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SPONSORED LEGISLATION
HB4980 - MEDICAID-SERVICE AUTHORIZATION
Robyn Gabel, Dagmara Avelar
Last updated 8 months ago
2 Co-Sponsors
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to: (1) adopt a single, uniform service authorization program under which service authorization determinations for all individuals enrolled in a managed care organization (MCO) shall be made by the Department's contracted utilization review organization (URO), as defined; (2) require all service authorization determinations made by the URO to be binding upon the MCO; (3) prohibit an MCO from denying or reducing payment of a claim, or recouping payment of a paid claim, for health care services approved by the URO, except in cases of fraud; (4) adopt certain rules concerning service authorization determinations; (5) seek approval from the federal Centers for Medicare and Medicaid Services for enhanced federal matching funds for such improvements to the Department's Medicaid Management Information System to implement the single, uniform service authorization program; and other matters. Makes these changes applicable to managed care contracts issued, amended, delivered, or renewed on or after January 1, 2025. Makes changes to provisions on when an MCO is required to pay for post-stabilization services as a covered service. Prohibits MCOs and the URO from imposing any requirements for prior approval of emergency services. Provides that MCOs are not obligated to cover health care services, as defined, that are provided on an emergency basis but are not covered services under its contract with the Department. Requires the Department to impose sanctions on an MCO for noncompliance, including, but not limited to, financial penalties, suspension of enrollment of new enrollees, and termination of the MCO's contract with the Department. Effective immediately.
STATUS
Introduced
HB4978 - DHFS-EXTENDED HOSP STAYS
Robyn Gabel, Dagmara Avelar
Last updated 8 months ago
2 Co-Sponsors
Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to by rule implement a methodology to reimburse hospitals for inpatient stays extended beyond medical necessity due to the inability of the Department, the managed care organization (MCO) in which a medical assistance recipient is enrolled in, or the hospital discharge planner to find an appropriate placement after discharge from the hospital to the next level of care. Requires the Department to by rule implement a methodology effective for dates of service January 1, 2025 and later to reimburse hospitals for emergency department stays extended beyond medical necessity due to the inability of the Department, the MCO, or the hospital discharge planner to find an appropriate placement after discharge from the hospital setting to the next appropriate level of care. Provides that both methodologies shall provide reasonable compensation for the services provided attributable to the hours of the extended stay for which the prevailing rate methodology provides no reimbursement. Contains provisions concerning the rate for inpatient days of care; hourly rates of reimbursement for emergency department stays; a prohibition on MCOs restricting coverage due to delays caused by the Department or the MCOs in completing the pre-admission screening and resident review process; a prohibition on MCOs imposing authorization or documentation requirements and other conditions of reimbursement that are more restrictive than standards under the fee-for-service medical assistance program; sanctions on MCOs for noncompliance; and administrative rules. Effective immediately.
STATUS
Introduced
HR0652 - CONGRATS-JOEL J. AFRICK
Robyn Gabel
Last updated 6 months ago
1 Co-Sponsor
Congratulates Joel Africk on his retirement from full-time employment as the CEO of Respiratory Health and commends him on his many years of service on behalf the residents in the State of Illinois and beyond.
STATUS
Passed
HB5142 - PREGNANCY/POSTPARTUM CARE
Robyn Gabel, Anna Moeller, Mary Beth Canty
Last updated about 2 months ago
67 Co-Sponsors
Reinserts the provisions of the bill as amended by House Amendment No. 1 with changes. Further amends the Illinois Insurance Code. Provides that coverage for abortion care may not impose any deductible, coinsurance, waiting period, or other cost-sharing limitation, except to the extent that the coverage would disqualify a high-deductible health plan from eligibility for a health savings account (rather than coverage for abortion care may not impose any deductible, coinsurance, waiting period, or other cost-sharing limitation that is greater than that required for other pregnancy-related benefits covered by the policy). Defines "perinatal doula" and "lactation consultant". Provides that coverage for postpartum services shall apply for all covered services rendered within the first 12 months after the end of pregnancy (rather than the coverage shall apply for at least one year after the end of pregnancy), except that a policy is not required to cover more than $8,000 for doula visits for each pregnancy and subsequent postpartum period. Provides that all outpatient coverage, other than health care services for home births, required under a provision concerning coverage for pregnancy, postpartum, and newborn care must be provided without cost sharing, except that, for mental health services, the cost-sharing prohibition does not apply to inpatient or residential services, and, for treatment of substance use disorders, the prohibition on cost-sharing applies to the levels of treatment below and not including Level 3.1 (Clinically Managed Low-Intensity Residential) established by the American Society of Addiction Medicine. Makes other changes. Effective January 1, 2026, except that certain changes to the Illinois Public Aid Code are effective January 1, 2025.
