Rep. Greg Harris
Filed: 11/6/2014
 
 

 

 

 
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1
AMENDMENT TO SENATE BILL 3171 




2    AMENDMENT NO. ______. Amend Senate Bill 3171 by replacing 
3everything after the enacting clause with the following:


 
 
4    "Section 5. The Illinois Public Aid Code is amended  by 
5changing 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, 
92012 shall be adjusted and
services shall be affected as 
10required by any other provision of this amendatory Act of
the 
1197th General Assembly. In addition, the Department shall do the 
12following: 
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.
 
 
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1        (2) Cease payment for bed reserves in nursing 
2    facilities and specialized mental health rehabilitation 
3    facilities; for purposes of therapeutic home visits for  
4    individuals scoring as TBI on the MDS 3.0, beginning June 
5    1, 2015, the Department shall approve payments for bed 
6    reserves in nursing facilities and specialized mental 
7    health rehabilitation facilities that have at least a 90% 
8    occupancy level and at least 90% of their residents are 
9    Medicaid eligible. Payment shall be at a daily rate of 75% 
10    of an individual's current Medicaid per diem and shall not 
11    exceed 10 days in a calendar month.
12        (2.5) Cease payment for bed reserves for purposes of 
13    inpatient hospitalizations to intermediate care facilities 
14    for persons with development disabilities, except in the 
15    instance of residents who are under 21 years of age. 
16        (3) Cease payment of the $10 per day add-on payment to 
17    nursing facilities for certain residents with 
18    developmental disabilities.
19    (b) After the application of subsection (a), 
20notwithstanding any other provision of this
Code to the 
21contrary and to the extent permitted by federal law, on and 
22after July 1,
2012, the rates of reimbursement for services and 
23other payments provided under this
Code shall further be 
24reduced as follows: 
25        (1) Rates or payments for physician services, dental 
26    services, or community health center services reimbursed 
 
 
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1    through an encounter rate, and services provided under the 
2    Medicaid Rehabilitation Option of the Illinois Title XIX 
3    State Plan shall not be further reduced. 
4        (2) Rates or payments, or the portion thereof, paid to 
5    a provider that is operated by a  unit of local government 
6    or State University that provides the non-federal share of 
7    such services shall not be further reduced. 
8        (3) Rates or payments for hospital services delivered 
9    by a hospital defined as a Safety-Net Hospital under 
10    Section 5-5e.1 of this Code shall not be further reduced. 
11        (4) Rates or payments for hospital services delivered 
12    by a Critical Access Hospital, which is an Illinois 
13    hospital designated as a critical care hospital by the 
14    Department of Public Health in accordance with 42 CFR 485, 
15    Subpart F, shall not be further reduced. 
16        (5) Rates or payments for Nursing Facility Services 
17    shall only be further adjusted pursuant to Section 5-5.2 of 
18    this Code. 
19        (6) Rates or payments for services delivered by long 
20    term care facilities licensed under the ID/DD Community 
21    Care Act and developmental training services shall not be 
22    further reduced. 
23        (7) Rates or payments for services provided under 
24    capitation rates shall be adjusted taking into 
25    consideration the rates reduction and covered services 
26    required by this amendatory Act of the 97th General 
 
 
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1    Assembly. 
2        (8) For hospitals not previously described in this 
3    subsection, the rates or payments for hospital services 
4    shall be further reduced by 3.5%, except for payments 
5    authorized under Section 5A-12.4 of this Code. 
6        (9) For all other rates or payments for services 
7    delivered by providers not specifically referenced in 
8    paragraphs (1) through (8), rates or payments shall be 
9    further reduced by 2.7%. 
10    (c) Any assessment imposed by this Code shall continue and 
11nothing in this Section shall be construed to cause it to 
12cease. 

13    (d) Notwithstanding any other provision of this Code to the 
14contrary, subject to federal approval under Title XIX of the 
15Social Security Act, for dates of service on and after July 1, 
162014, rates or payments for services provided for the purpose 
17of transitioning children from a hospital to home placement or 
18other appropriate setting by a children's community-based 
19health care center authorized under the Alternative Health Care 
20Delivery Act shall be $683 per day. 
21    (e) Notwithstanding any other provision of this Code to the 
22contrary, subject to federal approval under Title XIX of the 
23Social Security Act, for dates of service on and after July 1, 
242014, rates or payments for home health visits shall be $72. 
25    (f)  Notwithstanding any other provision of this Code to the 
26contrary, subject to federal approval under Title XIX of the 
 
 
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1Social Security Act, for dates of service on and after July 1, 
22014, rates or payments for the certified nursing assistant 
3component of the home health agency rate shall be $20. 
4(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13; 
598-651, eff. 6-16-14.)
 
 
6    Section 99. Effective date. This Act takes effect June 1, 
72015.".