093_HB0701enr

 
HB0701 Enrolled                      LRB093 05499 MKM 05590 b

 1        AN ACT in relation to public aid.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The State Finance Act is  amended  by  adding
 5    Sections  5.620,  5.621, and 6z-56 and changing Section 8h as
 6    follows:

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

 9        (30 ILCS 105/5.621 new)
10        Sec. 5.621.  The Health and Human Services Medicaid Trust
11    Fund.

12        (30 ILCS 105/6z-56 new)
13        Sec. 6z-56.  The Health Care  Services  Trust  Fund.  The
14    Health  Care  Services  Trust  Fund  is  hereby  created as a
15    special fund in the State treasury.
16        The Fund shall consist of moneys deposited,  transferred,
17    or  appropriated into the Fund from units of local government
18    other than a county with a population greater than 3,000,000,
19    from the State, from federal  matching  funds,  or  from  any
20    other legal source.
21        Subject to appropriation, the moneys in the Fund shall be
22    used  by  the  Department  of  Public Aid to make payments to
23    providers of services covered under  the  Medicaid  or  State
24    Children's  Health  Insurance  programs. Payments may be made
25    out  of  the  Fund  only  to  providers  located  within  the
26    geographic jurisdiction of units  of  local  government  that
27    make deposits, transfers, or appropriations into the Fund.
28        The Department of Public Aid shall adopt rules concerning
29    application for and disbursement of the moneys in the Fund.
 
HB0701 Enrolled            -2-       LRB093 05499 MKM 05590 b
 1        (30 ILCS 105/8h)
 2        Sec.    8h.    Transfers   to   General   Revenue   Fund.
 3    Notwithstanding any other State  law  to  the  contrary,  the
 4    Director  of  the  Governor's Office of Management and Budget
 5    Bureau of the Budget may from time to time direct  the  State
 6    Treasurer  and  Comptroller  to transfer a specified sum from
 7    any fund held by the State Treasurer to the  General  Revenue
 8    Fund  in order to help defray the State's operating costs for
 9    the fiscal year.  The total transfer under this Section  from
10    any fund in any fiscal year shall not exceed the lesser of 8%
11    of  the  revenues  to  be deposited into the fund during that
12    year or 25% of  the  beginning  balance  in  the  fund.    No
13    transfer  may  be  made  from  a fund under this Section that
14    would have the effect of reducing the  available  balance  in
15    the  fund  to  an  amount  less  than  the  amount  remaining
16    unexpended  and  unreserved from the total appropriation from
17    that fund for that fiscal year.  This Section does not  apply
18    to any funds that are restricted by federal law to a specific
19    use  or  to  any  funds  in  the  Motor  Fuel Tax Fund or the
20    Hospital Provider Fund.  Notwithstanding any other  provision
21    of  this  Section, the total transfer under this Section from
22    the Road Fund or the State Construction  Account  Fund  shall
23    not  exceed  5% of the revenues to be deposited into the fund
24    during that year.
25        In determining the  available  balance  in  a  fund,  the
26    Director  of  the  Governor's Office of Management and Budget
27    Bureau of the Budget may include receipts, transfers into the
28    fund, and other resources anticipated to be available in  the
29    fund in that fiscal year.
30        The  State  Treasurer  and Comptroller shall transfer the
31    amounts designated under this  Section  as  soon  as  may  be
32    practicable  after  receiving  the direction to transfer from
33    the Director of  the  Governor's  Office  of  Management  and
34    Budget Bureau of the Budget.
 
HB0701 Enrolled            -3-       LRB093 05499 MKM 05590 b
 1    (Source: P.A. 93-32, eff. 6-20-03; revised 8-21-03.)

 2        Section  10.   The Illinois Public Aid Code is amended by
 3    changing Sections 5-5.4, 5A-1, 5A-2, 5A-3, 5A-4, 5A-5,  5A-7,
 4    5A-8,  5A-10,  and  14-1 and by adding Sections 5A-12, 5A-13,
 5    and 5A-14 as follows:

 6        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 7        Sec. 5-5.4.  Standards of Payment - Department of  Public
 8    Aid.  The Department of Public Aid shall develop standards of
 9    payment of skilled nursing and intermediate care services  in
10    facilities providing such services under this Article which:
11        (1)  Provide   for  the  determination  of  a  facility's
12    payment for skilled nursing and intermediate care services on
13    a prospective basis. The amount of the payment rate  for  all
14    nursing  facilities  certified  by  the  Department of Public
15    Health under the Nursing Home Care Act as  Intermediate  Care
16    for  the  Developmentally Disabled facilities, Long Term Care
17    for Under Age 22 facilities, Skilled Nursing  facilities,  or
18    Intermediate  Care  facilities  under  the medical assistance
19    program shall be prospectively established  annually  on  the
20    basis   of   historical,   financial,  and  statistical  data
21    reflecting actual costs from  prior  years,  which  shall  be
22    applied  to  the current rate year and updated for inflation,
23    except that the capital cost element  for  newly  constructed
24    facilities  shall  be  based  upon  projected  budgets.   The
25    annually established payment rate shall take effect on July 1
26    in 1984 and subsequent years.  No rate increase and no update
27    for  inflation shall be provided on or after July 1, 1994 and
28    before July 1, 2004, unless specifically provided for in this
29    Section.
30        For facilities  licensed  by  the  Department  of  Public
31    Health  under  the Nursing Home Care Act as Intermediate Care
32    for the Developmentally Disabled facilities or Long Term Care
 
HB0701 Enrolled            -4-       LRB093 05499 MKM 05590 b
 1    for Under Age 22 facilities, the rates taking effect on  July
 2    1,  1998  shall  include  an  increase of 3%.  For facilities
 3    licensed by the Department of Public Health under the Nursing
 4    Home Care Act as Skilled Nursing facilities  or  Intermediate
 5    Care  facilities,  the  rates  taking  effect on July 1, 1998
 6    shall include an increase of 3% plus $1.10 per  resident-day,
 7    as defined by the Department.
 8        For  facilities  licensed  by  the  Department  of Public
 9    Health under the Nursing Home Care Act as  Intermediate  Care
10    for the Developmentally Disabled facilities or Long Term Care
11    for  Under Age 22 facilities, the rates taking effect on July
12    1, 1999 shall include an increase  of  1.6%  plus  $3.00  per
13    resident-day,  as  defined by the Department.  For facilities
14    licensed by the Department of Public Health under the Nursing
15    Home Care Act as Skilled Nursing facilities  or  Intermediate
16    Care  facilities,  the  rates  taking  effect on July 1, 1999
17    shall include an increase of 1.6% and, for services  provided
18    on  or after October 1, 1999, shall be increased by $4.00 per
19    resident-day, as defined by the Department.
20        For facilities  licensed  by  the  Department  of  Public
21    Health  under  the Nursing Home Care Act as Intermediate Care
22    for the Developmentally Disabled facilities or Long Term Care
23    for Under Age 22 facilities, the rates taking effect on  July
24    1,  2000  shall include an increase of 2.5% per resident-day,
25    as defined by the Department.  For facilities licensed by the
26    Department of Public Health under the Nursing Home  Care  Act
27    as   Skilled   Nursing   facilities   or   Intermediate  Care
28    facilities, the rates taking effect on  July  1,  2000  shall
29    include  an  increase of 2.5% per resident-day, as defined by
30    the Department.
31        For facilities  licensed  by  the  Department  of  Public
32    Health  under  the  Nursing  Home Care Act as skilled nursing
33    facilities or intermediate care  facilities,  a  new  payment
34    methodology  must be implemented for the nursing component of
 
