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SB 2647

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2025 Regular Session Introduced by Sollie Norwood

Requires Illinois Medicaid to reimburse pediatric primary care preventive and screening services at no less than 100% of Medicare rates, starting Jan 1, 2026.

Died In Committee
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Bill Summary · SB 2647

Summary — SB 2647 (Villivalam) — Pediatric primary care reimbursement

Short title / subject: Amend the Illinois Public Aid Code to set minimum Medicaid reimbursement rates for pediatric primary care preventive and screening services.

Sponsor: Sen. Ram Villivalam

Purpose and intent

The bill would require that, beginning January 1, 2026, providers offering pediatric primary care be reimbursed under Illinois medical assistance (Medicaid) at rates that are no lower than 100% of the Medicare program’s rates for preventive and screening services. The stated intent is to raise Medicaid reimbursement for pediatric preventive care to parity with Medicare for those services.

Key provisions

  • Adds Section 5-65 to the Medical Assistance Article of the Illinois Public Aid Code (305 ILCS 5).
  • Effective date provision: the reimbursement requirement begins January 1, 2026.
  • Reimbursement floor: pediatric primary care providers shall be reimbursed at rates no lower than 100% of Medicare rates for preventive and screening services.
  • Scope: limited to pediatric primary care and to preventive and screening services (as described in the bill text).

Who is affected

  • Primary affected parties: pediatric primary care providers who deliver preventive and screening services to patients covered by Illinois medical assistance (Medicaid).
  • Indirectly affected: children and families enrolled in Medicaid (through potential changes in provider participation and access), state Medicaid program administrators, and the state budget (if payments increase).

Procedural status & timeline

  • Introduced/Filed: March–April 2025 (sponsor filing listed as April 8, 2025).
  • Committee activity (per source): referred to committees, scheduled for and considered in a public hearing (testimony taken), and ultimately “left pending in committee.”
  • Final status listed in the provided materials: Died In Committee.

Fiscal and policy considerations

  • Raising Medicaid payments to at least 100% of Medicare for the specified services would likely increase program expenditures relative to current Medicaid rates and could require appropriation or budget adjustments.
  • Potential policy effects: improved provider participation in Medicaid, improved access to preventive pediatric care, and potential downstream public-health benefits; fiscal impact depends on number of services and current rate differentials.

Note on source inconsistencies

The supplied materials include some inconsistent administrative dates and subject classifications (e.g., a title in the prompt referencing election qualifications, and a committee referral to “Elections”), but the bill text clearly amends the Illinois Public Aid Code concerning pediatric primary care reimbursement (305 ILCS 5/5-65). The summary above reflects the bill text as introduced.

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

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