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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
| ||||||||||||||||||||||||||||||||||||||||||
3 | represented in the General Assembly:
| ||||||||||||||||||||||||||||||||||||||||||
4 | Section 5. If and only if Senate Bill 3088 of
the 96th | ||||||||||||||||||||||||||||||||||||||||||
5 | General Assembly becomes law, then the Illinois Public Aid Code | ||||||||||||||||||||||||||||||||||||||||||
6 | is amended by changing Sections 5-5.2, 5-5.4, 5B-1, 5B-2, 5B-4, | ||||||||||||||||||||||||||||||||||||||||||
7 | and 5B-7 as follows:
| ||||||||||||||||||||||||||||||||||||||||||
8 | (305 ILCS 5/5-5.2) (from Ch. 23, par. 5-5.2)
| ||||||||||||||||||||||||||||||||||||||||||
9 | Sec. 5-5.2. Payment.
| ||||||||||||||||||||||||||||||||||||||||||
10 | (a) All nursing facilities that are grouped pursuant to | ||||||||||||||||||||||||||||||||||||||||||
11 | Section
5-5.1 of this Act shall receive the same rate of | ||||||||||||||||||||||||||||||||||||||||||
12 | payment for similar
services.
| ||||||||||||||||||||||||||||||||||||||||||
13 | (b) It shall be a matter of State policy that the Illinois | ||||||||||||||||||||||||||||||||||||||||||
14 | Department
shall utilize a uniform billing cycle throughout the | ||||||||||||||||||||||||||||||||||||||||||
15 | State for the
long-term care providers.
| ||||||||||||||||||||||||||||||||||||||||||
16 | (c) Notwithstanding any other provisions of this Code, | ||||||||||||||||||||||||||||||||||||||||||
17 | beginning January July 1, 2012 the methodologies for | ||||||||||||||||||||||||||||||||||||||||||
18 | reimbursement of nursing facility services as provided under | ||||||||||||||||||||||||||||||||||||||||||
19 | this Article shall no longer be applicable for bills payable | ||||||||||||||||||||||||||||||||||||||||||
20 | for State fiscal years 2012 and thereafter. The Department of | ||||||||||||||||||||||||||||||||||||||||||
21 | Healthcare and Family Services shall, effective January July 1, | ||||||||||||||||||||||||||||||||||||||||||
22 | 2012, implement an evidence-based payment methodology for the | ||||||||||||||||||||||||||||||||||||||||||
23 | reimbursement of nursing facility services. The methodology |
| |||||||
| |||||||
1 | shall continue to take into consideration the needs of | ||||||
2 | individual residents, as assessed and reported by the most | ||||||
3 | current version of the nursing facility Resident Assessment | ||||||
4 | Instrument, adopted and in use by the federal government. | ||||||
5 | Additionally, the revised methodology shall incorporate | ||||||
6 | patient acuity, patient health outcomes, and measures of | ||||||
7 | quality and quality improvement for the determination of | ||||||
8 | payment. | ||||||
9 | (Source: P.A. 87-809; 88-380; 96SB3088 Enrolled.)
| ||||||
10 | (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4) | ||||||
11 | Sec. 5-5.4. Standards of Payment - Department of Healthcare | ||||||
12 | and Family Services.
The Department of Healthcare and Family | ||||||
13 | Services shall develop standards of payment of
nursing facility | ||||||
14 | and ICF/DD services in facilities providing such services
under | ||||||
15 | this Article which:
| ||||||
16 | (1) Provide for the determination of a facility's payment
| ||||||
17 | for nursing facility or ICF/DD services on a prospective basis.
| ||||||
18 | The amount of the payment rate for all nursing facilities | ||||||
19 | certified by the
Department of Public Health under the MR/DD | ||||||
20 | Community Care Act or the Nursing Home Care Act as Intermediate
| ||||||
21 | Care for the Developmentally Disabled facilities, Long Term | ||||||
22 | Care for Under Age
22 facilities, Skilled Nursing facilities, | ||||||
23 | or Intermediate Care facilities
under the
medical assistance | ||||||
24 | program shall be prospectively established annually on the
| ||||||
25 | basis of historical, financial, and statistical data |
| |||||||
| |||||||
1 | reflecting actual costs
from prior years, which shall be | ||||||
2 | applied to the current rate year and updated
for inflation, | ||||||
3 | except that the capital cost element for newly constructed
| ||||||
4 | facilities shall be based upon projected budgets. The annually | ||||||
5 | established
payment rate shall take effect on July 1 in 1984 | ||||||
6 | and subsequent years. No rate
increase and no
update for | ||||||
7 | inflation shall be provided on or after July 1, 1994 and before | ||||||
8 | January
July 1, 2012, unless specifically provided for in this
| ||||||
9 | Section.
