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| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4573 Introduced 1/21/2022, by Rep. Elizabeth Hernandez SYNOPSIS AS INTRODUCED:
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Amends the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly fee-for-service facility-specific nursing component (rather than facility-specific RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Provides that no managed care contract shall provide for a level of reimbursement lower than the fee-for-service rate in effect for the facility at the time service is rendered. Provides that managed care organizations are expressly prohibited, at any time and for any reason, from offering, negotiating, or entering into contracts with a nursing facility for a level of compensation less than the fee-for-service rate in effect at the time the service is rendered. Effective immediately.
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| | A BILL FOR |
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| | HB4573 | | LRB102 23916 KTG 33114 b |
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| 1 | | AN ACT concerning public aid.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Public Aid Code is amended by |
| 5 | | changing Section 5F-35 as follows:
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| 6 | | (305 ILCS 5/5F-35) |
| 7 | | Sec. 5F-35. Reimbursement. The Department shall provide |
| 8 | | each managed care organization with the quarterly |
| 9 | | fee-for-service facility-specific RUG-IV nursing component per |
| 10 | | diem along with any add-ons for enhanced care services, |
| 11 | | support component per diem, and capital component per diem |
| 12 | | effective for each nursing home under contract with the |
| 13 | | managed care organization. No managed care contract shall |
| 14 | | provide for a level of reimbursement lower than the |
| 15 | | fee-for-service rate in effect for the facility at the time |
| 16 | | service is rendered. Managed care organizations are expressly |
| 17 | | prohibited, at any time and for any reason, from offering, |
| 18 | | negotiating, or entering into contracts with a nursing |
| 19 | | facility for a level of compensation less than the |
| 20 | | fee-for-service rate in effect at the time the service is |
| 21 | | rendered.
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| 22 | | (Source: P.A. 98-651, eff. 6-16-14.)
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