HB0701 Enrolled            -5-       LRB093 05499 MKM 05590 b
 1    the rate effective July 1, 2003. The Department of Public Aid
 2    shall develop the new payment methodology using  the  Minimum
 3    Data  Set  (MDS)  as  the  instrument  to collect information
 4    concerning  nursing  home  resident  condition  necessary  to
 5    compute the rate. The Department of Public Aid shall  develop
 6    the  new  payment  methodology  to  meet  the unique needs of
 7    Illinois nursing home residents while  remaining  subject  to
 8    the  appropriations  provided  by  the  General  Assembly.  A
 9    transition  period  from the payment methodology in effect on
10    June 30, 2003 to the payment methodology in effect on July 1,
11    2003 shall be provided for a period  not  exceeding  2  years
12    after  implementation  of  the  new  payment  methodology  as
13    follows:
14             (A)  For  a  facility  that  would  receive  a lower
15        nursing component rate per  patient  day  under  the  new
16        system  than  the facility received effective on the date
17        immediately  preceding  the  date  that  the   Department
18        implements  the  new  payment  methodology,  the  nursing
19        component  rate per patient day for the facility shall be
20        held at the level  in  effect  on  the  date  immediately
21        preceding the date that the Department implements the new
22        payment methodology until a higher nursing component rate
23        of reimbursement is achieved by that facility.
24             (B)  For  a  facility  that  would  receive a higher
25        nursing component rate per patient day under the  payment
26        methodology  in  effect on July 1, 2003 than the facility
27        received effective on the date immediately preceding  the
28        date  that  the  Department  implements  the  new payment
29        methodology, the nursing component rate per  patient  day
30        for the facility shall be adjusted.
31             (C)  Notwithstanding  paragraphs  (A)  and  (B), the
32        nursing component rate per patient day for  the  facility
33        shall  be  adjusted subject to appropriations provided by
34        the General Assembly.
 
HB0701 Enrolled            -6-       LRB093 05499 MKM 05590 b
 1        For facilities  licensed  by  the  Department  of  Public
 2    Health  under  the Nursing Home Care Act as Intermediate Care
 3    for the Developmentally Disabled facilities or Long Term Care
 4    for Under Age 22 facilities, the rates taking effect on March
 5    1, 2001 shall include  a  statewide  increase  of  7.85%,  as
 6    defined by the Department.
 7        For  facilities  licensed  by  the  Department  of Public
 8    Health under the Nursing Home Care Act as  Intermediate  Care
 9    for the Developmentally Disabled facilities or Long Term Care
10    for Under Age 22 facilities, the rates taking effect on April
11    1,  2002  shall  include  a  statewide  increase  of 2.0%, as
12    defined by the Department. This increase terminates  on  July
13    1,  2002;  beginning  July 1, 2002 these rates are reduced to
14    the level of the rates  in  effect  on  March  31,  2002,  as
15    defined by the Department.
16        For  facilities  licensed  by  the  Department  of Public
17    Health under the Nursing Home Care  Act  as  skilled  nursing
18    facilities  or intermediate care facilities, the rates taking
19    effect on July 1, 2001  shall  be  computed  using  the  most
20    recent cost reports on file with the Department of Public Aid
21    no later than April 1, 2000, updated for inflation to January
22    1,  2001.  For rates effective July 1, 2001 only, rates shall
23    be the greater of the rate computed for July 1, 2001  or  the
24    rate effective on June 30, 2001.
25        Notwithstanding  any other provision of this Section, for
26    facilities licensed by the Department of Public Health  under
27    the  Nursing  Home  Care Act as skilled nursing facilities or
28    intermediate care facilities, the Illinois  Department  shall
29    determine  by  rule  the rates taking effect on July 1, 2002,
30    which shall be 5.9% less than the rates in effect on June 30,
31    2002.
32        Notwithstanding any other provision of this Section,  for
33    facilities  licensed by the Department of Public Health under
34    the Nursing Home Care Act as skilled  nursing  facilities  or
 
HB0701 Enrolled            -7-       LRB093 05499 MKM 05590 b
 1    intermediate  care  facilities, the Illinois Department shall
 2    determine by rule the rates taking effect on  July  1,  2003,
 3    which shall be 3.0% less than the rates in effect on June 30,
 4    2002.  This  rate  shall  take  effect only upon approval and
 5    implementation of the payment  methodologies  required  under
 6    Section 5A-12.
 7        Rates  established  effective  each  July  1 shall govern
 8    payment for services rendered throughout  that  fiscal  year,
 9    except  that  rates  established  on  July  1,  1996 shall be
10    increased by 6.8% for services provided on or  after  January
11    1,  1997.  Such rates will be based upon the rates calculated
12    for the year beginning July 1, 1990, and for subsequent years
13    thereafter until June 30, 2001 shall be based on the facility
14    cost reports for the facility fiscal year ending at any point
15    in time during the previous calendar  year,  updated  to  the
16    midpoint  of the rate year.  The cost report shall be on file
17    with the Department no later than April 1 of the current rate
18    year.  Should the cost report not be on file by April 1,  the
19    Department  shall  base  the  rate  on the latest cost report
20    filed by each skilled care  facility  and  intermediate  care
21    facility,  updated  to the midpoint of the current rate year.
22    In determining rates for services rendered on and after  July
23    1,  1985, fixed time shall not be computed at less than zero.
24    The Department shall not make any alterations of  regulations
25    which  would  reduce  any component of the Medicaid rate to a
26    level below what that component would have been utilizing  in
27    the rate effective on July 1, 1984.
28        (2)  Shall take into account the actual costs incurred by
29    facilities  in  providing  services for recipients of skilled
30    nursing and intermediate  care  services  under  the  medical
31    assistance program.
32        (3)  Shall    take   into   account   the   medical   and
33    psycho-social characteristics and needs of the patients.
34        (4)  Shall take into account the actual costs incurred by
 
HB0701 Enrolled            -8-       LRB093 05499 MKM 05590 b
 1    facilities in meeting licensing and  certification  standards
 2    imposed  and  prescribed by the State of Illinois, any of its
 3    political subdivisions or  municipalities  and  by  the  U.S.
 4    Department of Health and Human Services pursuant to Title XIX
 5    of the Social Security Act.
 6        The  Department  of  Public  Aid  shall  develop  precise
 7    standards  for  payments  to reimburse nursing facilities for
 8    any utilization of appropriate rehabilitative  personnel  for
 9    the  provision of rehabilitative services which is authorized
10    by federal regulations, including reimbursement for  services
11    provided by qualified therapists or qualified assistants, and
12    which  is in accordance with accepted professional practices.
13    Reimbursement also may  be  made  for  utilization  of  other
14    supportive personnel under appropriate supervision.
15    (Source:  P.A.  92-10,  eff.  6-11-01;  92-31,  eff. 6-28-01;
16    92-597, eff. 6-28-02;  92-651,  eff.  7-11-02;  92-848,  eff.
17    1-1-03; 93-20, eff. 6-20-03.)

