Rep. Esther Golar

Filed: 3/26/2014

 

 


 

 


 
09800HB4019ham001LRB098 15578 KTG 57511 a

1
AMENDMENT TO HOUSE BILL 4019

2    AMENDMENT NO. ______. Amend House Bill 4019 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5e as follows:
 
6    (305 ILCS 5/5-5e)
7    Sec. 5-5e. Adjusted rates of reimbursement.
8    (a) Rates or payments for services in effect on June 30,
92012 shall be adjusted and services shall be affected as
10required by any other provision of this amendatory Act of the
1197th General Assembly. In addition, the Department shall do the
12following:
13        (1) Delink the per diem rate paid for supportive living
14    facility services from the per diem rate paid for nursing
15    facility services, effective for services provided on or
16    after May 1, 2011.

 

 

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1        (2) Cease payment for bed reserves in nursing
2    facilities and specialized mental health rehabilitation
3    facilities.
4        (2.5) (Blank). Cease payment for bed reserves for
5    purposes of inpatient hospitalizations to intermediate
6    care facilities for persons with development disabilities,
7    except in the instance of residents who are under 21 years
8    of age.
9        (3) Cease payment of the $10 per day add-on payment to
10    nursing facilities for certain residents with
11    developmental disabilities.
12    (b) After the application of subsection (a),
13notwithstanding any other provision of this Code to the
14contrary and to the extent permitted by federal law, on and
15after July 1, 2012, the rates of reimbursement for services and
16other payments provided under this Code shall further be
17reduced as follows:
18        (1) Rates or payments for physician services, dental
19    services, or community health center services reimbursed
20    through an encounter rate, and services provided under the
21    Medicaid Rehabilitation Option of the Illinois Title XIX
22    State Plan shall not be further reduced.
23        (2) Rates or payments, or the portion thereof, paid to
24    a provider that is operated by a unit of local government
25    or State University that provides the non-federal share of
26    such services shall not be further reduced.

 

 

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1        (3) Rates or payments for hospital services delivered
2    by a hospital defined as a Safety-Net Hospital under
3    Section 5-5e.1 of this Code shall not be further reduced.
4        (4) Rates or payments for hospital services delivered
5    by a Critical Access Hospital, which is an Illinois
6    hospital designated as a critical care hospital by the
7    Department of Public Health in accordance with 42 CFR 485,
8    Subpart F, shall not be further reduced.
9        (5) Rates or payments for Nursing Facility Services
10    shall only be further adjusted pursuant to Section 5-5.2 of
11    this Code.
12        (6) Rates or payments for services delivered by long
13    term care facilities licensed under the ID/DD Community
14    Care Act and developmental training services shall not be
15    further reduced.
16        (7) Rates or payments for services provided under
17    capitation rates shall be adjusted taking into
18    consideration the rates reduction and covered services
19    required by this amendatory Act of the 97th General
20    Assembly.
21        (8) For hospitals not previously described in this
22    subsection, the rates or payments for hospital services
23    shall be further reduced by 3.5%, except for payments
24    authorized under Section 5A-12.4 of this Code.
25        (9) For all other rates or payments for services
26    delivered by providers not specifically referenced in

 

 

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1    paragraphs (1) through (8), rates or payments shall be
2    further reduced by 2.7%.
3    (c) Any assessment imposed by this Code shall continue and
4nothing in this Section shall be construed to cause it to
5cease.
6(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
 
7    Section 99. Effective date. This Act takes effect upon
8becoming law.".