093_HB0700sam006

 










                                     LRB093 05497 DRJ 19863 a

 1                     AMENDMENT TO HOUSE BILL 700

 2        AMENDMENT NO.     .  Amend House Bill  700  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.   The State Finance Act is amended by adding
 5    Sections 5.620 and 6z-56 and changing Section 8h as follows:

 6        (30 ILCS 105/5.620 new)
 7        Sec. 5.620.  The Health Care Services Trust Fund.

 8        (30 ILCS 105/6z-56 new)
 9        Sec. 6z-56.  The Health Care  Services  Trust  Fund.  The
10    Health  Care  Services  Trust  Fund  is  hereby  created as a
11    special fund in the State treasury.
12        The Fund shall consist of moneys deposited,  transferred,
13    or  appropriated into the Fund from units of local government
14    other than a county with a population greater than 3,000,000,
15    from the State, from federal  matching  funds,  or  from  any
16    other legal source.
17        Subject to appropriation, the moneys in the Fund shall be
18    used  by  the  Department  of  Public Aid to make payments to
19    providers of services covered under  the  Medicaid  or  State
20    Children's  Health  Insurance  programs. Payments may be made
21    out  of  the  Fund  only  to  providers  located  within  the
 
                            -2-      LRB093 05497 DRJ 19863 a
 1    geographic jurisdiction of units  of  local  government  that
 2    make deposits, transfers, or appropriations into the Fund.
 3        The Department of Public Aid shall adopt rules concerning
 4    application for and disbursement of the moneys in the Fund.

 5        (30 ILCS 105/8h)
 6        Sec.    8h.    Transfers   to   General   Revenue   Fund.
 7    Notwithstanding any other State  law  to  the  contrary,  the
 8    Director  of  the  Governor's Office of Management and Budget
 9    Bureau of the Budget may from time to time direct  the  State
10    Treasurer  and  Comptroller  to transfer a specified sum from
11    any fund held by the State Treasurer to the  General  Revenue
12    Fund  in order to help defray the State's operating costs for
13    the fiscal year.  The total transfer under this Section  from
14    any fund in any fiscal year shall not exceed the lesser of 8%
15    of  the  revenues  to  be deposited into the fund during that
16    year or 25% of  the  beginning  balance  in  the  fund.    No
17    transfer  may  be  made  from  a fund under this Section that
18    would have the effect of reducing the  available  balance  in
19    the  fund  to  an  amount  less  than  the  amount  remaining
20    unexpended  and  unreserved from the total appropriation from
21    that fund for that fiscal year.  This Section does not  apply
22    to any funds that are restricted by federal law to a specific
23    use  or  to  any  funds  in  the  Motor  Fuel Tax Fund or the
24    Hospital Provider Fund.  Notwithstanding any other  provision
25    of  this  Section, the total transfer under this Section from
26    the Road Fund or the State Construction  Account  Fund  shall
27    not  exceed  5% of the revenues to be deposited into the fund
28    during that year.
29        In determining the  available  balance  in  a  fund,  the
30    Director  of  the  Governor's Office of Management and Budget
31    Bureau of the Budget may include receipts, transfers into the
32    fund, and other resources anticipated to be available in  the
33    fund in that fiscal year.
 
                            -3-      LRB093 05497 DRJ 19863 a
 1        The  State  Treasurer  and Comptroller shall transfer the
 2    amounts designated under this  Section  as  soon  as  may  be
 3    practicable  after  receiving  the direction to transfer from
 4    the Director of  the  Governor's  Office  of  Management  and
 5    Budget Bureau of the Budget.
 6    (Source: P.A. 93-32, eff. 6-20-03; revised 8-21-03.)

 7        Section  10.   The Illinois Public Aid Code is amended by
 8    changing Sections 5A-1, 5A-2, 5A-3, 5A-4, 5A-5,  5A-7,  5A-8,
 9    5A-10,  14-1,  and  14-8 and by adding Sections 5A-12, 5A-13,
10    and 5A-14 as follows:

11        (305 ILCS 5/5A-1) (from Ch. 23, par. 5A-1)
12        Sec. 5A-1.  Definitions. As used in this Article,  unless
13    the context requires otherwise:
14        "Fund" means the Hospital Provider Fund.
15        "Hospital"  means  an  institution,  place,  building, or
16    agency located in this State that is subject to licensure  by
17    the  Illinois  Department of Public Health under the Hospital
18    Licensing  Act,  whether  public  or  private   and   whether
19    organized for profit or not-for-profit.
20        "Hospital  provider"  means  a  person  licensed  by  the
21    Department  of Public Health to conduct, operate, or maintain
22    a hospital, regardless of whether the person  is  a  Medicaid
23    provider.  For purposes of this paragraph, "person" means any
24    political  subdivision  of  the State, municipal corporation,
25    individual, firm, partnership, corporation, company,  limited
26    liability  company,  association, joint stock association, or
27    trust, or a receiver, executor, trustee, guardian,  or  other
28    representative appointed by order of any court.
29        "Occupied  bed  days" means the sum of the number of days
30    that each bed was occupied by a patient for all  beds  during
31    calendar  year  2001.   Occupied  bed  days shall be computed
32    separately for each hospital  operated  or  maintained  by  a
 
                            -4-      LRB093 05497 DRJ 19863 a
 1    hospital provider.
 2        "Adjusted  gross  hospital  revenue"  shall be determined
 3    separately  for  each  hospital   conducted,   operated,   or
 4    maintained  by  a  hospital provider, and  means the hospital
 5    provider's  total  gross  patient  revenues   less   Medicare
 6    contractual  allowances,  but  does not include gross patient
 7    revenue  (and  the  portion  of  any   Medicare   contractual
 8    allowance  related  thereto)  from  skilled  or  intermediate
 9    long-term  care services within the meaning of Title XVIII or
10    XIX of the Social Security Act.
11        "Intergovernmental transfer payment" means  the  payments
12    established  under  Section  15-3  of this Code, and includes
13    without limitation payments payable under  that  Section  for
14    July, August, and September of 1992.
15    (Source: P.A. 87-861; 88-88.)

16        (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
17        Sec. 5A-2.  Assessment; no local authorization to tax.
18        (a)  Subject  to  Sections  5A-3  and  5A-10,  an  annual
19    assessment  on inpatient services is imposed on each hospital
20    provider for State fiscal years 2004 and 2005  in  an  amount
21    equal  to  the  hospital's  occupied  bed  days multiplied by
22    $84.19.
23        The Department of Public Aid  shall  use  the  number  of
24    occupied  bed days as reported by each hospital on the Annual
25    Survey of Hospitals conducted by  the  Department  of  Public
26    Health to calculate the hospital's annual assessment.  If the
27    sum  of a hospital's occupied bed days is not reported on the
28    Annual Survey of Hospitals, then the Department of Public Aid
29    may obtain the sum of  occupied  bed  days  from  any  source
30    available,  including, but not limited to, records maintained
31    by the hospital provider, which may be inspected at all times
32    during business hours of the day by the Department of  Public
33    Aid  or  its  duly  authorized  agents and employees. For the
 