18        (305 ILCS 5/5A-1) (from Ch. 23, par. 5A-1)
19        Sec.  5A-1.  Definitions. As used in this Article, unless
20    the context requires otherwise:
21        "Fund" means the Hospital Provider Fund.
22        "Hospital" means  an  institution,  place,  building,  or
23    agency  located in this State that is subject to licensure by
24    the Illinois Department of Public Health under  the  Hospital
25    Licensing   Act,   whether  public  or  private  and  whether
26    organized for profit or not-for-profit.
27        "Hospital  provider"  means  a  person  licensed  by  the
28    Department of Public Health to conduct, operate, or  maintain
29    a  hospital,  regardless  of whether the person is a Medicaid
30    provider.  For purposes of this paragraph, "person" means any
31    political subdivision of the  State,  municipal  corporation,
32    individual,  firm, partnership, corporation, company, limited
33    liability company, association, joint stock  association,  or
 
HB0701 Enrolled            -9-       LRB093 05499 MKM 05590 b
 1    trust,  or  a receiver, executor, trustee, guardian, or other
 2    representative appointed by order of any court.
 3        "Occupied bed days" means the sum of the number  of  days
 4    that  each  bed was occupied by a patient for all beds during
 5    calendar year 2001.  Occupied  bed  days  shall  be  computed
 6    separately  for  each  hospital  operated  or maintained by a
 7    hospital provider.
 8        "Adjusted gross hospital  revenue"  shall  be  determined
 9    separately   for   each   hospital  conducted,  operated,  or
10    maintained by a hospital provider, and   means  the  hospital
11    provider's   total   gross  patient  revenues  less  Medicare
12    contractual allowances, but does not  include  gross  patient
13    revenue   (and   the  portion  of  any  Medicare  contractual
14    allowance  related  thereto)  from  skilled  or  intermediate
15    long-term care services within the meaning of Title XVIII  or
16    XIX of the Social Security Act.
17        "Intergovernmental  transfer  payment" means the payments
18    established under Section 15-3 of  this  Code,  and  includes
19    without  limitation  payments  payable under that Section for
20    July, August, and September of 1992.
21    (Source: P.A. 87-861; 88-88.)

22        (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
23        Sec. 5A-2.  Assessment; no local authorization to tax.
24        (a)  Subject  to  Sections  5A-3  and  5A-10,  an  annual
25    assessment on inpatient services is imposed on each  hospital
26    provider  for  State  fiscal years 2004 and 2005 in an amount
27    equal to the  hospital's  occupied  bed  days  multiplied  by
28    $84.19.
29        The  Department  of  Public  Aid  shall use the number of
30    occupied bed days as reported by each hospital on the  Annual
31    Survey  of  Hospitals  conducted  by the Department of Public
32    Health to calculate the hospital's annual assessment.  If the
33    sum of a hospital's occupied bed days is not reported on  the
 
HB0701 Enrolled            -10-      LRB093 05499 MKM 05590 b
 1    Annual Survey of Hospitals, then the Department of Public Aid
 2    may  obtain  the  sum  of  occupied  bed days from any source
 3    available, including, but not limited to, records  maintained
 4    by the hospital provider, which may be inspected at all times
 5    during  business hours of the day by the Department of Public
 6    Aid or its duly authorized  agents  and  employees.  For  the
 7    privilege of engaging in the occupation of hospital provider,
 8    an  assessment is imposed upon each hospital provider for the
 9    State fiscal year beginning on July 1,  1993  and  ending  on
10    June  30, 1994, in an amount equal to 1.88% of the provider's
11    adjusted gross hospital revenue for the most recent  calendar
12    year ending before the beginning of that State fiscal year.
13        Effective  July  1, 1994 through June 30, 1996, an annual
14    assessment is imposed  upon  each  hospital  provider  in  an
15    amount  equal  to  the  provider's  adjusted  gross  hospital
16    revenue  for  the most recent calendar year ending before the
17    beginning  of  that  State  fiscal  year  multiplied  by  the
18    Provider's Savings Rate.
19        Effective  July  1,  1996  through  March  31,  1997,  an
20    assessment is imposed  upon  each  hospital  provider  in  an
21    amount  equal  to  three-fourths  of  the provider's adjusted
22    gross hospital revenue for calendar year 1995  multiplied  by
23    the  Provider's Savings Rate.  No assessment shall be imposed
24    on or after April 1, 1997.
25        Before July 1, 1995, the Provider's Savings Rate is 1.88%
26    multiplied by a fraction,  the  numerator  of  which  is  the
27    Maximum  Section  5A-2  Contribution  minus the Cigarette Tax
28    Contribution, and the denominator of  which  is  the  Maximum
29    Section  5A-2  Contribution.   Effective  July  1,  1995, the
30    Provider's Savings Rate is 1.25% multiplied  by  a  fraction,
31    the   numerator   of   which  is  the  Maximum  Section  5A-2
32    Contribution minus the Cigarette Tax  Contribution,  and  the
33    denominator   of   which   is   the   Maximum   Section  5A-2
34    Contribution.
 
HB0701 Enrolled            -11-      LRB093 05499 MKM 05590 b
 1        The Cigarette Tax Contribution is the sum  of  the  total
 2    amount  deposited  in  the  Hospital  Provider  Fund  in  the
 3    previous  State  fiscal  year pursuant to Section 2(a) of the
 4    Cigarette Tax Act, plus the total  amount  deposited  in  the
 5    Hospital  Provider  Fund  in  the  previous State fiscal year
 6    pursuant to Section 5A-3(c) of this Code.
 7        The Maximum Section 5A-2 Contribution is the total amount
 8    of tax imposed by this Section in the previous  State  fiscal
 9    year  on  providers  subject  to  this  Act,  multiplied by a
10    fraction the numerator of which is  adjusted  gross  hospital
11    revenues  reported  to the Department by providers subject to
12    this  Act  for  the  previous  State  fiscal  year  and   the
13    denominator  of  which  is  adjusted  gross hospital revenues
14    reported to the Department by providers subject to  this  Act
15    for  the State fiscal year immediately preceding the previous
16    State fiscal year.
17        The Department shall notify  hospital  providers  of  the
18    Provider's   Savings   Rate  by  mailing  a  notice  to  each
19    provider's last known address as reflected by the records  of
20    the Illinois Department.
21        (b)  Nothing  in  this amendatory Act of the 93rd General
22    Assembly 1995 shall be construed to authorize any  home  rule
23    unit or other unit of local government to license for revenue
24    or  to  impose a tax or assessment upon hospital providers or
25    the occupation of hospital provider, or a tax  or  assessment
26    measured by the income or earnings of a hospital provider.
27        (c)  As  provided  in  Section  5A-14,  this  Section  is
28    repealed on July 1, 2005.
29    (Source:   P.A.  88-88;  89-21,  eff.  7-1-95;  89-499,  eff.
30    6-28-96.)

