Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 140 - MEDICAL PAYMENT
Subpart G - MATERNAL AND CHILD HEALTH PROGRAM
Section 140.930 - Reimbursement
Universal Citation: 89 IL Admin Code ยง 140.930
Current through Register Vol. 48, No. 38, September 20, 2024
a) Reimbursement Rates for Maternal and Child Health Providers
1) Participating FQHC, as described in
Section
140.461(d),
that meet the criteria specified in
140.924(a)(2)(A),
shall be reimbursed in accordance with Section
140.464(b)
for covered services provided to a Maternal and Child Health Program
participant, as described in Section
140.922.
2) Participating encounter rate clinics shall
be reimbursed in accordance with Section
140.464(b)
for covered services provided to a Maternal and Child Health Program
participant, as described in Section 140.922.
3) Participating providers described in
Section
140.924(a)(1)
shall be eligible to receive a Well Child
Visit Incentive Payment.
A) The provider will
receive a one time annual payment of $30 for each qualifying child.
B) A qualifying child is a child who had its
first, second, third, fourth or fifth birthday during the calendar year and for
whom the provider personally, or through an affiliated provider, rendered all
recommended well child visits, as described in Section
140.488.
C) Recommended services must be rendered
during the 13-month period ending one month after the child's birthday. For
children turning one year old, the period begins ten days after birth and ends
one month after the child's birthday. Rendering of services will be based on
Department claims data.
D) Payments
will be made at least annually.
E)
For the purpose of payments under this Section, "affiliated provider" shall
mean providers designated pursuant to Section
140.994.
b) Patient Management Fee
Providers who have accepted primary care responsibilities for foster children residing in Cook County who are under the guardianship of the Department of Children and Family Services will receive a monthly patient management fee for each client enrolled with them.
c) Case Management Services
Providers of case management services will receive monthly payments. The payments will be prorated based upon an annual amount per case.
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