The changes made by Public Act 93-841
extending the | ||||||
10 | duration of the prohibition against a rate increase or update | ||||||
11 | for inflation are effective retroactive to July 1, 2004.
| ||||||
12 | For facilities licensed by the Department of Public Health | ||||||
13 | under the Nursing
Home Care Act as Intermediate Care for the | ||||||
14 | Developmentally Disabled facilities
or Long Term Care for Under | ||||||
15 | Age 22 facilities, the rates taking effect on July
1, 1998 | ||||||
16 | shall include an increase of 3%. For facilities licensed by the
| ||||||
17 | Department of Public Health under the Nursing Home Care Act as | ||||||
18 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
19 | the rates taking effect on July 1,
1998 shall include an | ||||||
20 | increase of 3% plus $1.10 per resident-day, as defined by
the | ||||||
21 | Department. For facilities licensed by the Department of Public | ||||||
22 | Health under the Nursing Home Care Act as Intermediate Care | ||||||
23 | Facilities for the Developmentally Disabled or Long Term Care | ||||||
24 | for Under Age 22 facilities, the rates taking effect on January | ||||||
25 | 1, 2006 shall include an increase of 3%.
For facilities | ||||||
26 | licensed by the Department of Public Health under the Nursing |
| |||||||
| |||||||
1 | Home Care Act as Intermediate Care Facilities for the | ||||||
2 | Developmentally Disabled or Long Term Care for Under Age 22 | ||||||
3 | facilities, the rates taking effect on January 1, 2009 shall | ||||||
4 | include an increase sufficient to provide a $0.50 per hour wage | ||||||
5 | increase for non-executive staff. | ||||||
6 | For facilities licensed by the Department of Public Health | ||||||
7 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
8 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
9 | Age 22 facilities, the rates taking
effect on July 1, 1999 | ||||||
10 | shall include an increase of 1.6% plus $3.00 per
resident-day, | ||||||
11 | as defined by the Department. For facilities licensed by the
| ||||||
12 | Department of Public Health under the Nursing Home Care Act as | ||||||
13 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
14 | the rates taking effect on July 1,
1999 shall include an | ||||||
15 | increase of 1.6% and, for services provided on or after
October | ||||||
16 | 1, 1999, shall be increased by $4.00 per resident-day, as | ||||||
17 | defined by
the Department.
| ||||||
18 | For facilities licensed by the Department of Public Health | ||||||
19 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
20 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
21 | Age 22 facilities, the rates taking
effect on July 1, 2000 | ||||||
22 | shall include an increase of 2.5% per resident-day,
as defined | ||||||
23 | by the Department. For facilities licensed by the Department of
| ||||||
24 | Public Health under the Nursing Home Care Act as Skilled | ||||||
25 | Nursing facilities or
Intermediate Care facilities, the rates | ||||||
26 | taking effect on July 1, 2000 shall
include an increase of 2.5% |
| |||||||
| |||||||
1 | per resident-day, as defined by the Department.
| ||||||
2 | For facilities licensed by the Department of Public Health | ||||||
3 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
4 | or intermediate care
facilities, a new payment methodology must | ||||||
5 | be implemented for the nursing
component of the rate effective | ||||||
6 | July 1, 2003. The Department of Public Aid
(now Healthcare and | ||||||
7 | Family Services) shall develop the new payment methodology | ||||||
8 | using the Minimum Data Set
(MDS) as the instrument to collect | ||||||
9 | information concerning nursing home
resident condition | ||||||
10 | necessary to compute the rate. The Department
shall develop the | ||||||
11 | new payment methodology to meet the unique needs of
Illinois | ||||||
12 | nursing home residents while remaining subject to the | ||||||
13 | appropriations
provided by the General Assembly.
A transition | ||||||
14 | period from the payment methodology in effect on June 30, 2003
| ||||||
15 | to the payment methodology in effect on July 1, 2003 shall be | ||||||
16 | provided for a
period not exceeding 3 years and 184 days after | ||||||
17 | implementation of the new payment
methodology as follows:
| ||||||
18 | (A) For a facility that would receive a lower
nursing | ||||||
19 | component rate per patient day under the new system than | ||||||
20 | the facility
received
effective on the date immediately | ||||||
21 | preceding the date that the Department
implements the new | ||||||
22 | payment methodology, the nursing component rate per | ||||||
23 | patient
day for the facility
shall be held at
the level in | ||||||
24 | effect on the date immediately preceding the date that the
| ||||||
25 | Department implements the new payment methodology until a | ||||||
26 | higher nursing
component rate of
reimbursement is achieved |
| |||||||
| |||||||
1 | by that
facility.
| ||||||
2 | (B) For a facility that would receive a higher nursing | ||||||
3 | component rate per
patient day under the payment | ||||||
4 | methodology in effect on July 1, 2003 than the
facility | ||||||
5 | received effective on the date immediately preceding the | ||||||
6 | date that the
Department implements the new payment | ||||||
7 | methodology, the nursing component rate
per patient day for | ||||||
8 | the facility shall be adjusted.
| ||||||
9 | (C) Notwithstanding paragraphs (A) and (B), the | ||||||
10 | nursing component rate per
patient day for the facility | ||||||
11 | shall be adjusted subject to appropriations
provided by the | ||||||
12 | General Assembly.