31        (305 ILCS 5/5A-3) (from Ch. 23, par. 5A-3)
32        Sec. 5A-3.  Exemptions; intergovernmental transfers.
33        (a)  Blank). A hospital provider which is a county with a
 
HB0701 Enrolled            -12-      LRB093 05499 MKM 05590 b
 1    population   of    more    than    3,000,000    that    makes
 2    intergovernmental  transfer  payments  as provided in Section
 3    15-3 of this Code shall be exempt from the assessment imposed
 4    by Section 5A-2, unless  the  exemption  is  adjudged  to  be
 5    unconstitutional  or  otherwise  invalid,  in  which case the
 6    county shall pay the assessment imposed by Section  5A-2  for
 7    all  assessment  periods  beginning on or after July 1, 1992,
 8    and the assessment so paid shall be  creditable  against  the
 9    intergovernmental transfer payments.
10        (b)  A  hospital provider that is a State agency, a State
11    university, or a county with a  population  of  3,000,000  or
12    more is exempt from the assessment imposed by Section 5A-2. A
13    hospital  organized under the University of Illinois Hospital
14    Act and exempt from the assessment imposed by Section 5A-2 is
15    hereby authorized to enter into an interagency agreement with
16    the Illinois Department to  make  intergovernmental  transfer
17    payments to the Illinois Department.  These payments shall be
18    deposited  into  the University of Illinois Hospital Services
19    Fund or, if that Fund  ceases  to  exist,  into  the  General
20    Revenue Fund.
21        (b-2)  A  hospital  provider  that  is  a  county  with a
22    population  of   less   than   3,000,000   or   a   township,
23    municipality,   hospital   district,   or   any  other  local
24    governmental unit is exempt from the  assessment  imposed  by
25    Section 5A-2.
26        (b-5)  (Blank).  A hospital operated by the Department of
27    Human Services in the course of performing its mental  health
28    and  developmental  disabilities functions is exempt from the
29    assessment imposed by Section 5A-2.
30        (b-10)  A  hospital  provider  whose  hospital  does  not
31    charge for its services is exempt from the assessment imposed
32    by Section 5A-2, unless  the  exemption  is  adjudged  to  be
33    unconstitutional  or  otherwise  invalid,  in  which case the
34    hospital provider shall pay the assessment imposed by Section
 
HB0701 Enrolled            -13-      LRB093 05499 MKM 05590 b
 1    5A-2.
 2        (b-15)  A hospital provider whose hospital is licensed by
 3    the Department of Public Health as a psychiatric hospital  is
 4    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-20)  A hospital provider whose hospital is licensed by
 9    the  Department of Public Health as a rehabilitation hospital
10    is exempt from the assessment imposed by Section 5A-2, unless
11    the exemption is adjudged to be unconstitutional or otherwise
12    invalid, in which case the hospital provider  shall  pay  the
13    assessment imposed by Section 5A-2.
14        (b-25)  A  hospital  provider whose hospital (i) is not a
15    psychiatric hospital, rehabilitation hospital, or  children's
16    hospital  and  (ii)  has  an average length of inpatient stay
17    greater than 25 days is exempt from the assessment imposed by
18    Section  5A-2,  unless  the  exemption  is  adjudged  to   be
19    unconstitutional  or  otherwise  invalid,  in  which case the
20    hospital provider shall pay the assessment imposed by Section
21    5A-2.
22        (c)  (Blank).   The   Illinois   Department   is   hereby
23    authorized to enter into agreements with  publicly  owned  or
24    operated   hospitals   to   make  intergovernmental  transfer
25    payments to the Illinois Department.  These payments shall be
26    deposited into the Hospital Provider Fund,  except  that  any
27    payments arising under an agreement with a hospital organized
28    under  the  University  of  Illinois  Hospital  Act  shall be
29    deposited into the University of Illinois  Hospital  Services
30    Fund, if that Fund exists.
31    (Source:  P.A.  88-88;  88-554,  eff.  7-26-94;  89-21,  eff.
32    7-1-95; 89-507, eff. 7-1-97.)

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

10        (305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)
11        Sec.  5A-5.   Notice  Reporting;  penalty; maintenance of
12    records.
13        (a)  After December 31 of each year (except as  otherwise
14    provided  in  this  subsection), and on or before March 31 of
15    the succeeding year, the Department of Public Aid shall  send
16    a  notice of assessment to every hospital provider subject to
17    assessment under this Article shall file a  return  with  the
18    Illinois  Department.   The notice of assessment shall notify
19    the hospital of its return shall report  the  adjusted  gross
20    hospital  revenue from the calendar year just ended and shall
21    be utilized by  the  Illinois  Department  to  calculate  the
22    assessment  for  the State fiscal year commencing on the next
23    July 1, except that the notice return for  the  State  fiscal
24    year  commencing  July 1, 2003 1992 and the report of revenue
25    for calendar year 1991 shall be sent filed on or before  June
26    1,  2004 September 30, 1992.  The notice return shall be on a
27    form prepared by the Illinois Department and shall state  the
28    following:
29             (1)  The name of the hospital provider.
30             (2)  The   address   of   the   hospital  provider's
31        principal place  of  business  from  which  the  provider
32        engages  in  the  occupation of hospital provider in this
33        State,  and  the  name  and  address  of  each   hospital
 
