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SB 1737

DHFS-MCO-DURABLE MED EQUIPMENT

104th Regular Session Introduced by Lakesia Collins and 4 co-sponsors

SB 1737 - DHFS-MCO-DURABLE MED EQUIPMENT OverviewBill Number: SB 1737 Title: DHFS-MCO-DURABLE MED EQUIPMENT Status: Chief Sponsor Changed to Sen. David Koehler Introduced: Febru

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Bill Summary · SB 1737

SB 1737 - DHFS-MCO-DURABLE MED EQUIPMENT

Overview

Bill Number: SB 1737
Title: DHFS-MCO-DURABLE MED EQUIPMENT
Status: Chief Sponsor Changed to Sen. David Koehler
Introduced: February 27, 2025

Purpose and Intent

The primary goal of SB 1737 is to establish new requirements and oversight mechanisms for the provision of durable medical equipment (DME) to Medicaid managed care enrollees in Illinois. The bill aims to ensure that Medicaid managed care organizations (MCOs) provide timely access to necessary DME and improve transparency around the DME procurement and authorization process.

Key Provisions

  • Requires MCOs to establish a DME advisory committee to provide input on DME policies and procedures
  • Mandates that MCOs maintain an adequate network of DME suppliers and prohibits "exclusive contracts" that limit enrollee choice
  • Directs MCOs to develop and publish clear, standardized criteria for DME authorization decisions
  • Compels MCOs to provide written explanations for any DME denials or modifications, including information on the appeals process
  • Establishes timelines for MCOs to respond to DME prior authorization requests and deliver approved equipment
  • Empowers the Illinois Department of Healthcare and Family Services (DHFS) to monitor MCO compliance and impose penalties for violations

Affected Parties and Impacts

The primary stakeholders affected by SB 1737 are:

  • Medicaid managed care enrollees who rely on durable medical equipment
  • Durable medical equipment suppliers that contract with Illinois Medicaid MCOs
  • Medicaid managed care organizations operating in the state

The bill aims to improve access to necessary DME, enhance transparency, and strengthen enrollee protections within the Medicaid managed care system. Supporters argue it will help ensure equitable, timely provision of critical medical devices.

Procedural and Timeline Considerations

SB 1737 was introduced in the Illinois Senate on February 27, 2025 and has been referred to the Senate Health Committee for consideration. If passed by the committee, the bill would then proceed to a full Senate vote. Enactment would require the Governor's signature. The bill's sponsors hope to see it enacted into law by the end of the 2025 legislative session.

Compiled from official sources — confirm details with the bill’s official record.

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