| ||||||
13 | For facilities licensed by the Department of Public Health | ||||||
14 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
15 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
16 | Age 22 facilities, the rates taking
effect on March 1, 2001 | ||||||
17 | shall include a statewide increase of 7.85%, as
defined by the | ||||||
18 | Department.
| ||||||
19 | Notwithstanding any other provision of this Section, for | ||||||
20 | facilities licensed by the Department of Public Health under | ||||||
21 | the
Nursing Home Care Act as skilled nursing facilities or | ||||||
22 | intermediate care
facilities, except facilities participating | ||||||
23 | in the Department's demonstration program pursuant to the | ||||||
24 | provisions of Title 77, Part 300, Subpart T of the Illinois | ||||||
25 | Administrative Code, the numerator of the ratio used by the | ||||||
26 | Department of Healthcare and Family Services to compute the |
| |||||||
| |||||||
1 | rate payable under this Section using the Minimum Data Set | ||||||
2 | (MDS) methodology shall incorporate the following annual | ||||||
3 | amounts as the additional funds appropriated to the Department | ||||||
4 | specifically to pay for rates based on the MDS nursing | ||||||
5 | component methodology in excess of the funding in effect on | ||||||
6 | December 31, 2006: | ||||||
7 | (i) For rates taking effect January 1, 2007, | ||||||
8 | $60,000,000. | ||||||
9 | (ii) For rates taking effect January 1, 2008, | ||||||
10 | $110,000,000. | ||||||
11 | (iii) For rates taking effect January 1, 2009, | ||||||
12 | $194,000,000. | ||||||
13 | (iv) (Blank) For rates taking effect April 1, 2011, or | ||||||
14 | the first day of the month that begins at least 45 days | ||||||
15 | after the effective date of this amendatory Act of the 96th | ||||||
16 | General Assembly, $416,500,000 or an amount as may be | ||||||
17 | necessary to complete the transition to the MDS methodology | ||||||
18 | for the nursing component of the rate . | ||||||
19 | Notwithstanding any other provision of this Section, for | ||||||
20 | facilities licensed by the Department of Public Health under | ||||||
21 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
22 | intermediate care facilities, the support component of the | ||||||
23 | rates taking effect on January 1, 2008 shall be computed using | ||||||
24 | the most recent cost reports on file with the Department of | ||||||
25 | Healthcare and Family Services no later than April 1, 2005, | ||||||
26 | updated for inflation to January 1, 2006. |
| |||||||
| |||||||
1 | For facilities licensed by the Department of Public Health | ||||||
2 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
3 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
4 | Age 22 facilities, the rates taking
effect on April 1, 2002 | ||||||
5 | shall include a statewide increase of 2.0%, as
defined by the | ||||||
6 | Department.
This increase terminates on July 1, 2002;
beginning | ||||||
7 | July 1, 2002 these rates are reduced to the level of the rates
| ||||||
8 | in effect on March 31, 2002, as defined by the Department.
| ||||||
9 | For facilities licensed by the Department of Public Health | ||||||
10 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
11 | or intermediate care
facilities, the rates taking effect on | ||||||
12 | July 1, 2001 shall be computed using the most recent cost | ||||||
13 | reports
on file with the Department of Public Aid no later than | ||||||
14 | April 1, 2000,
updated for inflation to January 1, 2001. For | ||||||
15 | rates effective July 1, 2001
only, rates shall be the greater | ||||||
16 | of the rate computed for July 1, 2001
or the rate effective on | ||||||
17 | June 30, 2001.
| ||||||
18 | Notwithstanding any other provision of this Section, for | ||||||
19 | facilities
licensed by the Department of Public Health under | ||||||
20 | the Nursing Home Care Act
as skilled nursing facilities or | ||||||
21 | intermediate care facilities, the Illinois
Department shall | ||||||
22 | determine by rule the rates taking effect on July 1, 2002,
| ||||||
23 | which shall be 5.9% less than the rates in effect on June 30, | ||||||
24 | 2002.
| ||||||
25 | Notwithstanding any other provision of this Section, for | ||||||
26 | facilities
licensed by the Department of Public Health under |
| |||||||
| |||||||
1 | the Nursing Home Care Act as
skilled nursing
facilities or | ||||||
2 | intermediate care facilities, if the payment methodologies | ||||||
3 | required under Section 5A-12 and the waiver granted under 42 | ||||||
4 | CFR 433.68 are approved by the United States Centers for | ||||||
5 | Medicare and Medicaid Services, the rates taking effect on July | ||||||
6 | 1, 2004 shall be 3.0% greater than the rates in effect on June | ||||||
7 | 30, 2004. These rates shall take
effect only upon approval and
| ||||||
8 | implementation of the payment methodologies required under | ||||||
9 | Section 5A-12.
| ||||||
10 | Notwithstanding any other provisions of this Section, for | ||||||
11 | facilities licensed by the Department of Public Health under | ||||||
12 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
13 | intermediate care facilities, the rates taking effect on | ||||||
14 | January 1, 2005 shall be 3% more than the rates in effect on | ||||||
15 | December 31, 2004.
