Sec. 5-16.5. Expedited payments.
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Sec. 5-16.5. Expedited payments.
(a)(Blank).
(b)In a county with a population of 3,000,000 or more, a managed care community network shall receive expedited payment of its capitated reimbursement for each of its managed care enrollees if both of the following criteria are met:
(1)At least 75% of its membership is composed of hospitals that are qualified on or
after July 1, 1994 as disproportionate share hospitals.
(2)At least 75% of its managed care enrollees receive services at the disproportionate
share hospitals or those hospitals' affiliated sites.
(c)For counties whose population is less than 3,000,000, the Illinois Department shall establish by rule the terms and conditions under which a managed care community network shall receive expedited payment, including a determination of the qualifying percentage criteria for disproportionate share hospitals and managed care enrollees within a network receiving services at disproportionate share hospitals or their affiliated sites.