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 1        operated,  conducted,  or  maintained  by the provider in
 2        this State.
 3             (3)  The occupied bed days adjusted  gross  hospital
 4        revenue  of  the  hospital provider for the calendar year
 5        just  ended,  the  amount  of  assessment  imposed  under
 6        Section 5A-2 for the State  fiscal  year  for  which  the
 7        notice  return  is  sent  filed,  and  the amount of each
 8        quarterly installment to be paid during the State  fiscal
 9        year.
10             (4)  (Blank). The amount of penalty due, if any.
11             (5)  Other  reasonable  information as determined by
12        the Illinois Department requires.
13        (b)  If  a  hospital  provider  conducts,  operates,   or
14    maintains  more  than  one  hospital licensed by the Illinois
15    Department of Public Health, the provider shall may not  file
16    a  single return covering all those hospitals, but shall file
17    a separate return for each hospital and shall compute and pay
18    the assessment for each hospital separately.
19        (c)  Notwithstanding any other provision in this Article,
20    in the case of a person who ceases to  conduct,  operate,  or
21    maintain a hospital in respect of which the person is subject
22    to  assessment under this Article as a hospital provider, the
23    assessment for the State fiscal year in which  the  cessation
24    occurs  shall  be  adjusted  by  multiplying  the  assessment
25    computed  under  Section 5A-2 by a fraction, the numerator of
26    which is the number of days months in the year  during  which
27    the  provider  conducts,  operates, or maintains the hospital
28    and the denominator of which is  365  12.   Immediately  upon
29    ceasing  to  conduct,  operate,  or  maintain a hospital, the
30    person shall pay  file  a  final,  amended  return  with  the
31    Illinois Department not more than 90 days after the cessation
32    reflecting the adjustment and shall pay with the final return
33    the assessment for the year as so adjusted (to the extent not
34    previously paid).
 
HB0701 Enrolled            -17-      LRB093 05499 MKM 05590 b
 1        (d)  Notwithstanding any other provision in this Article,
 2    a   provider   who   commences   conducting,   operating,  or
 3    maintaining  a  hospital,  upon  notice   by   the   Illinois
 4    Department, shall file an initial return for the State fiscal
 5    year   in  which  the  commencement  occurs  within  90  days
 6    thereafter  and  shall  pay  the  assessment  computed  under
 7    Section 5A-2 and subsection (e) in equal installments on  the
 8    due  dates stated in the notice date of the return and on the
 9    regular installment due  dates  for  the  State  fiscal  year
10    occurring  after  the  due  dates  date of the initial notice
11    return.
12        (e)  Notwithstanding any other provision in this Article,
13    in the case of a hospital  provider  that  did  not  conduct,
14    operate,  or maintain a hospital throughout the calendar year
15    2001 preceding a State fiscal year, the assessment  for  that
16    State   fiscal  year  shall  be  computed  on  the  basis  of
17    hypothetical  occupied  bed  days  adjusted  gross   hospital
18    revenue  for  the  full  calendar year as determined by rules
19    adopted by the Illinois Department (which  may  be  based  on
20    annualization of the provider's actual revenues for a portion
21    of  the  calendar  year, or revenues of a comparable hospital
22    for the year, including revenues realized by a prior provider
23    from the same hospital during the year).
24        (f)  (Blank). In the case of a hospital provider existing
25    as a corporation or legal entity other  than  an  individual,
26    the  return  filed  by  it  shall be signed by its president,
27    vice-president, secretary, or treasurer or  by  its  properly
28    authorized agent.
29        (g)  (Blank).  If  a  hospital provider fails to file its
30    return for a State fiscal year on or before the due  date  of
31    the  return,  there  shall,  unless  waived  by  the Illinois
32    Department for reasonable cause, be added to  the  assessment
33    imposed  by  Section 5A-2 for the State fiscal year a penalty
34    assessment equal to 25% of the  assessment  imposed  for  the
 
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 1    year.
 2        (h)  (Blank).   Every   hospital   provider   subject  to
 3    assessment under this Article shall keep  sufficient  records
 4    to  permit  the  determination  of  adjusted  gross  hospital
 5    revenue  on a calendar year basis.  All such records shall be
 6    kept in the English language and shall, at all  times  during
 7    business  hours  of  the day, be subject to inspection by the
 8    Illinois  Department  or  its  duly  authorized  agents   and
 9    employees.
10    (Source: P.A. 87-861.)

11        (305 ILCS 5/5A-7) (from Ch. 23, par. 5A-7)
12        Sec. 5A-7. Administration; enforcement provisions.
13        (a)  To  the  extent practicable, the Illinois Department
14    shall administer and enforce this  Article  and  collect  the
15    assessments,  interest, and penalty assessments imposed under
16    this Article using procedures employed in its  administration
17    of  this  Code  generally  and, as it deems appropriate, in a
18    manner similar to that in which  the  Department  of  Revenue
19    administers  and collects the retailers' occupation tax under
20    the Retailers' Occupation  Tax  Act  ("ROTA").    Instead  of
21    certificates  of  registration, the Illinois Department shall
22    establish and maintain a listing of  all  hospital  providers
23    appearing  in  the  licensing  records  of  the Department of
24    Public  Health,  which  shall  show  each  provider's   name,
25    principal place of business, and the name and address of each
26    hospital  operated,  conducted, or maintained by the provider
27    in  this  State.   In  addition,  the   following   specified
28    provisions   of   the   Retailers'  Occupation  Tax  Act  are
29    incorporated by reference into this Section except  that  the
30    Illinois   Department  and  its  Director  (rather  than  the
31    Department of Revenue and its Director)  and  every  hospital
32    provider  subject to assessment measured by occupied bed days
33    adjusted gross hospital revenue  and  to  the  return  filing
 
HB0701 Enrolled            -19-      LRB093 05499 MKM 05590 b
 1    requirements  of this Article (rather than persons subject to
 2    retailers' occupation tax measured by gross receipts from the
 3    sale of tangible personal  property  at  retail  and  to  the
 4    return  filing  requirements  of ROTA) shall have the powers,
 5    duties, and rights specified in  these  ROTA  provisions,  as
 6    modified  in  this Section or by the Illinois Department in a
 7    manner consistent with this Article and except as  manifestly
 8    inconsistent with the other provisions of this Article:
 9             (1)  ROTA,  Section 4 (examination of return; notice
10        of  correction;  evidence;   limitations;   protest   and
11        hearing),  except  that (i) the Illinois Department shall
12        issue  notices  of  assessment  liability  (rather   than
13        notices of tax liability as provided in ROTA, Section 4);
14        (ii) in the case of a fraudulent return or in the case of
15        an  extended  period agreed to by the Illinois Department
16        and the hospital provider before the  expiration  of  the
17        limitation  period,  no  notice  of  assessment liability
18        shall be issued more than 3 years after the later of  the
19        due  date  of  the return required by Section 5A-5 or the
20        date the return (or an amended return) was filed  (rather
21        within  the  period stated in ROTA, Section 4); and (iii)
22        the penalty provisions  of  ROTA,  Section  4  shall  not
23        apply.
24             (2)  ROTA,  Sec.  5 (failure to make return; failure
25        to pay assessment), except that the penalty and  interest
26        provisions of ROTA, Section 5 shall not apply.
27             (3)  ROTA,    Section    5a    (lien;    attachment;
28        termination;  notice;  protest;  review; release of lien;
29        status of lien).
30             (4)  ROTA, Section 5b  (State  lien  notices;  State
31        lien index; duties of recorder and registrar of titles).
32             (5)  ROTA,   Section   5c   (liens;  certificate  of
33        release).
34             (6)  ROTA, Section 5d (Department  not  required  to
 