| ||||||
16 | Notwithstanding any other provision of this Section, for | ||||||
17 | facilities licensed by the Department of Public Health under | ||||||
18 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
19 | intermediate care facilities, effective January 1, 2009, the | ||||||
20 | per diem support component of the rates effective on January 1, | ||||||
21 | 2008, computed using the most recent cost reports on file with | ||||||
22 | the Department of Healthcare and Family Services no later than | ||||||
23 | April 1, 2005, updated for inflation to January 1, 2006, shall | ||||||
24 | be increased to the amount that would have been derived using | ||||||
25 | standard Department of Healthcare and Family Services methods, | ||||||
26 | procedures, and inflators. |
| |||||||
| |||||||
1 | Notwithstanding any other provisions of this Section, for | ||||||
2 | facilities licensed by the Department of Public Health under | ||||||
3 | the Nursing Home Care Act as intermediate care facilities that | ||||||
4 | are federally defined as Institutions for Mental Disease, a | ||||||
5 | socio-development component rate equal to 6.6% of the | ||||||
6 | facility's nursing component rate as of January 1, 2006 shall | ||||||
7 | be established and paid effective July 1, 2006. The | ||||||
8 | socio-development component of the rate shall be increased by a | ||||||
9 | factor of 2.53 on the first day of the month that begins at | ||||||
10 | least 45 days after January 11, 2008 (the effective date of | ||||||
11 | Public Act 95-707). As of August 1, 2008, the socio-development | ||||||
12 | component rate shall be equal to 6.6% of the facility's nursing | ||||||
13 | component rate as of January 1, 2006, multiplied by a factor of | ||||||
14 | 3.53. For services provided on or after January 1, 2012 April | ||||||
15 | 1, 2011, or the first day of the month that begins at least 45 | ||||||
16 | days after the effective date of this amendatory Act of the | ||||||
17 | 96th General Assembly, whichever is later , the Illinois | ||||||
18 | Department may by rule adjust these socio-development | ||||||
19 | component rates, and may use different adjustment | ||||||
20 | methodologies for those facilities participating, and those | ||||||
21 | not participating, in the Illinois Department's demonstration | ||||||
22 | program pursuant to the provisions of Title 77, Part 300, | ||||||
23 | Subpart T of the Illinois Administrative Code, but in no case | ||||||
24 | may such rates be diminished below those in effect on August 1, | ||||||
25 | 2008.
| ||||||
26 | For facilities
licensed
by the
Department of Public Health |
| |||||||
| |||||||
1 | under the Nursing Home Care Act as Intermediate
Care for
the | ||||||
2 | Developmentally Disabled facilities or as long-term care | ||||||
3 | facilities for
residents under 22 years of age, the rates | ||||||
4 | taking effect on July 1,
2003 shall
include a statewide | ||||||
5 | increase of 4%, as defined by the Department.
| ||||||
6 | For facilities licensed by the Department of Public Health | ||||||
7 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
8 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
9 | Age 22 facilities, the rates taking
effect on the first day of | ||||||
10 | the month that begins at least 45 days after the effective date | ||||||
11 | of this amendatory Act of the 95th General Assembly shall | ||||||
12 | include a statewide increase of 2.5%, as
defined by the | ||||||
13 | Department. | ||||||
14 | Notwithstanding any other provision of this Section, for | ||||||
15 | facilities licensed by the Department of Public Health under | ||||||
16 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
17 | intermediate care facilities, effective January 1, 2005, | ||||||
18 | facility rates shall be increased by the difference between (i) | ||||||
19 | a facility's per diem property, liability, and malpractice | ||||||
20 | insurance costs as reported in the cost report filed with the | ||||||
21 | Department of Public Aid and used to establish rates effective | ||||||
22 | July 1, 2001 and (ii) those same costs as reported in the | ||||||
23 | facility's 2002 cost report. These costs shall be passed | ||||||
24 | through to the facility without caps or limitations, except for | ||||||
25 | adjustments required under normal auditing procedures.
| ||||||
26 | Rates established effective each July 1 shall govern |
| |||||||
| |||||||
1 | payment
for services rendered throughout that fiscal year, | ||||||
2 | except that rates
established on July 1, 1996 shall be | ||||||
3 | increased by 6.8% for services
provided on or after January 1, | ||||||
4 | 1997. Such rates will be based
upon the rates calculated for | ||||||
5 | the year beginning July 1, 1990, and for
subsequent years | ||||||
6 | thereafter until June 30, 2001 shall be based on the
facility | ||||||
7 | cost reports
for the facility fiscal year ending at any point | ||||||
8 | in time during the previous
calendar year, updated to the | ||||||
9 | midpoint of the rate year. The cost report
shall be on file | ||||||
10 | with the Department no later than April 1 of the current
rate | ||||||
11 | year. Should the cost report not be on file by April 1, the | ||||||
12 | Department
shall base the rate on the latest cost report filed | ||||||
13 | by each skilled care
facility and intermediate care facility, | ||||||
14 | updated to the midpoint of the
current rate year. In | ||||||
15 | determining rates for services rendered on and after
July 1, | ||||||
16 | 1985, fixed time shall not be computed at less than zero. The
| ||||||
17 | Department shall not make any alterations of regulations which | ||||||
18 | would reduce
any component of the Medicaid rate to a level | ||||||
19 | below what that component would
have been utilizing in the rate | ||||||
20 | effective on July 1, 1984.
