Article V - MEDICAL ASSISTANCE
- Section 305 ILCS 5/5-1 - Declaration of purpose
- Section 305 ILCS 5/5-1.1 - Definitions
- Section 305 ILCS 5/5-1.2 - Recipient eligibility verification
- Section 305 ILCS 5/5-1.3 - Payer of Last Resort
- Section 305 ILCS 5/5-1.4 - Moratorium on Eligibility Expansions
- Section 305 ILCS 5/5-1.5 - COVID-19 public health emergency
- Section 305 ILCS 5/5-1.6 - Continuous eligibility; ex parte redeterminations
- Section 305 ILCS 5/5-2 - Classes of persons eligible
- Section 305 ILCS 5/5-2a - Medicaid State Plan; eligibility determination status
- Section 305 ILCS 5/5-2b - Medically fragile and technology dependent children eligibility and program; provider reimbursement rates
- Section 305 ILCS 5/5-2.01 - Medicaid Accountability through Transparency Program
- Section 305 ILCS 5/5-2.03 - Presumptive Eligibility
- Section 305 ILCS 5/5-2.05 - Children with Disabilities
- Section 305 ILCS 5/5-2.06 - Payment rates; Children's Community-Based Health Care Centers
- Section 305 ILCS 5/5-2.06a - Medically fragile children; reimbursement for legally responsible family caregivers
- Section 305 ILCS 5/5-2.07 - Use of Medicaid spend-down
- Section 305 ILCS 5/5-2.08 - Spousal Caregiver Demonstration
- Section 305 ILCS 5/5-2.09 - Enhanced federal medical assistance percentage
- Section 305 ILCS 5/5-2.1 - Property transfers
- Section 305 ILCS 5/5-2.1a - Treatment of trust amounts
- Section 305 ILCS 5/5-2.1d - Retroactive eligibility
- Section 305 ILCS 5/5-2.2 - Cooperation in establishing support obligation
- Section 305 ILCS 5/5-2.3 - Notice of rights concerning institutionalization
- Section 305 ILCS 5/5-24 - [Repealed] (§§ 5/5-2.4 — 5/5-24)
- Section 305 ILCS 5/5-2.10 - Increased accountability for nursing facilities
- Section 305 ILCS 5/5-3 - Residence
- Section 305 ILCS 5/5-4 - Amount and nature of medical assistance
- Section 305 ILCS 5/5-4.1 - Co-payments
- Section 305 ILCS 5/5-4.2 - (Text of Section from P.A. 103-593) Ambulance services payments
- Section 305 ILCS 5/5-4.2 - (Text of Section from P.A. 103-605) Ambulance services payments
- Section 305 ILCS 5/5-4.20 - [Repealed]
- Section 305 ILCS 5/5-4.21 - [Repealed]
- Section 305 ILCS 5/5-4.22 - [Repealed]
- Section 305 ILCS 5/5-4.23 - [Repealed]
- Section 305 ILCS 5/5-4.24 - [Repealed]
- Section 305 ILCS 5/5-4.25 - [Repealed]
- Section 305 ILCS 5/5-4.26 - [Repealed]
- Section 305 ILCS 5/5-4.27 - [Repealed]
- Section 305 ILCS 5/5-4.28 - [Repealed]
- Section 305 ILCS 5/5-4.29 - [Repealed]
- Section 305 ILCS 5/5-4.30 - [Repealed]
- Section 305 ILCS 5/5-4.31 - [Repealed]
- Section 305 ILCS 5/5-4.32 - [Repealed]
- Section 305 ILCS 5/5-4.33 - [Repealed]
- Section 305 ILCS 5/5-4.34 - [Repealed]
- Section 305 ILCS 5/5-4.35 - [Repealed]
- Section 305 ILCS 5/5-4.36 - [Repealed]
- Section 305 ILCS 5/5-4.37 - [Repealed]
- Section 305 ILCS 5/5-4.38 - [Repealed]
- Section 305 ILCS 5/5-4.39 - [Repealed]
- Section 305 ILCS 5/5-5 - (Text of Section from P.A. 103-593§5-5) Medical services
- Section 305 ILCS 5/5-5 - (Text of Section from P.A. 103-593§90-5) Medical services
- Section 305 ILCS 5/5-5 - (Text of Section from P.A. 103-605) Medical services