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 1        furnish bond; claim to property attached or levied upon).
 2             (7)  ROTA,   Section   5e   (foreclosure  on  liens;
 3        enforcement).
 4             (8)  ROTA, Section 5f (demand for payment; levy  and
 5        sale of property; limitation).
 6             (9)  ROTA,    Section    5g   (sale   of   property;
 7        redemption).
 8             (10)  ROTA, Section 5j (sales on  transfers  outside
 9        usual  course of business; report; payment of assessment;
10        rights and duties of  purchaser;  penalty),  except  that
11        notice  shall  be  provided to the Illinois Department as
12        specified by rule.
13             (11)  ROTA, Section 6 (erroneous payments; credit or
14        refund), provided that (i) the  Illinois  Department  may
15        only  apply  an  amount  otherwise  subject  to credit or
16        refund to a liability arising under  this  Article;  (ii)
17        except in the case of an extended period agreed to by the
18        Illinois  Department and the hospital provider before the
19        expiration of this limitation period, a claim for  credit
20        or  refund  must  be filed no more than 3 years after the
21        due date of the return required by Section  5A-5  (rather
22        than  the time limitation stated in ROTA, Section 6); and
23        (iii) credits or refunds shall not bear interest.
24             (12)  ROTA,  Section  6a  (claims  for   credit   or
25        refund).
26             (13)  ROTA,  Section  6b (tentative determination of
27        claim; notice; hearing; review), provided that a hospital
28        provider or its representative shall have 60 days (rather
29        than 20 days)  within which to file a protest and request
30        for hearing in response to a tentative  determination  of
31        claim.
32             (14)  ROTA,   Section   6c  (finality  of  tentative
33        determinations).
34             (15)  ROTA,   Section   8     (investigations    and
 
HB0701 Enrolled            -21-      LRB093 05499 MKM 05590 b
 1        hearings).
 2             (16)  ROTA, Section 9 (witness; immunity).
 3             (17)  ROTA,   Section  10  (issuance  of  subpoenas;
 4        attendance  of  witnesses;  production   of   books   and
 5        records).
 6             (18)  ROTA,  Section  11  (information confidential;
 7        exceptions).
 8             (19)  ROTA,  Section  12  (rules  and   regulations;
 9        hearing;  appeals), except that a hospital provider shall
10        not be required to file a bond or be subject to a lien in
11        lieu thereof in order to  seek  court  review  under  the
12        Administrative  Review  Law  of  a  final  assessment  or
13        revised final assessment or the equivalent thereof issued
14        by the Illinois Department under this Article.
15        (b)  In  addition  to  any  other remedy provided for and
16    without  sending  a  notice  of  assessment  liability,   the
17    Illinois  Department  may  collect  an  unpaid  assessment by
18    withholding, as payment of the assessment, reimbursements  or
19    other amounts otherwise payable by the Illinois Department to
20    the provider.
21    (Source: P.A. 87-861.)

22        (305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
23        Sec. 5A-8.  Hospital Provider Fund.
24        (a)  There  is created in the State Treasury the Hospital
25    Provider Fund. Interest earned by the Fund shall be  credited
26    to  the  Fund.   The  Fund  shall  not be used to replace any
27    moneys appropriated to the Medicaid program  by  the  General
28    Assembly.
29        (b)  The  Fund  is  created  for the purpose of receiving
30    moneys in accordance with Section 5A-6 and disbursing  moneys
31    only  for  the  following purposes, notwithstanding any other
32    provision of law as follows:
33             (1)  For making payments to  hospitals  as  required
 
HB0701 Enrolled            -22-      LRB093 05499 MKM 05590 b
 1        under  Articles  V,  VI, and XIV hospital inpatient care,
 2        hospital  ambulatory  care,  and  disproportionate  share
 3        hospital distributive expenditures made under  Title  XIX
 4        of the Social Security Act and Article V of this Code and
 5        under the Children's Health Insurance Program Act.
 6             (2)  For  the  reimbursement  of moneys collected by
 7        the  Illinois  Department  from  hospitals  or   hospital
 8        providers  through  error  or  mistake  in performing the
 9        activities authorized under this Article and Article V of
10        this Code and for making required payments under  Section
11        14-9  of  this  Code if there are no moneys available for
12        those payments in the Hospital Services Trust Fund.
13             (3)  For payment of administrative expenses incurred
14        by the Illinois Department or its agent in performing the
15        activities authorized by this Article.
16             (4)  For  payments  of   any   amounts   which   are
17        reimbursable  to the federal government for payments from
18        this Fund which are required to be paid by State warrant.
19             (5)  For making transfers to the General  Obligation
20        Bond Retirement and Interest Fund, as those transfers are
21        authorized  in the proceedings authorizing debt under the
22        Short Term Borrowing Act, but transfers made  under  this
23        paragraph  (5)  shall  not exceed the principal amount of
24        debt issued in anticipation of the receipt by  the  State
25        of moneys to be deposited into the Fund.
26             (6)  For  making  transfers to any other fund in the
27        State treasury, but transfers made under  this  paragraph
28        (6)  shall  not  exceed the amount transferred previously
29        from that other fund into the Hospital Provider Fund.
30             (7)  For making transfers to the  Health  and  Human
31        Services Medicaid Trust Fund, including 20% of the moneys
32        received  from  hospital providers under Section 5A-4 and
33        transferred into the Hospital Provider Fund under Section
34        5A-6. Transfers under this paragraph shall be made within
 
HB0701 Enrolled            -23-      LRB093 05499 MKM 05590 b
 1        7 days after the payments have been received pursuant  to
 2        the  schedule  of  payments provided in subsection (a) of
 3        Section 5A-4.
 4             (8)  For  making  refunds  to   hospital   providers
 5        pursuant to Section 5A-10.
 6        Disbursements   from   the  Fund,  other  than  transfers
 7    authorized under paragraphs (5) and (6) of this subsection to
 8    the General Obligation Bond  Retirement  and  Interest  Fund,
 9    shall  be  by  warrants  drawn  by the State Comptroller upon
10    receipt of  vouchers  duly  executed  and  certified  by  the
11    Illinois Department.
12        (c)  The Fund shall consist of the following:
13             (1)  All   moneys   collected  or  received  by  the
14        Illinois Department from the hospital provider assessment
15        imposed by this Article.
16             (2)  All federal  matching  funds  received  by  the
17        Illinois  Department  as a result of expenditures made by
18        the Illinois Department that are attributable  to  moneys
19        deposited in the Fund.
20             (3)  Any  interest  or penalty levied in conjunction
21        with the administration of this Article.
22             (4)  Moneys transferred from  another  fund  in  the
23        State  treasury.  Any  balance  in  the Hospital Services
24        Trust Fund in the State Treasury.  The balance  shall  be
25        transferred   to  the  Fund  upon  certification  by  the
26        Illinois Department to the State Comptroller that all  of
27        the  disbursements  required  by Section 14-2(b)  of this
28        Code have been made.
29             (5)  All other moneys received for the Fund from any
30        other source, including interest earned thereon.
31        (d)  (Blank). The Fund shall cease to exist on October 1,
32    1999.  Any balance in the Fund  as  of  that  date  shall  be
33    transferred  to  the  General  Revenue Fund.  Any moneys that
34    otherwise would be paid into the Fund on or after  that  date
 
HB0701 Enrolled            -24-      LRB093 05499 MKM 05590 b
 1    shall  be  deposited  into  the  General  Revenue  Fund.  Any
 2    disbursements on or after that date that otherwise  would  be
 3    made  from  the  Fund  may  be  appropriated  by  the General
 4    Assembly from the General Revenue Fund.
 5    (Source: P.A. 89-626, eff. 8-9-96; 90-587, eff. 7-1-98.)