| ||||||
21 | (2) Shall take into account the actual costs incurred by | ||||||
22 | facilities
in providing services for recipients of skilled | ||||||
23 | nursing and intermediate
care services under the medical | ||||||
24 | assistance program.
| ||||||
25 | (3) Shall take into account the medical and psycho-social
| ||||||
26 | characteristics and needs of the patients.
|
| |||||||
| |||||||
1 | (4) Shall take into account the actual costs incurred by | ||||||
2 | facilities in
meeting licensing and certification standards | ||||||
3 | imposed and prescribed by the
State of Illinois, any of its | ||||||
4 | political subdivisions or municipalities and by
the U.S. | ||||||
5 | Department of Health and Human Services pursuant to Title XIX | ||||||
6 | of the
Social Security Act.
| ||||||
7 | The Department of Healthcare and Family Services
shall | ||||||
8 | develop precise standards for
payments to reimburse nursing | ||||||
9 | facilities for any utilization of
appropriate rehabilitative | ||||||
10 | personnel for the provision of rehabilitative
services which is | ||||||
11 | authorized by federal regulations, including
reimbursement for | ||||||
12 | services provided by qualified therapists or qualified
| ||||||
13 | assistants, and which is in accordance with accepted | ||||||
14 | professional
practices. Reimbursement also may be made for | ||||||
15 | utilization of other
supportive personnel under appropriate | ||||||
16 | supervision.
| ||||||
17 | The Department shall develop enhanced payments to offset | ||||||
18 | the additional costs incurred by a
facility serving exceptional | ||||||
19 | need residents and shall allocate at least $8,000,000 of the | ||||||
20 | funds
collected from the assessment established by Section 5B-2 | ||||||
21 | of this Code for such payments. For
the purpose of this | ||||||
22 | Section, "exceptional needs" means, but need not be limited to, | ||||||
23 | ventilator care, tracheotomy care,
bariatric care, complex | ||||||
24 | wound care, and traumatic brain injury care. | ||||||
25 | (5) Beginning January July 1, 2012 the methodologies for | ||||||
26 | reimbursement of nursing facility services as provided under |
| |||||||
| |||||||
1 | this Section 5-5.4 shall no longer be applicable for bills | ||||||
2 | payable for State fiscal years 2012 and thereafter. | ||||||
3 | (Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707, | ||||||
4 | eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09; | ||||||
5 | 96-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff. 7-2-10; | ||||||
6 | 96SB3088 Enrolled.)
| ||||||
7 | (305 ILCS 5/5B-1) (from Ch. 23, par. 5B-1)
| ||||||
8 | Sec. 5B-1. Definitions. As used in this Article, unless the
| ||||||
9 | context requires otherwise:
| ||||||
10 | "Fund" means the Long-Term Care Provider Fund.
| ||||||
11 | "Long-term care facility" means (i) a nursing facility, | ||||||
12 | whether
public or private and whether organized for profit or
| ||||||
13 | not-for-profit, that is subject to licensure by the Illinois | ||||||
14 | Department
of Public Health under the Nursing Home Care Act or | ||||||
15 | the MR/DD Community Care Act, including a
county nursing home | ||||||
16 | directed and maintained under Section
5-1005 of the Counties | ||||||
17 | Code, and (ii) a part of a hospital in
which skilled or | ||||||
18 | intermediate long-term care services within the
meaning of | ||||||
19 | Title XVIII or XIX of the Social Security Act are
provided; | ||||||
20 | except that the term "long-term care facility" does
not include | ||||||
21 | a facility operated by a State agency, a facility participating | ||||||
22 | in the Illinois Department's demonstration program pursuant to | ||||||
23 | the provisions of Title 77, Part 300, Subpart T of the Illinois | ||||||
24 | Administrative Code, or operated solely as an intermediate care
| ||||||
25 | facility for the mentally retarded within the meaning of Title
|
| |||||||
| |||||||
1 | XIX of the Social Security Act.
| ||||||
2 | "Long-term care provider" means (i) a person licensed
by | ||||||
3 | the Department of Public Health to operate and maintain a
| ||||||
4 | skilled nursing or intermediate long-term care facility or (ii) | ||||||
5 | a hospital provider that
provides skilled or intermediate | ||||||
6 | long-term care services within
the meaning of Title XVIII or | ||||||
7 | XIX of the Social Security Act.