- Section 305 ILCS 5/5-5 - [Effective 1/1/2026] (Text of Section from P.A. 103-808) Medical services
- Section 305 ILCS 5/5-5 - (Text of Section from P.A. 103-909) Medical services
- Section 305 ILCS 5/5-5 - (Text of Section from P.A. 103-1040) Medical services
- Section 305 ILCS 5/5-5.01
- Section 305 ILCS 5/5-5.01a - (Text of Section from P.A. 103-593§15-5) Supportive living facilities program
- Section 305 ILCS 5/5-5.01a - (Text of Section from P.A. 103-593 §100-5) Supportive living facilities program
- Section 305 ILCS 5/5-5.01a - (Text of Section from P.A. 103-593 §165-5) Supportive living facilities program
- Section 305 ILCS 5/5-5.01a - (Text of Section from P.A. 103-605) Supportive living facilities program
- Section 305 ILCS 5/5-5.01a - (Text of Section from P.A. 103-886) Supportive living facilities program
- Section 305 ILCS 5/5-5.01b - Certified Nursing Assistant Intern Program
- Section 305 ILCS 5/5-5.02 - Hospital reimbursements
- Section 305 ILCS 5/5-5.03 - Trauma center adjustment
- Section 305 ILCS 5/5-5.04 - Persons Living With HIV/AIDS
- Section 305 ILCS 5/5-5.05 - Hospitals; psychiatric services
- Section 305 ILCS 5/5-5.05a - Reimbursement rates; community mental health centers
- Section 305 ILCS 5/5-5.05b - Access to psychiatric treatment
- Section 305 ILCS 5/5-5.05c - Access to physician services
- Section 305 ILCS 5/5-5.05d - Academic detailing for behavioral health providers
- Section 305 ILCS 5/5-5.05e - Tracking availability of beds for withdrawal management services
- Section 305 ILCS 5/5-5.05f - Medicaid coverage for peer recovery support services
- Section 305 ILCS 5/5-5.05g - Alignment of substance use prevention and recovery and mental health policy
- Section 305 ILCS 5/5-5.05h - Reimbursement rates for psychiatric evaluations and medication monitoring
- Section 305 ILCS 5/5-5.06 - Dental home initiative
- Section 305 ILCS 5/5-5.06a - Increased funding for dental services
- Section 305 ILCS 5/5-5.06b - Dental services
- Section 305 ILCS 5/5-5.06c - Access to prenatal and postpartum care
- Section 305 ILCS 5/5-5.06d - External cephalic version rate
- Section 305 ILCS 5/5-5.06e - Increased funding for dental services
- Section 305 ILCS 5/5-5.07 - Inpatient psychiatric stay; DCFS per diem rate
- Section 305 ILCS 5/5-5.08 - Dialysis center funding
- Section 305 ILCS 5/5-5.08a - Renal dialysis; add-on payments for home dialysis providers in skilled nursing facilities
- Section 305 ILCS 5/5-5.09 - Mental health professionals; veterans
- Section 305 ILCS 5/5-5.1 - Grouping of Facilities
- Section 305 ILCS 5/5-5.2 - (Text of Section from P.A. 103-593) Payment
- Section 305 ILCS 5/5-5.2 - (Text of Section from P.A. 103-605) Payment
- Section 305 ILCS 5/5-5.3 - Conditions of Payment-Prospective Rates-Accounting Principles
- Section 305 ILCS 5/5-5.4 - Standards of payment; Department of Healthcare and Family Services
- Section 305 ILCS 5/5-5.4a - [Repealed]
- Section 305 ILCS 5/5-5.4b - Publicly owned or publicly operated nursing facilities
- Section 305 ILCS 5/5-5.4c - [Repealed]
- Section 305 ILCS 5/5-5.4d - MDS Payment Methodology; Quarterly Rate Adjustments