 6        (305 ILCS 5/5A-10) (from Ch. 23, par. 5A-10)
 7        Sec. 5A-10. Applicability.
 8        (a)  The assessment imposed by  Section  5A-2  shall  not
 9    take  effect  or  shall  cease  to be imposed, and any moneys
10    remaining in the Fund shall be refunded to hospital providers
11    in proportion to the amounts paid by them, if:
12             (1)  the sum of the appropriations for State  fiscal
13        years  2004  and  2005  from the General Revenue Fund for
14        hospital payments under the medical assistance program is
15        less than $4,500,000,000; or
16             (2)  the Department of Public Aid makes  changes  in
17        its   rules   that   reduce  the  hospital  inpatient  or
18        outpatient payment rates,  including  adjustment  payment
19        rates, in effect on October 1, 2003, except for hospitals
20        described  in  subsection  (b) of Section 5A-3 and except
21        for changes in outpatient payment rates  made  to  comply
22        with   the   federal  Health  Insurance  Portability  and
23        Accountability Act, so  long  as  those  changes  do  not
24        reduce  aggregate  expenditures below the amount expended
25        in State fiscal year 2003 for such services; or
26             (3)  the  payments  to  hospitals   required   under
27        Section 5A-12 are changed or are not eligible for federal
28        matching  funds  under  Title  XIX  or  XXI of the Social
29        Security Act.
30        (b)  The assessment imposed by  Section  5A-2  shall  not
31    take effect or shall cease to be imposed if the assessment is
32    determined  to  be  an  impermissible  tax amount of matching
33    federal funds under Title XIX of the Social Security  Act  is
 
HB0701 Enrolled            -25-      LRB093 05499 MKM 05590 b
 1    eliminated   or  significantly  reduced  on  account  of  the
 2    assessment.  Moneys in the  Hospital  Provider  Fund  derived
 3    from  assessments imposed prior thereto shall be disbursed in
 4    accordance with Section 5A-8 to the extent  federal  matching
 5    is  not  reduced  due  to  the  impermissibility  of  by  the
 6    assessments,  and  any  remaining moneys assessments shall be
 7    refunded to hospital providers in proportion to  the  amounts
 8    paid by them.
 9    (Source: P.A. 87-861.)

10        (305 ILCS 5/5A-12 new)
11        Sec. 5A-12.  Hospital access improvement payments.
12        (a)  To improve access to hospital services, for hospital
13    services rendered on or after June 1, 2004, the Department of
14    Public  Aid  shall make payments to hospitals as set forth in
15    this Section, except for hospitals  described  in  subsection
16    (b)  of  Section  5A-3.  These  payments  shall  be paid on a
17    quarterly basis. For State fiscal year 2004,  the  Department
18    shall  pay  the  total  amounts  required under this Section;
19    these amounts shall be paid on or before June 15 of the year.
20    In subsequent State fiscal years, the total amounts  required
21    under  this  Section shall be paid in 4 equal installments on
22    or before July 15, October 15, January 14, and  April  15  of
23    the  year.  Payments  under  this  Section  are  not  due and
24    payable, however, until (i) the  methodologies  described  in
25    this  Section  are  approved  by the federal government in an
26    appropriate State Plan amendment, (ii) the assessment imposed
27    under this Article is determined  to  be  a  permissible  tax
28    under  Title  XIX  of  the Social Security Act, and (iii) the
29    assessment is in effect.
30        (b)  High volume payment. In addition to rates  paid  for
31    inpatient  hospital  services,  the  Department of Public Aid
32    shall pay, to each Illinois hospital that provided more  than
33    20,000  Medicaid  inpatient  days of care during State fiscal
 
HB0701 Enrolled            -26-      LRB093 05499 MKM 05590 b
 1    year 2001 (except for hospitals that qualify  for  adjustment
 2    payments   under  Section  5-5.02  for  the  12-month  period
 3    beginning  on  October  1,  2002),  $190  for  each  Medicaid
 4    inpatient day of care provided during  that  fiscal  year.  A
 5    hospital  that  provided  less than 30,000 Medicaid inpatient
 6    days of care during that period, however, is not entitled  to
 7    receive more than $3,500,000 per year in such payments.
 8        (c)  Medicaid  inpatient  utilization rate adjustment. In
 9    addition to rates paid for inpatient hospital  services,  the
10    Department  of  Public  Aid  shall pay each Illinois hospital
11    (except for hospitals described in Section  5A-3),  for  each
12    Medicaid  inpatient  day of care provided during State fiscal
13    year  2001,  an  amount  equal  to  the  product  of   $57.25
14    multiplied  by  the  quotient  of 1 divided by the greater of
15    1.6% or the hospital's Medicaid  inpatient  utilization  rate
16    (as  used  to  determine  eligibility for adjustment payments
17    under Section 5-5.02 for the  12-month  period  beginning  on
18    October 1, 2002). The total payments under this subsection to
19    a hospital may not exceed $10,500,000 annually.
20        (d)  Psychiatric base rate adjustment.
21             (1)  In   addition   to  rates  paid  for  inpatient
22        psychiatric services, the Department of Public Aid  shall
23        pay  each  Illinois  general  acute  care hospital with a
24        distinct  part-psychiatric  unit,   for   each   Medicaid
25        inpatient  psychiatric  day  of  care  provided  in State
26        fiscal year 2001,  an  amount  equal  to  $400  less  the
27        hospital's   per-diem   rate   for   Medicaid   inpatient
28        psychiatric  services as in effect on October 1, 2003. In
29        no event, however, shall that amount be less than zero.
30             (2)  For distinct part-psychiatric units of Illinois
31        general acute care hospitals, except  for  all  hospitals
32        excluded  in  Section 5A-3, whose inpatient per-diem rate
33        as in effect on October 1, 2003 is greater than $400, the
34        Department shall pay, in addition to  any  other  amounts
 