                            -5-      LRB093 05497 DRJ 19863 a
 1    privilege of engaging in the occupation of hospital provider,
 2    an assessment is imposed upon each hospital provider for  the
 3    State  fiscal  year  beginning  on July 1, 1993 and ending on
 4    June 30, 1994, in an amount equal to 1.88% of the  provider's
 5    adjusted  gross hospital revenue for the most recent calendar
 6    year ending before the beginning of that State fiscal year.
 7        Effective July 1, 1994 through June 30, 1996,  an  annual
 8    assessment  is  imposed  upon  each  hospital  provider in an
 9    amount  equal  to  the  provider's  adjusted  gross  hospital
10    revenue for the most recent calendar year ending  before  the
11    beginning  of  that  State  fiscal  year  multiplied  by  the
12    Provider's Savings Rate.
13        Effective  July  1,  1996  through  March  31,  1997,  an
14    assessment  is  imposed  upon  each  hospital  provider in an
15    amount equal to  three-fourths  of  the  provider's  adjusted
16    gross  hospital  revenue for calendar year 1995 multiplied by
17    the Provider's Savings Rate.  No assessment shall be  imposed
18    on or after April 1, 1997.
19        Before July 1, 1995, the Provider's Savings Rate is 1.88%
20    multiplied  by  a  fraction,  the  numerator  of which is the
21    Maximum Section 5A-2 Contribution  minus  the  Cigarette  Tax
22    Contribution,  and  the  denominator  of which is the Maximum
23    Section 5A-2  Contribution.   Effective  July  1,  1995,  the
24    Provider's  Savings  Rate  is 1.25% multiplied by a fraction,
25    the  numerator  of  which  is  the   Maximum   Section   5A-2
26    Contribution  minus  the  Cigarette Tax Contribution, and the
27    denominator  of   which   is   the   Maximum   Section   5A-2
28    Contribution.
29        The  Cigarette  Tax  Contribution is the sum of the total
30    amount  deposited  in  the  Hospital  Provider  Fund  in  the
31    previous State fiscal year pursuant to Section  2(a)  of  the
32    Cigarette  Tax  Act,  plus  the total amount deposited in the
33    Hospital Provider Fund in  the  previous  State  fiscal  year
34    pursuant to Section 5A-3(c) of this Code.
 
                            -6-      LRB093 05497 DRJ 19863 a
 1        The Maximum Section 5A-2 Contribution is the total amount
 2    of  tax  imposed by this Section in the previous State fiscal
 3    year on providers  subject  to  this  Act,  multiplied  by  a
 4    fraction  the  numerator  of which is adjusted gross hospital
 5    revenues reported to the Department by providers  subject  to
 6    this   Act  for  the  previous  State  fiscal  year  and  the
 7    denominator of which  is  adjusted  gross  hospital  revenues
 8    reported  to  the Department by providers subject to this Act
 9    for the State fiscal year immediately preceding the  previous
10    State fiscal year.
11        The  Department  shall  notify  hospital providers of the
12    Provider's  Savings  Rate  by  mailing  a  notice   to   each
13    provider's  last known address as reflected by the records of
14    the Illinois Department.
15        (b)  Nothing in this amendatory Act of the  93rd  General
16    Assembly  1995  shall be construed to authorize any home rule
17    unit or other unit of local government to license for revenue
18    or to impose a tax or assessment upon hospital  providers  or
19    the  occupation  of hospital provider, or a tax or assessment
20    measured by the income or earnings of a hospital provider.
21        (c)  As  provided  in  Section  5A-14,  this  Section  is
22    repealed on July 1, 2005.
23    (Source:  P.A.  88-88;  89-21,  eff.  7-1-95;  89-499,   eff.
24    6-28-96.)

25        (305 ILCS 5/5A-3) (from Ch. 23, par. 5A-3)
26        Sec. 5A-3.  Exemptions; intergovernmental transfers.
27        (a)  Blank). A hospital provider which is a county with a
28    population    of    more    than    3,000,000    that   makes
29    intergovernmental transfer payments as  provided  in  Section
30    15-3 of this Code shall be exempt from the assessment imposed
31    by  Section  5A-2,  unless  the  exemption  is adjudged to be
32    unconstitutional or otherwise  invalid,  in  which  case  the
33    county  shall  pay the assessment imposed by Section 5A-2 for
 
                            -7-      LRB093 05497 DRJ 19863 a
 1    all assessment periods beginning on or after  July  1,  1992,
 2    and  the  assessment  so paid shall be creditable against the
 3    intergovernmental transfer payments.
 4        (b)  A hospital provider that is a State agency, a  State
 5    university,  or  a  county  with a population of 3,000,000 or
 6    more is exempt from the assessment imposed by Section 5A-2. A
 7    hospital organized under the University of Illinois  Hospital
 8    Act and exempt from the assessment imposed by Section 5A-2 is
 9    hereby authorized to enter into an interagency agreement with
10    the  Illinois  Department  to make intergovernmental transfer
11    payments to the Illinois Department.  These payments shall be
12    deposited into the University of Illinois  Hospital  Services
13    Fund  or,  if  that  Fund  ceases  to exist, into the General
14    Revenue Fund.
15        (b-2)  A hospital  provider  that  is  a  county  with  a
16    population   of   less   than   3,000,000   or   a  township,
17    municipality,  hospital  district,   or   any   other   local
18    governmental  unit  is  exempt from the assessment imposed by
19    Section 5A-2.
20        (b-5)  (Blank). A hospital operated by the Department  of
21    Human  Services in the course of performing its mental health
22    and developmental disabilities functions is exempt  from  the
23    assessment imposed by Section 5A-2.
24        (b-10)  A  hospital  provider  whose  hospital  does  not
25    charge for its services is exempt from the assessment imposed
26    by  Section  5A-2,  unless  the  exemption  is adjudged to be
27    unconstitutional or otherwise  invalid,  in  which  case  the
28    hospital provider shall pay the assessment imposed by Section
29    5A-2.
30        (b-15)  A hospital provider whose hospital is licensed by
31    the  Department of Public Health as a psychiatric hospital is
32    exempt from the assessment imposed by  Section  5A-2,  unless
33    the exemption is adjudged to be unconstitutional or otherwise
34    invalid,  in  which  case the hospital provider shall pay the
 
                            -8-      LRB093 05497 DRJ 19863 a
 1    assessment imposed by Section 5A-2.
 2        (b-20)  A hospital provider whose hospital is licensed by
 3    the Department of Public Health as a rehabilitation  hospital
 4    is exempt from the assessment imposed by Section 5A-2, unless
 5    the exemption is adjudged to be unconstitutional or otherwise
 6    invalid,  in  which  case the hospital provider shall pay the
 7    assessment imposed by Section 5A-2.
 8        (b-25)  A hospital provider whose hospital (i) is  not  a
 9    psychiatric  hospital, rehabilitation hospital, or children's
10    hospital and (ii) has an average  length  of  inpatient  stay
11    greater than 25 days is exempt from the assessment imposed by
12    Section   5A-2,  unless  the  exemption  is  adjudged  to  be
13    unconstitutional or otherwise  invalid,  in  which  case  the
14    hospital provider shall pay the assessment imposed by Section
15    5A-2.
16        (c)  (Blank).   The   Illinois   Department   is   hereby
17    authorized  to  enter  into agreements with publicly owned or
18    operated  hospitals  to   make   intergovernmental   transfer
19    payments to the Illinois Department.  These payments shall be
20    deposited  into  the  Hospital Provider Fund, except that any
21    payments arising under an agreement with a hospital organized
22    under the  University  of  Illinois  Hospital  Act  shall  be
23    deposited  into  the University of Illinois Hospital Services
24    Fund, if that Fund exists.
25    (Source:  P.A.  88-88;  88-554,  eff.  7-26-94;  89-21,  eff.
26    7-1-95; 89-507, eff. 7-1-97.)