For purposes of this paragraph, | ||||||
8 | "person" means any political
subdivision of the State, | ||||||
9 | municipal corporation, individual,
firm, partnership, | ||||||
10 | corporation, company, limited liability
company, association, | ||||||
11 | joint stock association, or trust, or a
receiver, executor, | ||||||
12 | trustee, guardian, or other representative
appointed by order | ||||||
13 | of any court. "Hospital provider" means a
person licensed by | ||||||
14 | the Department of Public Health to conduct,
operate, or | ||||||
15 | maintain a hospital.
| ||||||
16 | "Occupied bed days" shall be computed separately for
each | ||||||
17 | long-term care facility operated or maintained by a long-term
| ||||||
18 | care provider, and means the sum for all beds of the number
of | ||||||
19 | days during the month on which each bed was occupied by a
| ||||||
20 | resident, other than a resident for whom Medicare Part A is the | ||||||
21 | primary payer.
| ||||||
22 | "Licensed bed days" shall be computed separately for each | ||||||
23 | nursing home operated or maintained by a nursing home provider | ||||||
24 | and means, with respect to a nursing home provider, the sum for | ||||||
25 | all nursing home beds of the number of days during a calendar | ||||||
26 | quarter on which each bed is covered by a license issued to |
| |||||||
| |||||||
1 | that provider under the Nursing Home Care Act or the Hospital | ||||||
2 | Licensing Act. | ||||||
3 | (Source: P.A. 96-339, eff. 7-1-10; 96SB3088 Enrolled.)
| ||||||
4 | (305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
| ||||||
5 | Sec. 5B-2. Assessment; no local authorization to tax.
| ||||||
6 | (a) For the privilege of engaging in the occupation of | ||||||
7 | long-term care
provider, beginning July 1, 2011 an assessment | ||||||
8 | is imposed upon each long-term care provider in an amount equal | ||||||
9 | to $2.04 $6.07 times the number of licensed occupied bed days | ||||||
10 | due and payable each month. Notwithstanding any provision of | ||||||
11 | any other Act to the
contrary, this assessment shall be | ||||||
12 | construed as a tax, but may not be added
to the charges of an | ||||||
13 | individual's nursing home care that is paid for in
whole, or in | ||||||
14 | part, by a federal, State, or combined federal-state medical
| ||||||
15 | care program.
| ||||||
16 | (b) Nothing in this amendatory Act of 1992 shall be | ||||||
17 | construed to
authorize any home rule unit or other unit of | ||||||
18 | local government to license
for revenue or impose a tax or | ||||||
19 | assessment upon long-term care providers or
the occupation of | ||||||
20 | long-term care provider, or a tax or assessment measured
by the | ||||||
21 | income or earnings or occupied bed days or licensed bed days of | ||||||
22 | a long-term care provider.
| ||||||
23 | (Source: P.A. 87-861; 96SB3088 Enrolled.)
| ||||||
24 | (305 ILCS 5/5B-4) (from Ch. 23, par. 5B-4)
|
| |||||||
| |||||||
1 | Sec. 5B-4. Payment of assessment; penalty.
| ||||||
2 | (a) The assessment imposed by Section 5B-2 shall be due and | ||||||
3 | payable monthly, on the last State business day of the month | ||||||
4 | for licensed occupied bed days reported for the preceding third | ||||||
5 | month prior to the month in which the tax is payable and due. A | ||||||
6 | facility that has delayed payment due to the State's failure to | ||||||
7 | reimburse for services rendered may request an extension on the | ||||||
8 | due date for payment pursuant to subsection (b) and shall pay | ||||||
9 | the assessment within 30 days of reimbursement by the | ||||||
10 | Department.
The Illinois Department may provide that county | ||||||
11 | nursing homes directed and
maintained pursuant to Section | ||||||
12 | 5-1005 of the Counties Code may meet their
assessment | ||||||
13 | obligation by certifying to the Illinois Department that county
| ||||||
14 | expenditures have been obligated for the operation of the | ||||||
15 | county nursing
home in an amount at least equal to the amount | ||||||
16 | of the assessment.
| ||||||
17 | (a-5) Each assessment payment shall be accompanied by an | ||||||
18 | assessment report to be completed by the long-term care | ||||||
19 | provider. A separate report shall be completed for each | ||||||
20 | long-term care facility in this State operated by a long-term | ||||||
21 | care provider. The report shall be in a form and manner | ||||||
22 | prescribed by the Illinois Department and shall at a minimum | ||||||
23 | provide for the reporting of the number of occupied bed days of | ||||||
24 | the long-term care facility for the reporting period and other | ||||||
25 | reasonable information the Illinois Department requires for | ||||||
26 | the administration of its responsibilities under this Code. To |
| |||||||
| |||||||
1 | the extent practicable, the Department shall coordinate the | ||||||
2 | assessment reporting requirements with other reporting | ||||||
3 | required of long-term care facilities. | ||||||
4 | (b) The Illinois Department is authorized to establish
| ||||||
5 | delayed payment schedules for long-term care providers that are
| ||||||
6 | unable to make assessment payments when due under this Section
| ||||||
7 | due to financial difficulties, as determined by the Illinois
| ||||||
8 | Department. The Illinois Department may not deny a request for | ||||||
9 | delay of payment of the assessment imposed under this Article | ||||||
10 | if the long-term care provider has not been paid for services | ||||||
11 | provided during the month on which the assessment is levied.
