Illinois Compiled Statutes 305 ILCS 5/5-16.5 – Expedited payments
Current as of: 2024 | Check for updates
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(a) (Blank).
(b) In a county with a population of 3,000,000 or more, a managed care community network shall receive expedited payment of its capitated reimbursement for each of its managed care enrollees if both of the following criteria are met:
(1) At least 75% of its membership is composed of
(b) In a county with a population of 3,000,000 or more, a managed care community network shall receive expedited payment of its capitated reimbursement for each of its managed care enrollees if both of the following criteria are met:
(1) At least 75% of its membership is composed of
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hospitals that are qualified on or after July 1, 1994 as disproportionate share hospitals.
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(2) At least 75% of its managed care enrollees
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receive services at the disproportionate share hospitals or those hospitals’ affiliated sites.
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(c) For counties whose population is less than 3,000,000, the Illinois Department shall establish by rule the terms and conditions under which a managed care community network shall receive expedited payment, including a determination of the qualifying percentage criteria for disproportionate share hospitals and managed care enrollees within a network receiving services at disproportionate share hospitals or their affiliated sites.