- Section 305 ILCS 5/5-5.4e - Nursing Facilities; Ventilator Rates
- Section 305 ILCS 5/5-5.4f - Intermediate care facilities for persons with developmental disabilities quality workforce initiative
- Section 305 ILCS 5/5-5.4g - [Renumbered from 305 ILCS 5/5-5.4f] Minimum Data Set (MDS) Compliance Review; Preliminary Findings
- Section 305 ILCS 5/5-5.4h - Medicaid reimbursement for medically complex for the developmentally disabled facilities licensed under the MC/DD Act
- Section 305 ILCS 5/5-5.4i - Rates and reimbursements
- Section 305 ILCS 5/5-5.4j - ID/DD targeted Medicaid rate enhancement
- Section 305 ILCS 5/5-5.4k - Payments for long-acting injectable medications for mental health or substance use disorders
- Section 305 ILCS 5/5-5.5 - Elements of Payment Rate
- Section 305 ILCS 5/5-5.5a - Kosher kitchen and food service
- Section 305 ILCS 5/5-5.6 - Federal Requirements
- Section 305 ILCS 5/5-5.6a - [Repealed]
- Section 305 ILCS 5/5-5.6b - Prohibition against double payment
- Section 305 ILCS 5/5-5.7 - Cost Reports-Audits
- Section 305 ILCS 5/5-5.7a - Pandemic related stability payments for health care providers
- Section 305 ILCS 5/5-5.7b - Pandemic related stability payments to ambulance service providers in response to covid-19
- Section 305 ILCS 5/5-5.8 - Report on nursing home reimbursement
- Section 305 ILCS 5/5-5.8a - [Repealed]
- Section 305 ILCS 5/5-5.8b - Payment to Campus Facilities
- Section 305 ILCS 5/5-5.10 - Value-based purchasing
- Section 305 ILCS 5/5-5.11 - [Repealed]
- Section 305 ILCS 5/5-5.12 - Pharmacy payments
- Section 305 ILCS 5/5-5.12a - Title XIX waiver; pharmacy assistance program
- Section 305 ILCS 5/5-5.12b - Critical access care pharmacy program
- Section 305 ILCS 5/5-5.12c - Managed care organization uniform electronic prior authorization form; prescription benefits
- Section 305 ILCS 5/5-5.12d - Coverage for patient care services for hormonal contraceptives provided by a pharmacist
- Section 305 ILCS 5/5-5.12e - Managed care organization prior authorization of health care services
- Section 305 ILCS 5/5-5.12f - Prescription drugs for mental illness; no utilization or prior approval mandates
- Section 305 ILCS 5/5-5.13
- Section 305 ILCS 5/5-5.14 - Repealed
- Section 305 ILCS 5/5-5.14.5 - Treatment; substance use disorder and mental health
- Section 305 ILCS 5/5-5.15 - [Repealed]
- Section 305 ILCS 5/5-5.16 - Repealed internally, eff. 7-1-98
- Section 305 ILCS 5/5-5.17 - Separate reimbursement rate
- Section 305 ILCS 5/5-5.18 - Diagnosis accompanying request for reimbursement
- Section 305 ILCS 5/5-5.19 - Reimbursement request records
- Section 305 ILCS 5/5-5.20 - Clinic payments
- Section 305 ILCS 5/5-5.21 - [Repealed]
- Section 305 ILCS 5/5-5.22 - [Repealed]
- Section 305 ILCS 5/5-5.23 - Children's mental health services
- Section 305 ILCS 5/5-5.24 - Prenatal and perinatal care
- Section 305 ILCS 5/5-5.24a - (Text of Section from P.A. 103-593) Remote ultrasounds and remote fetal nonstress tests; reimbursement
- Section 305 ILCS 5/5-5.24a - [Effective 1/1/2025] (Text of Section from P.A. 103-870) Remote ultrasounds and remote fetal nonstress tests; reimbursement
