Illinois 103rd Regular Session Status: Introduced 1 D cosponsors

HB 5769 — MEDICAID-PROSTHETIC DEVICES

Last action — Referred to Rules Committee

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  1. 1
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 103rd Regular Session. It reached “Introduced” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that coverage for custom prosthetic and orthotic devices under the fee-for-service medical assistance program and under any Medicaid managed care plan shall be no less favorable than the terms and conditions that apply to substantially all medical and surgical benefits provided under the fee-for-service medical assistance program or the Medicaid managed care plan. Requires the Department of Healthcare and Family Services to increase the current 2024 Medicaid rate by 21% with staggered 7% increases on January 1, 2025, January 1, 2026, and January 1, 2027 under the fee-for-service medical assistance program for custom prosthetic and orthotic devices. Requires the Department to ensure that all Medicaid managed care plans comply with the network adequacy requirements for custom prosthetic, custom orthotic devices, and custom cranial remolding orthotic device services. Provides that the Department and contracted managed care organizations must comply with the Orthotics, Prosthetics, and Pedorthics Practice Act when making payments for custom orthotic and custom prosthetic devices.

Bill Text

How this bill changes current law

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AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill establishes reimbursement rates and coverage standards for custom prosthetic and orthotic devices under Illinois Medicaid.

  • 305 ILCS 5/5-52

    Coverage for custom prosthetic and orthotic devices under the fee-for-service medical assistance program and under any Medicaid managed care plan shall be no less favorable than the terms and conditions that apply to substantially all medical and surgical benefits provided under the fee-for-service medical assistance program or the Medicaid managed care plan.

    This establishes minimum coverage standards for custom prosthetic and orthotic devices in Medicaid.

  • 305 ILCS 5/5-52

    The Department shall increase the current 2024 Medicaid rate by 21% with staggered 7% increases on January 1, 2025, January 1, 2026, and January 1, 2027 under the fee-for-service medical assistance program for custom prosthetic and orthotic devices.

    This mandates a rate increase for custom prosthetic and orthotic devices under Medicaid.

  • 305 ILCS 5/5-52

    The Department must ensure that all Medicaid managed care plans comply with the network adequacy requirements for custom prosthetic, custom orthotic devices, and custom cranial remolding orthotic device services.

    This ensures network adequacy for the relevant services in Medicaid managed care plans.

  • 305 ILCS 5/5-52

    The Department and contracted managed care organizations must comply with the Orthotics, Prosthetics, and Pedorthics Practice Act when making payments for custom orthotic and custom prosthetic devices.

    This requires compliance with existing professional standards for payment practices.

Action History

  1. Referred to Rules Committee

  2. First Reading

  3. Filed with the Clerk by Rep. Will Guzzardi

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 182 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (182)

182 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Subjects

healthcare health-insurance
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Frequently asked questions

What does HB 5769 do?
Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that coverage for custom prosthetic and orthotic devices under the fee-for-service medical assistance program and under any Medicaid managed care plan shall be no less favorable than the terms and conditions that apply to substantially all medical and surgical benefits provided under the fee-for-service medical assistance program or the Medicaid managed care plan. Requires the Department of Healthcare and Family Services to increase the current 2024 Medicaid rate by 21% with staggered 7% increases on January 1, 2025, January 1, 2026, and January 1, 2027 under the fee-for-service medical assistance program for custom prosthetic and orthotic devices. Requires the Department to ensure that all Medicaid managed care plans comply with the network adequacy requirements for custom prosthetic, custom orthotic devices, and custom cranial remolding orthotic device services. Provides that the Department and contracted managed care organizations must comply with the Orthotics, Prosthetics, and Pedorthics Practice Act when making payments for custom orthotic and custom prosthetic devices.
Who sponsors HB 5769?
HB 5769 is sponsored by Will Guzzardi (Democrat).
What is the current status of HB 5769?
This bill died with 103rd Regular Session. It reached “Introduced” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HB 5769?
Track HB 5769 free on One Click Politics — get push/email alerts when it moves.

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