as hospital admissions, days in
7 skilled nursing homes, emergency-room visits, or more
8 frequent physician office visits.
9 (d) In carrying out the pilot project, the Department
10 shall examine all relevant scientific literature and shall
11 consult with health care practitioners including, but not
12 limited to, physicians, surgeons, and registered nurses.
13 (e) The Department shall consult with medical experts,
14 disease advocacy groups, and academic institutions to develop
15 criteria to be used in selecting a vendor for the pilot
16 project.
17 (f) The pilot project may not use any company whose
18 primary purpose is to market specific products or services,
19 other than disease management services to the entity
20 responsible for the patient's health care coverage.