27        (305 ILCS 5/5A-4) (from Ch. 23, par. 5A-4)
28        Sec. 5A-4.  Payment of assessment; penalty.
29        (a)  The annual assessment imposed by  Section  5A-2  for
30    State fiscal year 2004 shall be due and payable on June 18 of
31    the  year. The assessment imposed by Section 5A-2 for a State
32    fiscal year 2005  shall  be  due  and  payable  in  quarterly
33    installments, each equalling one-fourth of the assessment for
 
                            -9-      LRB093 05497 DRJ 19863 a
 1    the  year,  on  July 19, October 19, January 18, and April 19
 2    September 30, December 31, March 31, and May 31 of the  year;
 3    except  that  for  the  period July 1, 1996 through March 31,
 4    1997, the assessment imposed by Section 5A-2 for that  period
 5    shall be due and payable in 3 equal installments on September
 6    30,  December 31, and March 31 of that period. No installment
 7    payment of an assessment imposed by Section 5A-2 shall be due
 8    and payable, however, until after: (i) the hospital  provider
 9    receives  written  notice  from  the Department of Public Aid
10    that the payment methodologies to  hospitals  required  under
11    Section  5A-12 have been approved by the Centers for Medicare
12    and Medicaid Services of the U.S. Department  of  Health  and
13    Human  Services  and  the  waiver under 42 CFR 433.68 for the
14    assessment imposed by Section 5A-2 has been  granted  by  the
15    Centers  for  Medicare  and  Medicaid  Services  of  the U.S.
16    Department  of  Health  and  Human  Services;  and  (ii)  the
17    hospital has received the  payments  required  under  Section
18    5A-12.
19        (b)  The  Illinois  Department is authorized to establish
20    delayed payment schedules for  hospital  providers  that  are
21    unable  to  make  installment  payments  when  due under this
22    Section due to financial difficulties, as determined  by  the
23    Illinois Department.
24        (c)  If  a hospital provider fails to pay the full amount
25    of an installment when due (including any extensions  granted
26    under  subsection  (b)),  there  shall,  unless waived by the
27    Illinois Department for reasonable cause,  be  added  to  the
28    assessment imposed by Section 5A-2 a penalty assessment equal
29    to  the lesser of (i) 5% of the amount of the installment not
30    paid on or before the due date plus 5% of the portion thereof
31    remaining unpaid on the last day of each 30-day period  month
32    thereafter or (ii) 100% of the installment amount not paid on
33    or  before  the  due  date.  For purposes of this subsection,
34    payments will be credited first to unpaid installment amounts
 
                            -10-     LRB093 05497 DRJ 19863 a
 1    (rather than to penalty or interest), beginning with the most
 2    delinquent installments.
 3    (Source: P.A. 88-88; 89-499, eff. 6-28-96.)

 4        (305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)
 5        Sec. 5A-5.  Notice  Reporting;  penalty;  maintenance  of
 6    records.
 7        (a)  After  December 31 of each year (except as otherwise
 8    provided in this subsection), and on or before  March  31  of
 9    the  succeeding year, the Department of Public Aid shall send
10    a notice of assessment to every hospital provider subject  to
11    assessment  under  this  Article shall file a return with the
12    Illinois Department.  The notice of assessment  shall  notify
13    the  hospital  of  its return shall report the adjusted gross
14    hospital revenue from the calendar year just ended and  shall
15    be  utilized  by  the  Illinois  Department  to calculate the
16    assessment for the State fiscal year commencing on  the  next
17    July  1,  except  that the notice return for the State fiscal
18    year commencing July 1, 2003 1992 and the report  of  revenue
19    for  calendar  year  1991  shall  be  sent filed on or before
20    December 15, 2003 September  30,  1992.   The  notice  return
21    shall  be  on  a form prepared by the Illinois Department and
22    shall state the following:
23             (1)  The name of the hospital provider.
24             (2)  The  address   of   the   hospital   provider's
25        principal  place  of  business  from  which  the provider
26        engages in the occupation of hospital  provider  in  this
27        State,   and  the  name  and  address  of  each  hospital
28        operated, conducted, or maintained  by  the  provider  in
29        this State.
30             (3)  The  occupied  bed days adjusted gross hospital
31        revenue of the hospital provider for  the  calendar  year
32        just  ended,  the  amount  of  assessment  imposed  under
33        Section  5A-2  for  the  State  fiscal year for which the
 
                            -11-     LRB093 05497 DRJ 19863 a
 1        notice return is sent  filed,  and  the  amount  of  each
 2        quarterly  installment to be paid during the State fiscal
 3        year.
 4             (4)  (Blank). The amount of penalty due, if any.
 5             (5)  Other reasonable information as  determined  by
 6        the Illinois Department requires.
 7        (b)  If   a  hospital  provider  conducts,  operates,  or
 8    maintains more than one hospital  licensed  by  the  Illinois
 9    Department  of Public Health, the provider shall may not file
10    a single return covering all those hospitals, but shall  file
11    a separate return for each hospital and shall compute and pay
12    the assessment for each hospital separately.
13        (c)  Notwithstanding any other provision in this Article,
14    in  the  case  of a person who ceases to conduct, operate, or
15    maintain a hospital in respect of which the person is subject
16    to assessment under this Article as a hospital provider,  the
17    assessment  for  the State fiscal year in which the cessation
18    occurs  shall  be  adjusted  by  multiplying  the  assessment
19    computed under Section 5A-2 by a fraction, the  numerator  of
20    which  is  the number of days months in the year during which
21    the provider conducts, operates, or  maintains  the  hospital
22    and  the  denominator  of  which is 365 12.  Immediately upon
23    ceasing to conduct, operate,  or  maintain  a  hospital,  the
24    person  shall  pay  file  a  final,  amended  return with the
25    Illinois Department not more than 90 days after the cessation
26    reflecting the adjustment and shall pay with the final return
27    the assessment for the year as so adjusted (to the extent not
28    previously paid).
29        (d)  Notwithstanding any other provision in this Article,
30    a  provider   who   commences   conducting,   operating,   or
31    maintaining   a   hospital,   upon  notice  by  the  Illinois
32    Department, shall file an initial return for the State fiscal
33    year  in  which  the  commencement  occurs  within  90   days
34    thereafter  and  shall  pay  the  assessment  computed  under
 
                            -12-     LRB093 05497 DRJ 19863 a
 1    Section  5A-2 and subsection (e) in equal installments on the
 2    due dates stated in the notice date of the return and on  the
 3    regular  installment  due  dates  for  the  State fiscal year
 4    occurring after the due dates  date  of  the  initial  notice
 5    return.
 6        (e)  Notwithstanding any other provision in this Article,
 7    in  the  case  of  a  hospital provider that did not conduct,
 8    operate, or maintain a hospital throughout the calendar  year
 9    2001  preceding  a State fiscal year, the assessment for that
10    State  fiscal  year  shall  be  computed  on  the  basis   of
11    hypothetical   occupied  bed  days  adjusted  gross  hospital
12    revenue for the full calendar year  as  determined  by  rules
13    adopted  by  the  Illinois  Department (which may be based on
14    annualization of the provider's actual revenues for a portion
15    of the calendar year, or revenues of  a  comparable  hospital
16    for the year, including revenues realized by a prior provider
17    from the same hospital during the year).
18        (f)  (Blank). In the case of a hospital provider existing
19    as  a  corporation  or legal entity other than an individual,
20    the return filed by it shall  be  signed  by  its  president,
21    vice-president,  secretary,  or  treasurer or by its properly
22    authorized agent.
23        (g)  (Blank). If a hospital provider fails  to  file  its
24    return  for  a State fiscal year on or before the due date of
25    the return,  there  shall,  unless  waived  by  the  Illinois
26    Department  for  reasonable cause, be added to the assessment
27    imposed by Section 5A-2 for the State fiscal year  a  penalty
28    assessment  equal  to  25%  of the assessment imposed for the
29    year.
30        (h)  (Blank).  Every   hospital   provider   subject   to
31    assessment  under  this Article shall keep sufficient records
32    to  permit  the  determination  of  adjusted  gross  hospital
33    revenue on a calendar year basis.  All such records shall  be
34    kept  in  the English language and shall, at all times during
 
                            -13-     LRB093 05497 DRJ 19863 a
 1    business hours of the day, be subject to  inspection  by  the
 2    Illinois   Department  or  its  duly  authorized  agents  and
 3    employees.
 4    (Source: P.A. 87-861.)