- Section 305 ILCS 5/5-5.25 - Access to behavioral health, medical, and epilepsy treatment services
- Section 305 ILCS 5/5-5.26 - Multiple Sclerosis; Home Services; Waiver
- Section 305 ILCS 5/5-5.27 - Coverage for clinical trials
- Section 305 ILCS 5/5-5a - Waiver for home and community-based services
- Section 305 ILCS 5/5-5a.1 - Telehealth services for persons with intellectual and developmental disabilities
- Section 305 ILCS 5/5-5b - Payment Reductions
- Section 305 ILCS 5/5-5b.1 - Reimbursement rates; Fiscal Year 2015 reductions
- Section 305 ILCS 5/5-5c - Waiver for home and community-based services for traumatic brain injury (TBI) patients
- Section 305 ILCS 5/5-5d - Enhanced transition and follow-up services
- Section 305 ILCS 5/5-5e - Adjusted rates of reimbursement
- Section 305 ILCS 5/5-5e.1 - Safety-Net Hospitals
- Section 305 ILCS 5/5-5e.2 - Academic medical centers and major teaching hospital status
- Section 305 ILCS 5/5-5f - Elimination and limitations of medical assistance services
- Section 305 ILCS 5/5-5g - Long-term care patient; resident status
- Section 305 ILCS 5/5-5h - Long-term acute care hospital base rates
- Section 305 ILCS 5/5-5i - Rate increase for speech, physical, and occupational therapy services
- Section 305 ILCS 5/5-6 - Obligations incurred prior to death of a recipient
- Section 305 ILCS 5/5-7 - [Repealed]
- Section 305 ILCS 5/5-8 - Practitioners
- Section 305 ILCS 5/5-9 - Choice of Medical Dispensers
- Section 305 ILCS 5/5-10 - Entitlement to Social Services
- Section 305 ILCS 5/5-11 - Co-operative arrangements; contracts with other State agencies, health care and rehabilitation organizations, and fiscal intermediaries
- Section 305 ILCS 5/5-11a - Health Benefit Information Systems
- Section 305 ILCS 5/5-11.1 - Cooperative arrangements; contracts
- Section 305 ILCS 5/5-12 - Funeral and burial
- Section 305 ILCS 5/5-13 - Claim against estate of recipients
- Section 305 ILCS 5/5-13.1 - Cost-effectiveness waiver, hardship waivers, and making information about waivers more accessible
- Section 305 ILCS 5/5-13.2 - Notice of claim for payment or against estate
- Section 305 ILCS 5/5-13.5 - [Repealed]
- Section 305 ILCS 5/5-14 - Exemption for Townships
- Section 305 ILCS 5/5-15
- Section 305 ILCS 5/5-15.5 - Preventive physical examinations; demonstration program
- Section 305 ILCS 5/5-16 - Managed Care
- Section 305 ILCS 5/5-16.1 - Case Management Services
- Section 305 ILCS 5/5-16.2 - Long range plan for case management
- Section 305 ILCS 5/5-16.3 - Repealed
- Section 305 ILCS 5/5-16.4 - [Repealed]
- Section 305 ILCS 5/5-16.5 - Expedited payments
- Section 305 ILCS 5/5-16.6 - Provider compliance with certain requirements
- Section 305 ILCS 5/5-16.7 - [Effective Until 1/1/2026] Post-parturition care
- Section 305 ILCS 5/5-16.7 - [Effective 1/1/2026] Post-parturition care
- Section 305 ILCS 5/5-16.7a - Reimbursement For Epidural Anesthesia Services
- Section 305 ILCS 5/5-16.8 - (Text of Section from P.A. 103-605) Required health benefits
- Section 305 ILCS 5/5-16.8 - [Effective 1/1/2026] (Text of Section from P.A. 103-703) Required health benefits