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 1        authorized   under  this  Code,  $25  for  each  Medicaid
 2        inpatient psychiatric  day  of  care  provided  in  State
 3        fiscal year 2001.
 4        (e)  Supplemental  tertiary  care adjustment. In addition
 5    to rates paid  for  inpatient  services,  the  Department  of
 6    Public  Aid  shall pay to each Illinois hospital eligible for
 7    tertiary care adjustment payments under  89  Ill.  Adm.  Code
 8    148.296,   as  in  effect  for  State  fiscal  year  2003,  a
 9    supplemental tertiary care adjustment payment  equal  to  the
10    tertiary  care adjustment payment required under 89 Ill. Adm.
11    Code 148.296, as in effect for State fiscal year 2003.
12        (f)  Medicaid outpatient utilization rate adjustment.  In
13    addition  to rates paid for outpatient hospital services, the
14    Department of Public Aid shall  pay  each  Illinois  hospital
15    (except  for  hospitals described in Section 5A-3), an amount
16    equal to the product of 2.45% multiplied  by  the  hospital's
17    Medicaid  outpatient  charges multiplied by the quotient of 1
18    divided by the greater of 1.6%  or  the  hospital's  Medicaid
19    outpatient  utilization  rate.  The total payments under this
20    subsection to a hospital may not exceed $6,750,000 annually.
21        For purposes of this subsection:
22        "Medicaid  outpatient  charges"  means  the  charges  for
23    outpatient services provided to Medicaid patients  for  State
24    fiscal  year  2001  as submitted by the hospital on the UB-92
25    billing form or under the ambulatory  procedure  listing  and
26    adjudicated  by  the  Department  of  Public Aid on or before
27    September 12, 2003.
28        "Medicaid outpatient utilization rate" means a  fraction,
29    the  numerator of which is the hospital's Medicaid outpatient
30    charges and the denominator of which is the total  number  of
31    the  hospital's  charges  for  outpatient  services  for  the
32    hospital's fiscal year ending in 2001.
33        (g)  State  outpatient service adjustment. In addition to
34    rates paid for outpatient hospital services,  the  Department
 
HB0701 Enrolled            -28-      LRB093 05499 MKM 05590 b
 1    of  Public  Aid  shall  pay  each Illinois hospital an amount
 2    equal to the product of 75.5% multiplied  by  the  hospital's
 3    Medicaid  outpatient  services submitted to the Department on
 4    the UB-92 billing form for State fiscal year 2001  multiplied
 5    by the hospital's outpatient access fraction.
 6        For  purposes  of  this  subsection,  "outpatient  access
 7    fraction"  means  a  fraction,  the numerator of which is the
 8    hospital's Medicaid  payments  for  outpatient  services  for
 9    ambulatory   procedure  listing  services  submitted  to  the
10    Department on the UB-92 billing form for  State  fiscal  year
11    2001, and the denominator of which is the hospital's Medicaid
12    outpatient  services submitted to the Department on the UB-92
13    billing form for State fiscal year 2001.
14        The total payments under this subsection  to  a  hospital
15    may not exceed $3,000,000 annually.
16        (h)  Rural hospital outpatient adjustment. In addition to
17    rates  paid  for outpatient hospital services, the Department
18    of Public Aid shall  pay  each  Illinois  rural  hospital  an
19    amount  equal to the product of $14,500,000 multiplied by the
20    rural hospital outpatient adjustment fraction.
21        For  purposes  of  this   subsection,   "rural   hospital
22    outpatient   adjustment   fraction"  means  a  fraction,  the
23    numerator of which is  the  hospital's  Medicaid  visits  for
24    outpatient services for ambulatory procedure listing services
25    submitted  to  the  Department  on the UB-92 billing form for
26    State fiscal year 2001, and the denominator of which  is  the
27    total  Medicaid visits for outpatient services for ambulatory
28    procedure listing services for all Illinois  rural  hospitals
29    submitted  to  the  Department  on the UB-92 billing form for
30    State fiscal year 2001.
31        For purposes of this subsection, "rural hospital" has the
32    same meaning as in 89 Ill. Adm. Code 148.25, as in effect  on
33    September 30, 2003.
34        (i)  Merged/closed  hospital  adjustment. If any hospital
 
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 1    files a combined Medicaid cost report with  another  hospital
 2    after  January  1,  2001,  and  if that hospital subsequently
 3    closes, then except for the payments described in  subsection
 4    (e),  all  payments  described  in the various subsections of
 5    this Section shall, before  the  application  of  the  annual
 6    limitation  amount  specified  in  each  such  subsection, be
 7    multiplied by a fraction,  the  numerator  of  which  is  the
 8    number of occupied bed days attributable to the open hospital
 9    and  the  denominator  of  which  is the sum of the number of
10    occupied bed days of  each  open  hospital  and  each  closed
11    hospital.  For  purposes  of  this  subsection, "occupied bed
12    days" has  the  same  meaning  as  the  term  is  defined  in
13    subsection (a) of Section 5A-2.
14        (j)  For  purposes  of  this Section, the terms "Medicaid
15    days", "Medicaid charges", and  "Medicaid  services"  do  not
16    include any days, charges, or services for which Medicare was
17    liable for payment.
18        (k)  As  provided  in  Section  5A-14,  this  Section  is
19    repealed on July 1, 2005.

20        (305 ILCS 5/5A-13 new)
21        Sec.  5A-13.  Emergency  rulemaking.  The  Department  of
22    Public  Aid  may  adopt  rules  necessary  to  implement this
23    amendatory Act of the 93rd General Assembly through  the  use
24    of  emergency  rulemaking  in accordance with Section 5-45 of
25    the Illinois Administrative Procedure Act.  For  purposes  of
26    that  Act,  the  General  Assembly finds that the adoption of
27    rules to implement this amendatory Act of  the  93rd  General
28    Assembly  is deemed an emergency and necessary for the public
29    interest, safety, and welfare.

30        (305 ILCS 5/5A-14 new)
31        Sec. 5A-14. Repeal of assessments and disbursements.
32        (a)  Section 5A-2 is repealed on July 1, 2005.
 
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 1        (b)  Section 5A-12 is repealed on July 1, 2005.

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

 8        (305 ILCS 5/Art. V-D rep.)
 9        (305 ILCS 5/14-2 rep.)
10        (305 ILCS 5/14-3 rep.)
11        (305 ILCS 5/14-4 rep.)
12        (305 ILCS 5/14-5 rep.)
13        (305 ILCS 5/14-6 rep.)
14        (305 ILCS 5/14-7 rep.)
15        (305 ILCS 5/14-9 rep.)
16        (305 ILCS 5/14-10 rep.)
17        Section 11.  The Illinois Public Aid Code is  amended  by
18    repealing  Article  V-D  and Sections 14-2, 14-3, 14-4, 14-5,
19    14-6, 14-7, 14-9, and 14-10.

20        Section 99.  Effective date.  This Act takes effect  upon
21    becoming law.