 5        (305 ILCS 5/5A-7) (from Ch. 23, par. 5A-7)
 6        Sec. 5A-7. Administration; enforcement provisions.
 7        (a)  To the extent practicable, the  Illinois  Department
 8    shall  administer  and  enforce  this Article and collect the
 9    assessments, interest, and penalty assessments imposed  under
10    this  Article using procedures employed in its administration
11    of this Code generally and, as it  deems  appropriate,  in  a
12    manner  similar  to  that  in which the Department of Revenue
13    administers and collects the retailers' occupation tax  under
14    the  Retailers'  Occupation  Tax  Act  ("ROTA").   Instead of
15    certificates of registration, the Illinois  Department  shall
16    establish  and  maintain  a listing of all hospital providers
17    appearing in the  licensing  records  of  the  Department  of
18    Public   Health,  which  shall  show  each  provider's  name,
19    principal place of business, and the name and address of each
20    hospital operated, conducted, or maintained by  the  provider
21    in   this   State.   In  addition,  the  following  specified
22    provisions  of  the  Retailers'  Occupation   Tax   Act   are
23    incorporated  by  reference into this Section except that the
24    Illinois  Department  and  its  Director  (rather  than   the
25    Department  of  Revenue  and its Director) and every hospital
26    provider subject to assessment measured by occupied bed  days
27    adjusted  gross  hospital  revenue  and  to the return filing
28    requirements of this Article (rather than persons subject  to
29    retailers' occupation tax measured by gross receipts from the
30    sale  of  tangible  personal  property  at  retail and to the
31    return filing requirements of ROTA) shall  have  the  powers,
32    duties,  and  rights  specified  in these ROTA provisions, as
33    modified in this Section or by the Illinois Department  in  a
 
                            -14-     LRB093 05497 DRJ 19863 a
 1    manner  consistent with this Article and except as manifestly
 2    inconsistent with the other provisions of this Article:
 3             (1)  ROTA, Section 4 (examination of return;  notice
 4        of   correction;   evidence;   limitations;  protest  and
 5        hearing), except that (i) the Illinois  Department  shall
 6        issue   notices  of  assessment  liability  (rather  than
 7        notices of tax liability as provided in ROTA, Section 4);
 8        (ii) in the case of a fraudulent return or in the case of
 9        an extended period agreed to by the  Illinois  Department
10        and  the  hospital  provider before the expiration of the
11        limitation period,  no  notice  of  assessment  liability
12        shall  be issued more than 3 years after the later of the
13        due date of the return required by Section  5A-5  or  the
14        date  the return (or an amended return) was filed (rather
15        within the period stated in ROTA, Section 4);  and  (iii)
16        the  penalty  provisions  of  ROTA,  Section  4 shall not
17        apply.
18             (2)  ROTA, Sec. 5 (failure to make  return;  failure
19        to  pay assessment), except that the penalty and interest
20        provisions of ROTA, Section 5 shall not apply.
21             (3)  ROTA,    Section    5a    (lien;    attachment;
22        termination; notice; protest; review;  release  of  lien;
23        status of lien).
24             (4)  ROTA,  Section  5b  (State  lien notices; State
25        lien index; duties of recorder and registrar of titles).
26             (5)  ROTA,  Section  5c   (liens;   certificate   of
27        release).
28             (6)  ROTA,  Section  5d  (Department not required to
29        furnish bond; claim to property attached or levied upon).
30             (7)  ROTA,  Section  5e   (foreclosure   on   liens;
31        enforcement).
32             (8)  ROTA,  Section 5f (demand for payment; levy and
33        sale of property; limitation).
34             (9)  ROTA,   Section   5g   (sale    of    property;
 
                            -15-     LRB093 05497 DRJ 19863 a
 1        redemption).
 2             (10)  ROTA,  Section  5j (sales on transfers outside
 3        usual course of business; report; payment of  assessment;
 4        rights  and  duties  of  purchaser; penalty), except that
 5        notice shall be provided to the  Illinois  Department  as
 6        specified by rule.
 7             (11)  ROTA, Section 6 (erroneous payments; credit or
 8        refund),  provided  that  (i) the Illinois Department may
 9        only apply an  amount  otherwise  subject  to  credit  or
10        refund  to  a  liability arising under this Article; (ii)
11        except in the case of an extended period agreed to by the
12        Illinois Department and the hospital provider before  the
13        expiration  of this limitation period, a claim for credit
14        or refund must be filed no more than 3  years  after  the
15        due  date  of the return required by Section 5A-5 (rather
16        than the time limitation stated in ROTA, Section 6);  and
17        (iii) credits or refunds shall not bear interest.
18             (12)  ROTA,   Section   6a  (claims  for  credit  or
19        refund).
20             (13)  ROTA, Section 6b (tentative  determination  of
21        claim; notice; hearing; review), provided that a hospital
22        provider or its representative shall have 60 days (rather
23        than 20 days)  within which to file a protest and request
24        for  hearing  in response to a tentative determination of
25        claim.
26             (14)  ROTA,  Section  6c  (finality   of   tentative
27        determinations).
28             (15)  ROTA,    Section    8    (investigations   and
29        hearings).
30             (16)  ROTA, Section 9 (witness; immunity).
31             (17)  ROTA,  Section  10  (issuance  of   subpoenas;
32        attendance   of   witnesses;   production  of  books  and
33        records).
34             (18)  ROTA, Section  11  (information  confidential;
 
                            -16-     LRB093 05497 DRJ 19863 a
 1        exceptions).
 2             (19)  ROTA,   Section  12  (rules  and  regulations;
 3        hearing; appeals), except that a hospital provider  shall
 4        not be required to file a bond or be subject to a lien in
 5        lieu  thereof  in  order  to  seek court review under the
 6        Administrative  Review  Law  of  a  final  assessment  or
 7        revised final assessment or the equivalent thereof issued
 8        by the Illinois Department under this Article.
 9        (b)  In addition to any other  remedy  provided  for  and
10    without   sending  a  notice  of  assessment  liability,  the
11    Illinois Department  may  collect  an  unpaid  assessment  by
12    withholding,  as payment of the assessment, reimbursements or
13    other amounts otherwise payable by the Illinois Department to
14    the provider.
15    (Source: P.A. 87-861.)

