il-v50i37-89-ill-adm-code-149: 89 Ill. Adm. Code 149 — Diagnosis Related Grouping (DRG) Prospective Payment System (PPS)
Public comment closed · opened September 11, 2026.
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This proposed amendment pursuant to an agency initiative to participate in the federal CGT Access Model, these amendments authorize reimbursement to hospitals for high-cost drugs that cost more than $1,000,000 outside their bundled payment rate methodology. Hospitals will submit claims for high-cost drugs separately and be reimbursed for these drugs consistent with existing reimbursement methodologies for physician administered drugs. These amendments are intended to conform with IL SPA-25-0009, which was approved on December 18, 2025 and effective January 1, 2026.
The agency’s own summary, as published.
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