STATUS
Passed
HB5135 - PROFESSIONS–SKIN GROWTH ED
Robyn Gabel, Harry Benton, William Cunningham
Last updated about 1 month ago
3 Co-Sponsors
Reinserts the provisions of the introduced bill with the following changes. Deletes the proposed amendments to the Illinois Physical Therapy Act. Provides, in the remaining Acts, that the provisions added by the introduced bill are not to be construed to require or permit licensees or applicants under those Acts to practice medicine or otherwise practice outside of their specific scope of practice. Provides that a person licensed under the affected Acts may refer an individual to seek care from a medical professional regarding an abnormal skin growth. Specifies that neither a person licensed under the affected Acts who completes abnormal skin growth education as a part of the person's continuing education, nor the person's employer, shall be civilly or criminally liable for acting in good faith or failing to act on information obtained during the course of practicing in the person's profession or employment concerning potential abnormal skin growths.
STATUS
Passed
HB4112 - INS CD-INFERTILITY COVERAGE
Margaret Noble Croke, Harry Benton, Eva Dina Delgado
Last updated about 1 year ago
38 Co-Sponsors
Amends the Illinois Insurance Code. Provides that no group policy of accident and health insurance providing coverage for more than 25 employees that provides pregnancy related benefits may be issued, amended, delivered, or renewed in this State on or after January 1, 2025 unless the policy contains coverage for the diagnosis and treatment of infertility. Requires such coverage to include procedures necessary to screen or diagnose a fertilized egg before implantation. Provides that coverage for in vitro fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer shall be required only if the procedures: (1) are considered medically appropriate based on clinical guidelines or standards developed by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, or the Society for Assisted Reproductive Technology; and (2) are performed at medical facilities or clinics that conform to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization or the American Society for Reproductive Medicine minimum standards for practices offering assisted reproductive technologies. Makes changes in the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to provide that infertility insurance must be included in health insurance coverage for employees. Effective immediately.
STATUS
Introduced
HB5401 - GOVERNMENT-TECH
Robyn Gabel
Last updated 8 months ago
1 Co-Sponsor
Amends the State Employees Group Insurance Act of 1971. Makes a technical change in a Section concerning the short title.
STATUS
Introduced
HB5629 - EDUCATION-TECH
Robyn Gabel
Last updated 8 months ago
1 Co-Sponsor
Amends the Higher Education Student Assistance Act. Makes a technical change in a Section concerning the short title.
STATUS
Introduced
HB5386 - WETLANDS AND SMALL STREAMS
Anna Moeller, Nicholas K. Smith, Terra Costa Howard
Last updated 8 months ago
47 Co-Sponsors
Creates the Wetlands and Small Streams Protection Act to restore protections for wetlands and small streams that were formerly protected from pollution and destruction by the Clean Water Act. Provides provisions concerning: exemptions; wetlands delineation, classification, notification, permits and veto; general permits; appeal of final decisions made by the Department of Natural Resources and judicial review; investigation and enforcement; and county authority. Creates the Wetlands and Small Streams Advisory Committee and establishes duties and rules for the Committee. Creates the Wetlands and Small Streams Protection Fund. Provides for permit review fees. Defines terms. Makes conforming changes in the State Finance Act and the Illinois Environmental Protection Act. Effective immediately.
STATUS
Introduced
HR0606 - EQUAL PAY DAY
Anna Moeller, Elizabeth Hernandez, Diane Blair-Sherlock
Last updated 5 months ago
44 Co-Sponsors
Declares March 12, 2024 as "Equal Pay Day". Encourages the citizens of this State to learn about the pay gap that women experience in society and to learn about these various dates that bring attention to the pay gap that specific groups experience.
STATUS
Passed
BIOGRAPHY
INCUMBENT
Representative from Illinois district HD-018
COMMITTEES
Illinois House
BIRTH
--
ABOUT
Robyn Gabel graduated from Loyola University. She worked as a registered nurse and in medical management. Gabel served as Democratic Committeewoman and co-chair of Citizens for Miryam G. In 2010, she was elected to the Illinois House to represent the 18th district. Gabel serves on the Energy and Environment Committee, Mental Health Committee, and is Vice Chairperson of the Human Services Committee. Her legislative focuses include healthcare, education, civil rights, and government reform. In 2012, Gabel sponsored a bill requiring insurance coverage for autism diagnoses and treatment.read less
OFFICES HELD
Illinois House from Illinois
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