16        (305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
17        Sec. 5A-8.  Hospital Provider Fund.
18        (a)  There is created in the State Treasury the  Hospital
19    Provider  Fund. Interest earned by the Fund shall be credited
20    to the Fund.  The Fund shall  not  be  used  to  replace  any
21    moneys  appropriated  to  the Medicaid program by the General
22    Assembly.
23        (b)  The Fund is created for  the  purpose  of  receiving
24    moneys  in accordance with Section 5A-6 and disbursing moneys
25    only for the following purposes,  notwithstanding  any  other
26    provision of law as follows:
27             (1)  For  making  payments  to hospitals as required
28        under Articles V, VI, and XIV  hospital  inpatient  care,
29        hospital  ambulatory  care,  and  disproportionate  share
30        hospital  distributive  expenditures made under Title XIX
31        of the Social Security Act and Article V of this Code and
32        under the Children's Health Insurance Program Act.
33             (2)  For the reimbursement of  moneys  collected  by
 
                            -17-     LRB093 05497 DRJ 19863 a
 1        the   Illinois  Department  from  hospitals  or  hospital
 2        providers through error  or  mistake  in  performing  the
 3        activities authorized under this Article and Article V of
 4        this  Code and for making required payments under Section
 5        14-9 of this Code if there are no  moneys  available  for
 6        those payments in the Hospital Services Trust Fund.
 7             (3)  For payment of administrative expenses incurred
 8        by the Illinois Department or its agent in performing the
 9        activities authorized by this Article.
10             (4)  For   payments   of   any   amounts  which  are
11        reimbursable to the federal government for payments  from
12        this Fund which are required to be paid by State warrant.
13             (5)  For  making transfers to the General Obligation
14        Bond Retirement and Interest Fund, as those transfers are
15        authorized in the proceedings authorizing debt under  the
16        Short  Term  Borrowing Act, but transfers made under this
17        paragraph (5)  shall not exceed the principal  amount  of
18        debt  issued  in anticipation of the receipt by the State
19        of moneys to be deposited into the Fund.
20             (6)  For making transfers to any other fund  in  the
21        State  treasury,  but transfers made under this paragraph
22        (6) shall not exceed the  amount  transferred  previously
23        from that other fund into the Hospital Provider Fund.
24             (7)  For   making   refunds  to  hospital  providers
25        pursuant to Section 5A-10.
26        Disbursements  from  the  Fund,  other   than   transfers
27    authorized under paragraphs (5) and (6) of this subsection to
28    the  General  Obligation  Bond  Retirement and Interest Fund,
29    shall be by warrants drawn  by  the  State  Comptroller  upon
30    receipt  of  vouchers  duly  executed  and  certified  by the
31    Illinois Department.
32        (c)  The Fund shall consist of the following:
33             (1)  All  moneys  collected  or  received   by   the
34        Illinois Department from the hospital provider assessment
 
                            -18-     LRB093 05497 DRJ 19863 a
 1        imposed by this Article.
 2             (2)  All  federal  matching  funds  received  by the
 3        Illinois Department as a result of expenditures  made  by
 4        the  Illinois  Department that are attributable to moneys
 5        deposited in the Fund.
 6             (3)  Any interest or penalty levied  in  conjunction
 7        with the administration of this Article.
 8             (4)  Moneys  transferred  from  another  fund in the
 9        State treasury. Any  balance  in  the  Hospital  Services
10        Trust  Fund  in the State Treasury.  The balance shall be
11        transferred  to  the  Fund  upon  certification  by   the
12        Illinois  Department to the State Comptroller that all of
13        the disbursements required by  Section  14-2(b)  of  this
14        Code have been made.
15             (5)  All other moneys received for the Fund from any
16        other source, including interest earned thereon.
17        (d)  (Blank). The Fund shall cease to exist on October 1,
18    1999.   Any  balance  in  the  Fund  as of that date shall be
19    transferred to the General Revenue  Fund.   Any  moneys  that
20    otherwise  would  be paid into the Fund on or after that date
21    shall be  deposited  into  the  General  Revenue  Fund.   Any
22    disbursements  on  or after that date that otherwise would be
23    made from  the  Fund  may  be  appropriated  by  the  General
24    Assembly from the General Revenue Fund.
25    (Source: P.A. 89-626, eff. 8-9-96; 90-587, eff. 7-1-98.)

26        (305 ILCS 5/5A-10) (from Ch. 23, par. 5A-10)
27        Sec. 5A-10. Applicability.
28        (a)  The  assessment  imposed  by  Section 5A-2 shall not
29    take effect or shall cease to  be  imposed,  and  any  moneys
30    remaining in the Fund shall be refunded to hospital providers
31    in proportion to the amounts paid by them, if:
32             (1)  the  sum of the appropriations for State fiscal
33        years 2004 and 2005 from the  General  Revenue  Fund  for
 
                            -19-     LRB093 05497 DRJ 19863 a
 1        hospital payments under the medical assistance program is
 2        less than $4,250,000,000; or
 3             (2)  the  Department  of Public Aid makes changes in
 4        its  rules  that  reduce  the   hospital   inpatient   or
 5        outpatient  payment  rates,  including adjustment payment
 6        rates, in effect on October 1, 2003, except for hospitals
 7        described in subsection (b) of Section  5A-3  and  except
 8        for  changes  in  outpatient payment rates made to comply
 9        with  the  federal  Health  Insurance   Portability   and
10        Accountability  Act,  so  long  as  those  changes do not
11        reduce aggregate expenditures below the  amount  expended
12        in State fiscal year 2003 for such services; or
13             (3)  the   payments   to  hospitals  required  under
14        Section 5A-12 are changed or are not eligible for federal
15        matching funds under Title  XIX  or  XXI  of  the  Social
16        Security Act.
17        (b)  The  assessment  imposed  by  Section 5A-2 shall not
18    take effect or shall cease to be imposed if the assessment is
19    determined to be an  impermissible  tax  amount  of  matching
20    federal  funds  under Title XIX of the Social Security Act is
21    eliminated  or  significantly  reduced  on  account  of   the
22    assessment.   Moneys  in  the  Hospital Provider Fund derived
23    from assessments imposed prior thereto shall be disbursed  in
24    accordance  with  Section 5A-8 to the extent federal matching
25    is  not  reduced  due  to  the  impermissibility  of  by  the
26    assessments, and any remaining moneys  assessments  shall  be
27    refunded  to  hospital providers in proportion to the amounts
28    paid by them.
29    (Source: P.A. 87-861.)

30        (305 ILCS 5/5A-12 new)
31        Sec. 5A-12.  Hospital access improvement payments.
32        (a)  To improve access to hospital services, for hospital
33    services rendered on or after January 1, 2004, the Department
 
                            -20-     LRB093 05497 DRJ 19863 a
 1    of Public Aid shall make payments to hospitals as  set  forth
 2    in this Section, except for hospitals described in subsection
 3    (b)  of  Section  5A-3.  These  payments  shall  be paid on a
 4    quarterly basis. For State fiscal year 2004,  the  Department
 5    shall  pay  the  total  amounts  required under this Section;
 6    these amounts shall be paid on or before June 15 of the year.
 7    In subsequent State fiscal years, the total amounts  required
 8    under  this  Section shall be paid in 4 equal installments on
 9    or before July 15, October 15, January 14, and  April  15  of
10    the  year.  Payments  under  this  Section  are  not  due and
11    payable, however, until (i) the  methodologies  described  in
12    this  Section  are  approved  by the federal government in an
13    appropriate State Plan amendment, (ii) the assessment imposed
14    under this Article is determined  to  be  a  permissible  tax
15    under  Title  XIX  of  the Social Security Act, and (iii) the
16    assessment is in effect.
17        (b)  High volume payment. In addition to rates  paid  for
18    inpatient  hospital  services,  the  Department of Public Aid
19    shall pay, to each Illinois hospital that provided more  than
20    20,000  Medicaid  inpatient  days of care during State fiscal
21    year 2001 (except for hospitals that qualify  for  adjustment
22    payments   under  Section  5-5.02  for  the  12-month  period
23    beginning  on  October  1,  2002),  $190  for  each  Medicaid
24    inpatient day of care provided during  that  fiscal  year.  A
25    hospital  that  provided  less than 30,000 Medicaid impatient
26    days of care during that period, however, is not entitled  to
27    receive more than $3,500,000 per year in such payments.
28        (c)  Medicaid  inpatient  utilization rate adjustment. In
29    addition to rates paid for inpatient hospital  services,  the
30    Department  of  Public  Aid  shall pay each Illinois hospital
31    (except for hospitals described in Section  5A-3),  for  each
32    Medicaid  inpatient  day of care provided during State fiscal
33    year  2001,  an  amount  equal  to  the  product  of   $57.25
34    multiplied  by  the  quotient  of 1 divided by the greater of
 
