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| | SB3171 Enrolled | | LRB098 18157 KTG 53286 b |
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1 | | AN ACT concerning public aid.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Public Aid Code is amended by |
5 | | changing Section 5-5e as follows: |
6 | | (305 ILCS 5/5-5e) |
7 | | Sec. 5-5e. Adjusted rates of reimbursement. |
8 | | (a) Rates or payments for services in effect on June 30, |
9 | | 2012 shall be adjusted and
services shall be affected as |
10 | | required by any other provision of this amendatory Act of
the |
11 | | 97th General Assembly. In addition, the Department shall do the |
12 | | following: |
13 | | (1) Delink the per diem rate paid for supportive living |
14 | | facility services from the per diem rate paid for nursing |
15 | | facility services, effective for services provided on or |
16 | | after May 1, 2011. |
17 | | (2) Cease payment for bed reserves in nursing |
18 | | facilities and specialized mental health rehabilitation |
19 | | facilities ; for purposes of therapeutic home visits for |
20 | | individuals scoring as TBI on the MDS 3.0, beginning June |
21 | | 1, 2015, the Department shall approve payments for bed |
22 | | reserves in nursing facilities and specialized mental |
23 | | health rehabilitation facilities that have at least a 90% |
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1 | | occupancy level and at least 80% of their residents are |
2 | | Medicaid eligible. Payment shall be at a daily rate of 75% |
3 | | of an individual's current Medicaid per diem and shall not |
4 | | exceed 10 days in a calendar month . |
5 | | (2.5) Cease payment for bed reserves for purposes of |
6 | | inpatient hospitalizations to intermediate care facilities |
7 | | for persons with development disabilities, except in the |
8 | | instance of residents who are under 21 years of age. |
9 | | (3) Cease payment of the $10 per day add-on payment to |
10 | | nursing facilities for certain residents with |
11 | | developmental disabilities. |
12 | | (b) After the application of subsection (a), |
13 | | notwithstanding any other provision of this
Code to the |
14 | | contrary and to the extent permitted by federal law, on and |
15 | | after July 1,
2012, the rates of reimbursement for services and |
16 | | other payments provided under this
Code shall further be |
17 | | reduced as follows: |
18 | | (1) Rates or payments for physician services, dental |
19 | | services, or community health center services reimbursed |
20 | | through an encounter rate, and services provided under the |
21 | | Medicaid Rehabilitation Option of the Illinois Title XIX |
22 | | State Plan shall not be further reduced. |
23 | | (2) Rates or payments, or the portion thereof, paid to |
24 | | a provider that is operated by a unit of local government |
25 | | or State University that provides the non-federal share of |
26 | | such services shall not be further reduced. |
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1 | | (3) Rates or payments for hospital services delivered |
2 | | by a hospital defined as a Safety-Net Hospital under |
3 | | Section 5-5e.1 of this Code shall not be further reduced. |
4 | | (4) Rates or payments for hospital services delivered |
5 | | by a Critical Access Hospital, which is an Illinois |
6 | | hospital designated as a critical care hospital by the |
7 | | Department of Public Health in accordance with 42 CFR 485, |
8 | | Subpart F, shall not be further reduced. |
9 | | (5) Rates or payments for Nursing Facility Services |
10 | | shall only be further adjusted pursuant to Section 5-5.2 of |
11 | | this Code. |
12 | | (6) Rates or payments for services delivered by long |
13 | | term care facilities licensed under the ID/DD Community |
14 | | Care Act and developmental training services shall not be |
15 | | further reduced. |
16 | | (7) Rates or payments for services provided under |
17 | | capitation rates shall be adjusted taking into |
18 | | consideration the rates reduction and covered services |
19 | | required by this amendatory Act of the 97th General |
20 | | Assembly. |
21 | | (8) For hospitals not previously described in this |
22 | | subsection, the rates or payments for hospital services |
23 | | shall be further reduced by 3.5%, except for payments |
24 | | authorized under Section 5A-12.4 of this Code. |
25 | | (9) For all other rates or payments for services |
26 | | delivered by providers not specifically referenced in |
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1 | | paragraphs (1) through (8), rates or payments shall be |
2 | | further reduced by 2.7%. |
3 | | (c) Any assessment imposed by this Code shall continue and |
4 | | nothing in this Section shall be construed to cause it to |
5 | | cease.
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6 | | (d) Notwithstanding any other provision of this Code to the |
7 | | contrary, subject to federal approval under Title XIX of the |
8 | | Social Security Act, for dates of service on and after July 1, |
9 | | 2014, rates or payments for services provided for the purpose |
10 | | of transitioning children from a hospital to home placement or |
11 | | other appropriate setting by a children's community-based |
12 | | health care center authorized under the Alternative Health Care |
13 | | Delivery Act shall be $683 per day. |
14 | | (e) Notwithstanding any other provision of this Code to the |
15 | | contrary, subject to federal approval under Title XIX of the |
16 | | Social Security Act, for dates of service on and after July 1, |
17 | | 2014, rates or payments for home health visits shall be $72. |
18 | | (f) Notwithstanding any other provision of this Code to the |
19 | | contrary, subject to federal approval under Title XIX of the |
20 | | Social Security Act, for dates of service on and after July 1, |
21 | | 2014, rates or payments for the certified nursing assistant |
22 | | component of the home health agency rate shall be $20. |
23 | | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13; |
24 | | 98-651, eff. 6-16-14.)
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25 | | Section 99. Effective date. This Act takes effect June 1, |
26 | | 2015.
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