| ||||||
12 | (c) If a long-term care provider fails to pay the full
| ||||||
13 | amount of an assessment payment when due (including any | ||||||
14 | extensions
granted under subsection (b)), there shall, unless | ||||||
15 | waived by the
Illinois Department for reasonable cause, be | ||||||
16 | added to the
assessment imposed by Section 5B-2 a
penalty | ||||||
17 | assessment equal to the lesser of (i) 5% of the amount of
the | ||||||
18 | assessment payment not paid on or before the due date plus 5% | ||||||
19 | of the
portion thereof remaining unpaid on the last day of each | ||||||
20 | month
thereafter or (ii) 100% of the assessment payment amount | ||||||
21 | not paid on or
before the due date. For purposes of this | ||||||
22 | subsection, payments
will be credited first to unpaid | ||||||
23 | assessment payment amounts (rather than
to penalty or | ||||||
24 | interest), beginning with the most delinquent assessment | ||||||
25 | payments
. Payment cycles of longer than 60 days shall be one | ||||||
26 | factor the Director takes into account in granting a waiver |
| |||||||
| |||||||
1 | under this Section.
| ||||||
2 | (c-5) If a long-term care provider fails to file its report | ||||||
3 | with payment, there shall, unless waived by the Illinois | ||||||
4 | Department for reasonable cause, be added to the assessment due | ||||||
5 | a penalty assessment equal to 25% of the assessment due. | ||||||
6 | (d) Nothing in this amendatory Act of 1993 shall be | ||||||
7 | construed to prevent
the Illinois Department from collecting | ||||||
8 | all amounts due under this Article
pursuant to an assessment | ||||||
9 | imposed before the effective date of this amendatory
Act of | ||||||
10 | 1993.
| ||||||
11 | (e) Nothing in this amendatory Act of the 96th General | ||||||
12 | Assembly shall be construed to prevent
the Illinois Department | ||||||
13 | from collecting all amounts due under this Code
pursuant to an | ||||||
14 | assessment, tax, fee, or penalty imposed before the effective | ||||||
15 | date of this amendatory
Act of the 96th General Assembly. | ||||||
16 | (Source: P.A. 96-444, eff. 8-14-09; 96SB3088 Enrolled.)
| ||||||
17 | (305 ILCS 5/5B-7) (from Ch. 23, par. 5B-7)
| ||||||
18 | Sec. 5B-7. Administration; enforcement provisions.
| ||||||
19 | (a) To the extent practicable, the Illinois Department | ||||||
20 | shall administer
and enforce this Article and collect the | ||||||
21 | assessments, interest, and penalty
assessments imposed under | ||||||
22 | this Article, using procedures employed in its
administration | ||||||
23 | of this Code generally and, as it deems
appropriate, in a | ||||||
24 | manner similar to that in which the Department
of Revenue | ||||||
25 | administers and collects the retailers' occupation tax
under |
| |||||||
| |||||||
1 | the Retailers' Occupation Tax Act ("ROTA"). Instead
of | ||||||
2 | certificates of registration, the Illinois Department shall
| ||||||
3 | establish and maintain a listing of all long-term care | ||||||
4 | providers
appearing in the licensing records of the Department | ||||||
5 | of Public
Health, which shall show each provider's name, | ||||||
6 | principal place of business,
and the name and address of each | ||||||
7 | long-term care facility operated or
maintained by the provider | ||||||
8 | in this State. In addition, the following
provisions of the | ||||||
9 | Retailers' Occupation Tax Act are incorporated by
reference | ||||||
10 | into this Section, except that the Illinois Department
and its | ||||||
11 | Director (rather than the Department of Revenue and its | ||||||
12 | Director)
and every long-term care provider subject to | ||||||
13 | assessment measured by licensed
occupied bed days and to the | ||||||
14 | return filing requirements of this Article
(rather than persons | ||||||
15 | subject to retailers' occupation tax measured by gross
receipts | ||||||
16 | from the sale of tangible personal property at retail and to | ||||||
17 | the
return filing requirements of ROTA) shall have the powers, | ||||||
18 | duties, and
rights specified in these ROTA provisions, as | ||||||
19 | modified in this Section or
by the Illinois Department in a | ||||||
20 | manner consistent with this Article and
except as manifestly | ||||||
21 | inconsistent with the other provisions of this Article:
| ||||||
22 | (1) ROTA, Section 4 (examination of return; notice of
| ||||||
23 | correction; evidence; limitations; protest and hearing), | ||||||
24 | except
that (i) the Illinois Department shall issue notices | ||||||
25 | of
assessment liability (rather than notices of tax | ||||||
26 | liability as
provided in ROTA, Section 4); (ii) in the case |
| |||||||
| |||||||
1 | of a fraudulent
return or in the case of an extended period | ||||||
2 | agreed to by the
Illinois Department and the long-term care | ||||||
3 | provider before the
expiration of the limitation period, no | ||||||
4 | notice of assessment
liability shall be issued more than 3 | ||||||
5 | years after the later of
the due date of the return | ||||||
6 | required by Section 5B-5 or the date
the return (or an | ||||||
7 | amended return) was filed (rather within the
period stated | ||||||
8 | in ROTA, Section 4); and (iii) the penalty provisions of
| ||||||
9 | ROTA, Section 4 shall not apply.