                            -21-     LRB093 05497 DRJ 19863 a
 1    1.6% or the hospital's Medicaid  inpatient  utilization  rate
 2    (as  used  to  determine  eligibility for adjustment payments
 3    under Section 5-5.02 for the  12-month  period  beginning  on
 4    October 1, 2002). The total payments under this subsection to
 5    a hospital may not exceed $10,500,000 annually.
 6        (d)  Psychiatric base rate adjustment.
 7             (1)  In   addition   to  rates  paid  for  inpatient
 8        psychiatric services, the Department of Public Aid  shall
 9        pay  each  Illinois  general  acute  care hospital with a
10        distinct  part-psychiatric  unit,   for   each   Medicaid
11        inpatient  psychiatric  day  of  care  provided  in State
12        fiscal year 2001,  an  amount  equal  to  $400  less  the
13        hospital's   per-diem   rate   for   Medicaid   inpatient
14        psychiatric  services as in effect on October 1, 2003. In
15        no event, however, shall that amount be less than zero.
16             (2)  For distinct part-psychiatric units of Illinois
17        general acute care hospitals, except  for  all  hospitals
18        excluded  in  Section 5A-3, whose inpatient per-diem rate
19        as in effect on October 1, 2003 is greater than $400, the
20        Department shall pay, in addition to  any  other  amounts
21        authorized   under  this  Code,  $25  for  each  Medicaid
22        inpatient psychiatric  day  of  care  provided  in  State
23        fiscal year 2001.
24        (e)  Supplemental  tertiary  care adjustment. In addition
25    to rates paid  for  inpatient  services,  the  Department  of
26    Public  Aid  shall pay to each Illinois hospital eligible for
27    tertiary care adjustment payments under  89  Ill.  Adm.  Code
28    148.296,   as  in  effect  for  State  fiscal  year  2003,  a
29    supplemental tertiary care adjustment payment  equal  to  the
30    tertiary  care adjustment payment required under 89 Ill. Adm.
31    Code 148.296, as in effect for State fiscal year 2003.
32        (f)  Medicaid outpatient utilization rate adjustment.  In
33    addition  to rates paid for outpatient hospital services, the
34    Department of Public Aid shall  pay  each  Illinois  hospital
 
                            -22-     LRB093 05497 DRJ 19863 a
 1    (except  for  hospitals described in Section 5A-3), an amount
 2    equal to the product of 2.45% multiplied  by  the  hospital's
 3    Medicaid  outpatient  charges multiplied by the quotient of 1
 4    divided by the greater of 1.6%  or  the  hospital's  Medicaid
 5    outpatient  utilization  rate.  The total payments under this
 6    subsection to a hospital may not exceed $6,750,000 annually.
 7        For purposes of this subsection:
 8        "Medicaid  outpatient  charges"  means  the  charges  for
 9    outpatient services provided to Medicaid patients  for  State
10    fiscal  year  2001  as submitted by the hospital on the UB-92
11    billing form or under the ambulatory  procedure  listing  and
12    adjudicated  by  the  Department  of  Public Aid on or before
13    September 12, 2003.
14        "Medicaid outpatient utilization rate" means a  fraction,
15    the  numerator of which is the hospital's Medicaid outpatient
16    charges and the denominator of which is the total  number  of
17    the  hospital's  charges  for  outpatient  services  for  the
18    hospital's fiscal year ending in 2001.
19        (g)  State  outpatient service adjustment. In addition to
20    rates paid for outpatient hospital services,  the  Department
21    of  Public  Aid  shall  pay  each Illinois hospital an amount
22    equal to the product of 75.5% multiplied  by  the  hospital's
23    Medicaid  outpatient  services submitted to the Department on
24    the UB-92 billing form for State fiscal year 2001  multiplied
25    by the hospital's outpatient access fraction.
26        For  purposes  of  this  subsection,  "outpatient  access
27    fraction"  means  a  fraction,  the numerator of which is the
28    hospital's Medicaid  payments  for  outpatient  services  for
29    ambulatory   procedure  listing  services  submitted  to  the
30    Department on the UB-92 billing form for  State  fiscal  year
31    2001, and the denominator of which is the hospital's Medicaid
32    outpatient  services submitted to the Department on the UB-92
33    billing form for State fiscal year 2001.
34        The total payments under this subsection  to  a  hospital
 
                            -23-     LRB093 05497 DRJ 19863 a
 1    may not exceed $3,000,000 annually.
 2        (h)  Rural hospital outpatient adjustment. In addition to
 3    rates  paid  for outpatient hospital services, the Department
 4    of Public Aid shall  pay  each  Illinois  rural  hospital  an
 5    amount  equal to the product of $14,500,000 multiplied by the
 6    rural hospital outpatient adjustment fraction.
 7        For  purposes  of  this   subsection,   "rural   hospital
 8    outpatient   adjustment   fraction"  means  a  fraction,  the
 9    numerator of which is  the  hospital's  Medicaid  visits  for
10    outpatient services for ambulatory procedure listing services
11    submitted  to  the  Department  on the UB-92 billing form for
12    State fiscal year 2001, and the denominator of which  is  the
13    total  Medicaid visits for outpatient services for ambulatory
14    procedure listing services for all Illinois  rural  hospitals
15    submitted  to  the  Department  on the UB-92 billing form for
16    State fiscal year 2001.
17        For purposes of this subsection, "rural hospital" has the
18    same meaning as in 89 Ill. Adm. Code 148.25, as in effect  on
19    September 30, 2003.
20        (i)  For  purposes  of  this Section, the terms "Medicaid
21    days", "Medicaid charges", and  "Medicaid  services"  do  not
22    include any days, charges, or services for which Medicare was
23    liable for payment.
24        (j)  As  provided  in  Section  5A-14,  this  Section  is
25    repealed on July 1, 2005.

26        (305 ILCS 5/5A-13 new)
27        Sec.  5A-13.  Emergency  rulemaking.  The  Department  of
28    Public  Aid  may  adopt  rules  necessary  to  implement this
29    amendatory Act of the 93rd General Assembly through  the  use
30    of  emergency  rulemaking  in accordance with Section 5-45 of
31    the Illinois Administrative Procedure Act.  For  purposes  of
32    that  Act,  the  General  Assembly finds that the adoption of
33    rules to implement this amendatory Act of  the  93rd  General
 
                            -24-     LRB093 05497 DRJ 19863 a
 1    Assembly  is deemed an emergency and necessary for the public
 2    interest, safety, and welfare.

 3        (305 ILCS 5/5A-14 new)
 4        Sec. 5A-14. Repeal of assessments and disbursements.
 5        (a)  Section 5A-2 is repealed on July 1, 2005.
 6        (b)  Section 5A-12 is repealed on July 1, 2005.

