98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
SB1368

 

Introduced 2/5/2013, by Sen. David Koehler

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.5  from Ch. 23, par. 5-5.5

    Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning Medicaid payment rates for nursing facility and ICF/DD services in nursing facilities.


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A BILL FOR

 

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1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5.5 as follows:
 
6    (305 ILCS 5/5-5.5)  (from Ch. 23, par. 5-5.5)
7    Sec. 5-5.5. Elements of Payment Rate.
8    (a) The The Department of Healthcare and Family Services
9shall develop a prospective method for determining payment
10rates for nursing facility and ICF/DD services in nursing
11facilities composed of the following cost elements:
12        (1) Standard Services, with the cost of this component
13    being determined by taking into account the actual costs to
14    the facilities of these services subject to cost ceilings
15    to be defined in the Department's rules.
16        (2) Resident Services, with the cost of this component
17    being determined by taking into account the actual costs,
18    needs and utilization of these services, as derived from an
19    assessment of the resident needs in the nursing facilities.
20        (3) Ancillary Services, with the payment rate being
21    developed for each individual type of service. Payment
22    shall be made only when authorized under procedures
23    developed by the Department of Healthcare and Family

 

 

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1    Services.
2        (4) Nurse's Aide Training, with the cost of this
3    component being determined by taking into account the
4    actual cost to the facilities of such training.
5        (5) Real Estate Taxes, with the cost of this component
6    being determined by taking into account the figures
7    contained in the most currently available cost reports
8    (with no imposition of maximums) updated to the midpoint of
9    the current rate year for long term care services rendered
10    between July 1, 1984 and June 30, 1985, and with the cost
11    of this component being determined by taking into account
12    the actual 1983 taxes for which the nursing homes were
13    assessed (with no imposition of maximums) updated to the
14    midpoint of the current rate year for long term care
15    services rendered between July 1, 1985 and June 30, 1986.
16    (b) In developing a prospective method for determining
17payment rates for nursing facility and ICF/DD services in
18nursing facilities and ICF/DDs, the Department of Healthcare
19and Family Services shall consider the following cost elements:
20        (1) Reasonable capital cost determined by utilizing
21    incurred interest rate and the current value of the
22    investment, including land, utilizing composite rates, or
23    by utilizing such other reasonable cost related methods
24    determined by the Department. However, beginning with the
25    rate reimbursement period effective July 1, 1987, the
26    Department shall be prohibited from establishing,

 

 

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1    including, and implementing any depreciation factor in
2    calculating the capital cost element.
3        (2) Profit, with the actual amount being produced and
4    accruing to the providers in the form of a return on their
5    total investment, on the basis of their ability to
6    economically and efficiently deliver a type of service. The
7    method of payment may assure the opportunity for a profit,
8    but shall not guarantee or establish a specific amount as a
9    cost.
10    (c) The Illinois Department may implement the amendatory
11changes to this Section made by this amendatory Act of 1991
12through the use of emergency rules in accordance with the
13provisions of Section 5.02 of the Illinois Administrative
14Procedure Act. For purposes of the Illinois Administrative
15Procedure Act, the adoption of rules to implement the
16amendatory changes to this Section made by this amendatory Act
17of 1991 shall be deemed an emergency and necessary for the
18public interest, safety and welfare.
19    (d) No later than January 1, 2001, the Department of Public
20Aid shall file with the Joint Committee on Administrative
21Rules, pursuant to the Illinois Administrative Procedure Act, a
22proposed rule, or a proposed amendment to an existing rule,
23regarding payment for appropriate services, including
24assessment, care planning, discharge planning, and treatment
25provided by nursing facilities to residents who have a serious
26mental illness.

 

 

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1    (e) On and after July 1, 2012, the Department shall reduce
2any rate of reimbursement for services or other payments or
3alter any methodologies authorized by this Code to reduce any
4rate of reimbursement for services or other payments in
5accordance with Section 5-5e.
6(Source: P.A. 96-1123, eff. 1-1-11; 96-1530, eff. 2-16-11;
797-689, eff. 6-14-12.)