| ||||||
10 | (2) ROTA, Section 5 (failure to make return; failure to | ||||||
11 | pay
assessment), except that the penalty and interest | ||||||
12 | provisions
of ROTA, Section 5 shall not apply.
| ||||||
13 | (3) ROTA, Section 5a (lien; attachment; termination; | ||||||
14 | notice;
protest; review; release of lien; status of lien).
| ||||||
15 | (4) ROTA, Section 5b (State lien notices; State lien | ||||||
16 | index;
duties of recorder and registrar of titles).
| ||||||
17 | (5) ROTA, Section 5c (liens; certificate of release).
| ||||||
18 | (6) ROTA, Section 5d (Department not required to | ||||||
19 | furnish bond;
claim to property attached or levied upon).
| ||||||
20 | (7) ROTA, Section 5e (foreclosure on liens; | ||||||
21 | enforcement).
| ||||||
22 | (8) ROTA, Section 5f (demand for payment; levy and sale | ||||||
23 | of
property; limitation).
| ||||||
24 | (9) ROTA, Section 5g (sale of property; redemption).
| ||||||
25 | (10) ROTA, Section 5j (sales on transfers outside usual | ||||||
26 | course
of business; report; payment of assessment; rights |
| |||||||
| |||||||
1 | and duties of
purchaser; penalty).
| ||||||
2 | (11) ROTA, Section 6 (erroneous payments; credit or | ||||||
3 | refund),
provided that (i) the Illinois Department may only | ||||||
4 | apply an
amount otherwise subject to credit or refund to a | ||||||
5 | liability
arising under this Article; (ii) except in the | ||||||
6 | case of an
extended period agreed to by the Illinois | ||||||
7 | Department and the
long term care provider prior to the | ||||||
8 | expiration of this limitation
period, a claim for credit or | ||||||
9 | refund must be filed no more than 3
years after the due | ||||||
10 | date of the return required by Section 5B-5
(rather than | ||||||
11 | the time limitation stated in ROTA, Section 6); and
(iii) | ||||||
12 | credits or refunds shall not bear interest.
| ||||||
13 | (12) ROTA, Section 6a (claims for credit or refund).
| ||||||
14 | (13) ROTA, Section 6b (tentative determination of | ||||||
15 | claim; notice;
hearing; review), provided that a long-term | ||||||
16 | care provider or its
representative shall have 60 days | ||||||
17 | (rather than 20 days) within
which to file a protest and | ||||||
18 | request for hearing in response to a
tentative | ||||||
19 | determination of claim.
| ||||||
20 | (14) ROTA, Section 6c (finality of tentative | ||||||
21 | determinations).
| ||||||
22 | (15) ROTA, Section 8 (investigations and hearings).
| ||||||
23 | (16) ROTA, Section 9 (witness; immunity).
| ||||||
24 | (17) ROTA, Section 10 (issuance of subpoenas; | ||||||
25 | attendance of
witnesses; production of books and records).
| ||||||
26 | (18) ROTA, Section 11 (information confidential; |
| |||||||
| |||||||
1 | exceptions).
| ||||||
2 | (19) ROTA, Section 12 (rules and regulations; hearing;
| ||||||
3 | appeals), except that a long-term care provider shall not | ||||||
4 | be
required to file a bond or be subject to a lien in lieu | ||||||
5 | thereof
in order to seek court review under the | ||||||
6 | Administrative Review Law
of a final assessment or revised | ||||||
7 | final assessment or the
equivalent thereof issued by the | ||||||
8 | 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 Illinois | ||||||
11 | Department may collect an
unpaid assessment by withholding, as | ||||||
12 | payment of the assessment,
reimbursements or other amounts | ||||||
13 | otherwise payable by the Illinois
Department to the provider.
| ||||||
14 | (Source: P.A. 87-861.)
| ||||||
15 | (305 ILCS 5/Art. V-E rep.) | ||||||
16 | (305 ILCS 5/5E-5 rep.) | ||||||
17 | (305 ILCS 5/5E-10 rep.) | ||||||
18 | (305 ILCS 5/5E-15 rep.) | ||||||
19 | Section 10. If and only if Senate Bill 3088 of
the 96th | ||||||
20 | General Assembly becomes law, then the Illinois Public Aid Code | ||||||
21 | is amended by repealing Article V-E.
| ||||||
22 | Section 99. Effective date. This Act takes effect upon | ||||||
23 | becoming law or on the effective date of Senate Bill 3088 of | ||||||
24 | the 96th General Assembly, whichever is later.
|