 7        (305 ILCS 5/14-1) (from Ch. 23, par. 14-1)
 8        Sec. 14-1.  Definitions.  As used in this Article, unless
 9    the context requires otherwise:
10        "Fund" means the Hospital Services Trust Fund.
11        "Estimated Rate Year Utilization"  means  the  hospital's
12    projected  utilization for the State fiscal year in which the
13    fee is due (for example, fiscal year 1992 for fees imposed in
14    State fiscal year 1992, fiscal year 1993 for fees imposed  in
15    State fiscal year 1993, and so forth).
16        "Gross  Receipts" means all payments for medical services
17    delivered under Title XIX of  the  Social  Security  Act  and
18    Articles  V,  VI, and VII of this Code and shall mean any and
19    all payments made by the Illinois Department, or  a  Division
20    thereof,  to  a Medical Assistance Program provider certified
21    to participate in the Illinois  Medical  Assistance  Program,
22    for  services  rendered eligible for Medical Assistance under
23    Articles V, VI and VII of this Code,  State  regulations  and
24    the  federal  Medicaid Program as defined in Title XIX of the
25    Social Security Act and federal regulations.
26        "Hospital" means any  institution,  place,  building,  or
27    agency,  public  or  private, whether organized for profit or
28    not-for-profit, which is located in the State and is  subject
29    to  licensure  by  the  Illinois  Department of Public Health
30    under the Hospital Licensing Act or any  institution,  place,
31    building, or agency, public or private, whether organized for
32    profit   or   not-for-profit,   which  meets  all  comparable
 
                            -25-     LRB093 05497 DRJ 19863 a
 1    conditions and requirements of the Hospital Licensing Act  in
 2    effect  for the state in which it is located, and is required
 3    to submit cost reports to the Illinois Department under Title
 4    89, Part 148, of the Illinois Administrative Code, but  shall
 5    not include the University of Illinois Hospital as defined in
 6    the  University of Illinois Hospital Act or a county hospital
 7    in a county of over 3 million population.
 8        "Total Medicaid Base Year Spending" means the  hospital's
 9    State  fiscal  year  1991  weighted average payment rates, as
10    defined by rule, excluding payments under Section  5-5.02  of
11    this  Code,  reduced  by  5% and multiplied by the hospital's
12    estimated rate year utilization.
13    (Source: P.A. 87-13.)

14        (305 ILCS 5/14-8) (from Ch. 23, par. 14-8)
15        Sec. 14-8.  Disbursements to Hospitals.
16        (a)  For inpatient  hospital  services  rendered  on  and
17    after  September  1,  1991,  the  Illinois  Department  shall
18    reimburse  hospitals  for  inpatient services at an inpatient
19    payment rate calculated for  each  hospital  based  upon  the
20    Medicare  Prospective Payment System as set forth in Sections
21    1886(b), (d), (g), and (h) of  the  federal  Social  Security
22    Act,   and   the   regulations,   policies,   and  procedures
23    promulgated thereunder, except as modified by  this  Section.
24    Payment  rates for inpatient hospital services rendered on or
25    after September 1, 1991 and on or before September  30,  1992
26    shall  be  calculated  using the Medicare Prospective Payment
27    rates in effect on September  1,  1991.   Payment  rates  for
28    inpatient  hospital  services rendered on or after October 1,
29    1992 and on or before March  31,  1994  shall  be  calculated
30    using  the  Medicare  Prospective  Payment rates in effect on
31    September 1,  1992.  Payment  rates  for  inpatient  hospital
32    services  rendered  on  or  after  April  1,  1994  shall  be
33    calculated  using  the  Medicare  Prospective  Payment  rates
 
                            -26-     LRB093 05497 DRJ 19863 a
 1    (including  the  Medicare  grouping methodology and weighting
 2    factors  as  adjusted  pursuant  to  paragraph  (1)  of  this
 3    subsection)  in   effect  90  days  prior  to  the  date   of
 4    admission.   For  services rendered on or after July 1, 1995,
 5    the  reimbursement   methodology   implemented   under   this
 6    subsection  shall  not  include  those  costs  referred to in
 7    Sections 1886(d)(5)(B) and 1886(h)  of  the  Social  Security
 8    Act.  The  additional  payment amounts required under Section
 9    1886(d)(5)(F) of  the  Social  Security  Act,  for  hospitals
10    serving  a  disproportionate  share of low-income or indigent
11    patients, are not required under this Section.  For  hospital
12    inpatient  services  rendered  on  or after July 1, 1995, the
13    Illinois  Department  shall  reimburse  hospitals  using  the
14    relative  weighting  factors  and  the  base  payment   rates
15    calculated  for each hospital that were in effect on June 30,
16    1995, less the  portion  of  such  rates  attributed  by  the
17    Illinois Department to the cost of medical education.
18             (1)  The weighting factors established under Section
19        1886(d)(4)  of  the Social Security Act shall not be used
20        in  the  reimbursement  system  established  under   this
21        Section.  Rather, the Illinois Department shall establish
22        by  rule  Medicaid  weighting  factors  to be used in the
23        reimbursement system established under this Section.
24             (2)  The Illinois Department shall  define  by  rule
25        those hospitals or distinct parts of hospitals that shall
26        be exempt from the reimbursement system established under
27        this  Section.   In defining such hospitals, the Illinois
28        Department shall take into consideration those  hospitals
29        exempt from the Medicare Prospective Payment System as of
30        September 1, 1991.  For hospitals defined as exempt under
31        this  subsection,  the  Illinois Department shall by rule
32        establish a reimbursement system for payment of inpatient
33        hospital services rendered  on  and  after  September  1,
34        1991.  For all hospitals that are children's hospitals as
 
                            -27-     LRB093 05497 DRJ 19863 a
 1        defined in Section 5-5.02 of this Code, the reimbursement
 2        methodology  shall,  through  June  30,  1992, net of all
 3        applicable fees, at least equal each children's  hospital
 4        1990  ICARE payment rates, indexed to the current year by
 5        application of the DRI hospital cost index from  1989  to
 6        the  year  in  which payments are made.  Excepting county
 7        providers  as  defined  in  Article  XV  of  this   Code,
 8        hospitals  licensed  under  the  University  of  Illinois
 9        Hospital  Act,  and facilities operated by the Department
10        of Mental Health and Developmental Disabilities  (or  its
11        successor, the Department of Human Services) for hospital
12        inpatient services rendered on or after July 1, 1995, the
13        Illinois Department shall reimburse children's hospitals,
14        as  defined  in  89  Illinois Administrative Code Section
15        149.50(c)(3), at the rates in effect on  June  30,  1995,
16        and  shall  reimburse all other hospitals at the rates in
17        effect on June 30, 1995, less the portion of  such  rates
18        attributed  by  the  Illinois  Department  to the cost of
19        medical  education.  For  inpatient   hospital   services
20        provided  on  or  after  August  1,  1998,  the  Illinois
21        Department may establish by rule a means of adjusting the
22        rates  of children's hospitals, as defined in 89 Illinois
23        Administrative Code Section 149.50(c)(3),  that  did  not
24        meet  that  definition on June 30, 1995, in order for the
25        inpatient hospital rates of such hospitals to  take  into
26        account  the  average  inpatient  hospital rates of those
27        children's hospitals that  did  meet  the  definition  of
28        children's hospitals on June 30, 1995.
29             (3)  (Blank)
30             (4)  Notwithstanding  any  other  provision  of this
31        Section, hospitals  that  on  August  31,  1991,  have  a
32        contract  with  the Illinois Department under Section 3-4
33        of the Illinois Health Finance Reform Act  may  elect  to
34        continue  to  be  reimbursed  at  rates  stated  in  such
 