- Section 305 ILCS 5/5-16.8 - [Effective 1/1/2025] (Text of Section from P.A. 103-758) Required health benefits
- Section 305 ILCS 5/5-16.8 - [Effective 1/1/2025] (Text of Section from P.A. 103-1024) Required health benefits
- Section 305 ILCS 5/5-16.8a - Rules concerning continuous glucose monitor coverage
- Section 305 ILCS 5/5-16.9 - Access to obstetrical and gynecological care
- Section 305 ILCS 5/5-16.10 - Managed care entities; marketing
- Section 305 ILCS 5/5-16.11 - Uniform standards applied to managed care entities
- Section 305 ILCS 5/5-16.12 - [Effective Until 1/1/2025] Managed Care Reform and Patient Rights Act
- Section 305 ILCS 5/5-16.12 - [Effective 1/1/2025] Managed Care Reform and Patient Rights Act
- Section 305 ILCS 5/5-16.13 - [Repealed]
- Section 305 ILCS 5/5-17 - Programs to improve access to hospital care
- Section 305 ILCS 5/5-18 - Repealed
- Section 305 ILCS 5/5-18.3 - Birth center; facility fee
- Section 305 ILCS 5/5-18.5 - [Effective Until 1/1/2025] Perinatal doula and evidence-based home visiting services
- Section 305 ILCS 5/5-18.5 - [Effective 1/1/2025] Perinatal doula and evidence-based home visiting services
- Section 305 ILCS 5/5-18.10 - Reimbursement for postpartum visits
- Section 305 ILCS 5/5-19 - Healthy Kids Program
- Section 305 ILCS 5/5-20 - Electronic health care card
- Section 305 ILCS 5/5-21 - Immunization
- Section 305 ILCS 5/5-22 - [Repealed]
- Section 305 ILCS 5/5-23 - Repealed internally effective July 1, 2003
- Section 305 ILCS 5/5-25 - Pediatric Asthma Initiative
- Section 305 ILCS 5/5-26 - Federal Family Opportunity Act
- Section 305 ILCS 5/5-27 - [Repealed]
- Section 305 ILCS 5/5-28 - Community Transition Resources
- Section 305 ILCS 5/5-29 - Income Limits and Parental Responsibility
- Section 305 ILCS 5/5-30 - Care Coordination
- Section 305 ILCS 5/5-30.1 - (Text of Section from P.A. 103-593) Managed care protections
- Section 305 ILCS 5/5-30.1 - (Text of Section from P.A. 103-885) Managed care protections
- Section 305 ILCS 5/5-30.2 - Monthly reports; managed care enrollment
- Section 305 ILCS 5/5-30.3 - Empowering meaningful patient choice in Medicaid Managed Care
- Section 305 ILCS 5/5-30.4 - [Renumbered from 305 ILCS 5/5-30.3] Provider inquiry portal
- Section 305 ILCS 5/5-30.5 - [Renumbered from 305 ILCS 5/5-30.3] Managed care; automatic assignment
- Section 305 ILCS 5/5-30.6 - Managed care organization contracts procurement requirement
- Section 305 ILCS 5/5-30.7 - Encounter data guidelines; provider fee schedule
- Section 305 ILCS 5/5-30.8 - Managed care organization rate transparency
- Section 305 ILCS 5/5-30.9 - [Renumbered from 305 ILCS 5/5-30.6] Disenrollment requirements; managed care organization
- Section 305 ILCS 5/5-30.10 - [Renumbered from 305 ILCS 5/5-30.8] Electronic report submission
- Section 305 ILCS 5/5-30.11 - Treatment of autism spectrum disorder
- Section 305 ILCS 5/5-30.12 - Managed care claim rejection and denial management
- Section 305 ILCS 5/5-30.13 - [Text of section from P.A. 101-209] Managed care reports; minority-owned and women-owned businesses
- Section 305 ILCS 5/5-30.14 - Medicaid managed care organizations; preferred drug lists
- Section 305 ILCS 5/5-30.16 - Medicaid Business Opportunity Commission
