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HB 2552

MEDICAID-CHILDREN'S DENTAL

104th Regular Session Introduced by Joyce Mason

HB 2552 would raise Illinois Medicaid/CHIP pediatric dental reimbursement by 50% above 2025 rates, starting Jan 1, 2026, to improve access and boost dentist participation.

Rule 19(a) / Re-referred to Rules Committee
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Bill Summary · HB 2552

Summary — HB 2552 (Medicaid — Children's Dental)

Status: Filed in Illinois General Assembly (February 2025); Referred to Rules Committee.
Primary sponsor: Rep. Joyce Mason.
Effective date (if enacted): January 1, 2026.

Main purpose

HB 2552 directs a one-time upward adjustment to Medicaid reimbursement rates for pediatric dental services in Illinois. Its stated intent is to increase provider payment for dental services for children to improve access to care.

Key provision

  • Amends the Illinois Public Aid Code (305 ILCS 5/5-5) to require that, on and after January 1, 2026, reimbursement rates for all dental services for children shall be increased by 50% above the rates in effect on December 31, 2025.

Scope and implementation

  • Applies to "all dental services for children" covered under the Medical Assistance (Medicaid/CHIP) program in Illinois. The bill does not define a new age range; it uses the existing Medicaid/Children’s Health Insurance Program definitions already in state law.
  • The Department of Healthcare and Family Services (or relevant State Medicaid authority) would implement the increase by adjusting provider payment schedules and rate-setting procedures as necessary.
  • For managed care, claims and rate adjustments would follow existing procedures for payments through the Department or Managed Care Entities (MCEs), as appropriate.

Who is affected

  • Children enrolled in Illinois Medicaid and CHIP (beneficiaries) — potentially improved access to dental services.
  • Dental providers (general dentists, pediatric dentists, clinics) — higher reimbursement rates may increase provider participation in Medicaid.
  • Illinois Medicaid program and state budget — increased program expenditures to cover the higher payments; a portion of costs would be eligible for federal matching funds (FMAP).

Fiscal and operational considerations

  • The 50% increase will raise Medicaid dental expenditures for children; the bill does not specify appropriations or offsets. Actual state General Revenue impact depends on total dental spending for children and federal matching rates.
  • Administrative work required: updating fee schedules, notifying providers, and coordinating with MCE contracts and billing systems. Federal Medicaid rules and any necessary State Plan Amendments should be considered to ensure federal financial participation.

Legislative status / timeline

  • Filed/introduced in early February 2025 (filed Feb. 4, 2025 by Rep. Joyce Mason).
  • Referred to the Rules Committee; listed as Rule 19(a) / Re‑referred to Rules Committee (March 2025).
  • If enacted, the payment change takes effect January 1, 2026.

Note: Document materials provided also contain unrelated text from other states/sessions (including Arizona bill language). The summary above reflects the Illinois Public Aid Code amendment regarding pediatric dental reimbursement.

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

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