                            -28-     LRB093 05497 DRJ 19863 a
 1        contracts for general and specialty care.
 2             (5)  In  addition  to  any  payments made under this
 3        subsection (a), the Illinois Department  shall  make  the
 4        adjustment  payments  required  by Section 5-5.02 of this
 5        Code;  provided,  that  in  the  case  of  any   hospital
 6        reimbursed  under  a  per  case methodology, the Illinois
 7        Department shall add an amount equal to  the  product  of
 8        the  hospital's  average  length  of  stay, less one day,
 9        multiplied  by  20,  for  inpatient   hospital   services
10        rendered  on  or after September 1, 1991 and on or before
11        September 30, 1992.
12        (b)  (Blank)
13        (b-5)  Excepting county providers as defined  in  Article
14    XV  of  this Code, hospitals licensed under the University of
15    Illinois  Hospital  Act,  and  facilities  operated  by   the
16    Illinois   Department  of  Mental  Health  and  Developmental
17    Disabilities (or  its  successor,  the  Department  of  Human
18    Services),  for outpatient services rendered on or after July
19    1, 1995 and before July 1, 1998 the Illinois Department shall
20    reimburse children's hospitals, as defined  in  the  Illinois
21    Administrative  Code  Section  149.50(c)(3),  at the rates in
22    effect on June 30, 1995, less  that  portion  of  such  rates
23    attributed  by  the  Illinois  Department  to  the outpatient
24    indigent volume adjustment  and  shall  reimburse  all  other
25    hospitals  at  the rates in effect on June 30, 1995, less the
26    portions of such rates attributed by the Illinois  Department
27    to  the  cost  of  medical  education  and  attributed by the
28    Illinois  Department  to  the  outpatient   indigent   volume
29    adjustment.   For  outpatient  services  provided on or after
30    July 1, 1998, reimbursement rates  shall  be  established  by
31    rule.
32        (c)  In  addition  to any other payments under this Code,
33    the   Illinois   Department   shall   develop   a    hospital
34    disproportionate   share   reimbursement   methodology  that,
 
                            -29-     LRB093 05497 DRJ 19863 a
 1    effective July 1, 1991, through  September  30,  1992,  shall
 2    reimburse  hospitals  sufficiently  to  expend the fee monies
 3    described in subsection (b) of Section 14-3 of this Code  and
 4    the   federal   matching   funds  received  by  the  Illinois
 5    Department as a result of expenditures made by  the  Illinois
 6    Department  as  required  by  this subsection (c) and Section
 7    14-2 that are attributable to fee  monies  deposited  in  the
 8    Fund,  less  amounts  applied  to  adjustment  payments under
 9    Section 5-5.02.
10        (d)  Critical Care Access Payments.
11             (1)  In addition to any other  payments  made  under
12        this  Code,  the  Illinois  Department  shall  develop  a
13        reimbursement  methodology  that shall reimburse Critical
14        Care Access Hospitals for the specialized  services  that
15        qualify  them  as  Critical  Care  Access  Hospitals.  No
16        adjustment  payments  shall be made under this subsection
17        on or after July 1, 1995.
18             (2)  "Critical Care Access Hospitals" includes,  but
19        is  not  limited  to, hospitals that meet at least one of
20        the following criteria:
21                  (A)  Hospitals    located    outside    of    a
22             metropolitan statistical area that are designated as
23             Level  II  Perinatal  Centers  and  that  provide  a
24             disproportionate  share  of  perinatal  services  to
25             recipients; or
26                  (B)  Hospitals that are designated as  Level  I
27             Trauma  Centers  (adult  or  pediatric)  and certain
28             Level  II  Trauma  Centers  as  determined  by   the
29             Illinois Department; or
30                  (C)  Hospitals    located    outside    of    a
31             metropolitan  statistical  area  and  that provide a
32             disproportionate share of  obstetrical  services  to
33             recipients.
34        (e)  Inpatient  high  volume  adjustment.   For  hospital
 
                            -30-     LRB093 05497 DRJ 19863 a
 1    inpatient  services, effective with rate periods beginning on
 2    or after October 1, 1993,  in  addition  to  rates  paid  for
 3    inpatient  services  by the Illinois Department, the Illinois
 4    Department  shall  make  adjustment  payments  for  inpatient
 5    services furnished by Medicaid high  volume  hospitals.   The
 6    Illinois  Department  shall  establish  by  rule criteria for
 7    qualifying as a  Medicaid  high  volume  hospital  and  shall
 8    establish by rule a reimbursement methodology for calculating
 9    these  adjustment payments to Medicaid high volume hospitals.
10    No adjustment payment shall be made under this subsection for
11    services rendered on or after July 1, 1995.
12        (f)  The Illinois Department  shall  modify  its  current
13    rules  governing  adjustment  payments  for  targeted access,
14    critical care access,  and  uncompensated  care  to  classify
15    those   adjustment   payments   as   not  being  payments  to
16    disproportionate share  hospitals  under  Title  XIX  of  the
17    federal   Social  Security  Act.  Rules  adopted  under  this
18    subsection shall not be effective with  respect  to  services
19    rendered  on  or after July 1, 1995.  The Illinois Department
20    has no obligation to adopt or implement any rules or make any
21    payments under this subsection for services  rendered  on  or
22    after July 1, 1995.
23        (f-5)  The  State  recognizes that adjustment payments to
24    hospitals providing certain  services  or  incurring  certain
25    costs  may  be necessary to assure that recipients of medical
26    assistance  have  adequate  access   to   necessary   medical
27    services.   These  adjustments  include payments for teaching
28    costs  and  uncompensated  care,  trauma   center   payments,
29    rehabilitation  hospital payments, perinatal center payments,
30    obstetrical care payments, targeted access payments, Medicaid
31    high  volume  payments,  and   outpatient   indigent   volume
32    payments.    On   or  before  April  1,  1995,  the  Illinois
33    Department  shall   issue   recommendations   regarding   (i)
34    reimbursement  mechanisms  or  adjustment payments to reflect
 
                            -31-     LRB093 05497 DRJ 19863 a
 1    these costs and services,  including  methods  by  which  the
 2    payments  may  be  calculated  and  the  method  by which the
 3    payments may be financed, and (ii)  reimbursement  mechanisms
 4    or  adjustment  payments  to  reflect  costs  and services of
 5    federally qualified health centers with respect to recipients
 6    of medical assistance.
 7        (g)  If one or more hospitals  file  suit  in  any  court
 8    challenging  any  part  of  this  Article  XIV,  payments  to
 9    hospitals  under  this  Article XIV shall be made only to the
10    extent that sufficient monies are available in the  Fund  and
11    only  to  the  extent  that  any  monies  in the Fund are not
12    prohibited from disbursement under any order of the court.
13        (h)  Payments   under   the   disbursement    methodology
14    described  in  this  Section  are  subject to approval by the
15    federal government in an appropriate State plan amendment.
16        (i)  The  Illinois  Department  may  by  rule   establish
17    criteria   for   and  develop  methodologies  for  adjustment
18    payments to hospitals participating under this Article.
19        (j)  Hospital  Residing  Long  Term  Care  Services.   In
20    addition  to  any  other  payments  made under this Code, the
21    Illinois  Department  may  by  rule  establish  criteria  and
22    develop methodologies for payments to hospitals for  Hospital
23    Residing Long Term Care Services.
24        (k)  Nothing   in   this   Section   shall  preclude  the
25    Department of Public Aid from recognizing  in  its  inpatient
26    reimbursement  methodology,  by  rule, the direct cost of new
27    technologies that are expected to reduce the overall cost  of
28    inpatient   services   when   the  new  technology  has  been
29    recognized by Medicare for inpatient reimbursement.
30    (Source: P.A. 93-20, eff. 6-20-03.)

31        (305 ILCS 5/Art. V-D rep.)
32        (305 ILCS 5/14-2 rep.)
33        (305 ILCS 5/14-3 rep.)
 
                            -32-     LRB093 05497 DRJ 19863 a
 1        (305 ILCS 5/14-4 rep.)
 2        (305 ILCS 5/14-5 rep.)
 3        (305 ILCS 5/14-6 rep.)
 4        (305 ILCS 5/14-7 rep.)
 5        (305 ILCS 5/14-9 rep.)
 6        (305 ILCS 5/14-10 rep.)
 7        Section 11.  The Illinois Public Aid Code is  amended  by
 8    repealing  Article  V-D  and Sections 14-2, 14-3, 14-4, 14-5,
 9    14-6, 14-7, 14-9, and 14-10.

10        Section 99.  Effective date.  This Act takes effect  upon
11    becoming law.".