- Section 305 ILCS 5/5-30.17 - Medicaid Managed Care Oversight Commission
- Section 305 ILCS 5/5-30.18 - [Section Scheduled to be Repealed 12/31/2030] Service authorization program performance
- Section 305 ILCS 5/5-30a - Exemptions from managed care enrollment; children
- Section 305 ILCS 5/5-30b - Exemptions from managed care; ground ambulance services
- Section 305 ILCS 5/5-30d - Increased funding for transportation services
- Section 305 ILCS 5/5-31 - [Repealed]
- Section 305 ILCS 5/5-32 - [Repealed]
- Section 305 ILCS 5/5-33 - [Repealed]
- Section 305 ILCS 5/5-34 - [Repealed]
- Section 305 ILCS 5/5-35 - Personal needs allowance
- Section 305 ILCS 5/5-35.5 - Personal needs allowance; nursing home residents
- Section 305 ILCS 5/5-36 - Pharmacy benefits
- Section 305 ILCS 5/5-36.1 - Earned income for residents of community-integrated living arrangements
- Section 305 ILCS 5/5-36.5 - Education on mental health and substance use treatment services for children and young adults
- Section 305 ILCS 5/5-37 - Billing mechanism for preventive mental health services delivered to children
- Section 305 ILCS 5/5-38 - Alignment of children's mental health treatment systems
- Section 305 ILCS 5/5-39 - Behavioral health services for children; diagnostic assessment system
- Section 305 ILCS 5/5-40 - Human breast milk coverage
- Section 305 ILCS 5/5-41 - Inpatient hospitalization for opioid-related overdose or withdrawal patients
- Section 305 ILCS 5/5-42 - Tobacco cessation coverage; managed care
- Section 305 ILCS 5/5-43 - Supports Waiver Program for Young Adults with Developmental Disabilities
- Section 305 ILCS 5/5-44 - Screening, Brief Intervention, and Referral to Treatment
- Section 305 ILCS 5/5-45 - Reimbursement rates; substance use disorder treatment providers and facilities
- Section 305 ILCS 5/5-46 - General acute care hospitals
- Section 305 ILCS 5/5-47 - (Text of Section from P.A. 103-588) Medicaid reimbursement rates; substance use disorder treatment providers and facilities
- Section 305 ILCS 5/5-47 - (Text of Section from P.A. 103-605) Medicaid reimbursement rates; substance use disorder treatment providers and facilities
- Section 305 ILCS 5/5-48 - Increasing behavioral health service capacity in federally qualified health centers
- Section 305 ILCS 5/5-49 - Long-acting reversible contraception
- Section 305 ILCS 5/5-50 - Coverage for mental health and substance use disorder telehealth services
- Section 305 ILCS 5/5-51 - Proton beam therapy; managed care
- Section 305 ILCS 5/5-52 - (Text of Section from P.A. 103-593) Custom prosthetic and orthotic devices; reimbursement rates
- Section 305 ILCS 5/5-52 - [Effective 1/1/2026] (Text of Section from P.A. 103-703) Coverage for hormonal therapy to treat menopause
- Section 305 ILCS 5/5-52 - [Effective 1/1/2025] (Text of Section from P.A. 103-914) Custom prosthetic and orthotic devices; reimbursement rates
- Section 305 ILCS 5/5-53 - Coverage for self-measure blood pressure monitoring services
- Section 305 ILCS 5/5-55 - Reimbursement for music therapy services
- Section 305 ILCS 5/5-60 - Optometric services; reimbursement rates