SB1821ham001 99TH GENERAL ASSEMBLY

Rep. Jay Hoffman

Filed: 11/16/2016

09900SB1821ham001 LRB099 10143 KTG 51600 a

AMENDMENT TO SENATE BILL 1821

AMENDMENT NO. ______. Amend Senate Bill 1821 by replacing everything after the enacting clause with the following:

"Section 5. The Illinois Public Aid Code is amended by changing Section 5A-5 and by adding Section 14-13 as follows:

(305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)

Sec. 5A-5. Notice; penalty; maintenance of records.

(a) The Illinois Department shall send a notice of assessment to every hospital provider subject to assessment under this Article. The notice of assessment shall notify the hospital of its assessment and shall be sent after receipt by the Department of notification from the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services that the payment methodologies required under this Article and, if necessary, the waiver granted under 42 CFR 433.68 have been approved. The notice shall be on a form prepared by the Illinois Department and shall state the following:

(1) The name of the hospital provider.

(2) The address of the hospital provider's principal place of business from which the provider engages in the occupation of hospital provider in this State, and the name and address of each hospital operated, conducted, or maintained by the provider in this State.

(3) The occupied bed days, occupied bed days less Medicare days, adjusted gross hospital revenue, or outpatient gross revenue of the hospital provider (whichever is applicable), the amount of assessment imposed under Section 5A-2 for the State fiscal year for which the notice is sent, and the amount of each installment to be paid during the State fiscal year.

(4) (Blank).

(5) Other reasonable information as determined by the Illinois Department.

(b) If a hospital provider conducts, operates, or maintains more than one hospital licensed by the Illinois Department of Public Health, the provider shall pay the assessment for each hospital separately.

(c) Notwithstanding any other provision in this Article, in the case of a person who ceases to conduct, operate, or maintain a hospital in respect of which the person is subject to assessment under this Article as a hospital provider, the assessment for the State fiscal year in which the cessation occurs shall be adjusted by multiplying the assessment computed under Section 5A-2 by a fraction, the numerator of which is the number of days in the year during which the provider conducts, operates, or maintains the hospital and the denominator of which is 365. Immediately upon ceasing to conduct, operate, or maintain a hospital, the person shall pay the assessment for the year as so adjusted (to the extent not previously paid).

(d) Notwithstanding any other provision in this Article, a provider who commences conducting, operating, or maintaining a hospital, upon notice by the Illinois Department, shall pay the assessment computed under Section 5A-2 and subsection (e) in installments on the due dates stated in the notice and on the regular installment due dates for the State fiscal year occurring after the due dates of the initial notice.

(e) Notwithstanding any other provision in this Article, for State fiscal years 2009 through 2018, in the case of a hospital provider that did not conduct, operate, or maintain a hospital in 2005, the assessment for that State fiscal year shall be computed on the basis of hypothetical occupied bed days for the full calendar year as determined by the Illinois Department. Notwithstanding any other provision in this Article, for the portion of State fiscal year 2012 beginning June 10, 2012 through June 30, 2012, and for State fiscal years 2013 through 2018, in the case of a hospital provider that did not conduct, operate, or maintain a hospital in 2009, the assessment under subsection (b-5) of Section 5A-2 for that State fiscal year shall be computed on the basis of hypothetical gross outpatient revenue for the full calendar year as determined by the Illinois Department. The Illinois Department is prohibited from increasing any assessment based upon hypothetical occupied bed days or hypothetical gross outpatient revenue under this Section once the initial assessment has been calculated by the Department and the hospital has been notified of the amount of the assessment based upon hypothetical occupied bed days or hypothetical gross outpatient revenue.

(f) Every hospital provider subject to assessment under this Article shall keep sufficient records to permit the determination of adjusted gross hospital revenue for the hospital's fiscal year. All such records shall be kept in the English language and shall, at all times during regular business hours of the day, be subject to inspection by the Illinois Department or its duly authorized agents and employees.

(g) The Illinois Department may, by rule, provide a hospital provider a reasonable opportunity to request a clarification or correction of any clerical or computational errors contained in the calculation of its assessment, but such corrections shall not extend to updating the cost report information used to calculate the assessment.

(h) (Blank).

(Source: P.A. 98-104, eff. 7-22-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756, eff. 7-16-14; 99-78, eff. 7-20-15.)

(305 ILCS 5/14-13 new)

Sec. 14-13. Treatment of newly licensed general acute care hospitals.

(a) For any general acute care hospital licensed by the Department of Public Health after January 1, 2008, the Illinois Department must calculate and pay enhanced payments for Medicaid services similar to enhanced Medicaid payments received by other general acute care hospitals.

(b) The Illinois Department may create new payments or increase other existing Medicaid reimbursement programs in order to meet the requirements of subsection (a).

(c) The Illinois Department may meet the requirements of this Section by increasing Medicaid payment amounts for a hospital within the same system or ownership structure as the newly licensed hospital.

(d) The Illinois Department must insert any new Medicaid inpatient methodology created under this Section in the Medicaid Facilitation and Utilization Payment section of the Illinois Medicaid State Plan.

(e) The Illinois Department must insert any new Medicaid outpatient methodology created under this Section in the Hospital Outpatient Assistance Adjustment Payments section of the Illinois Medicaid State Plan.

(f) The Illinois Department may, by rule, specify the amount of funding to invest in the payments required by this Section if not otherwise specified below:

(1) For general acute care hospitals licensed after January 1, 2008 and before January 1, 2016, the pool must be $4,500,000 annually with no less than 2 years of this amount distributed before July 1, 2018.

(2) For general acute care hospitals licensed after January 1, 2016 and before July 1, 2016, the pool must be $3,500,000 annually with no less than 2 years of this amount distributed before July 1, 2018.

(3) For general acute care hospitals licensed on and after July 1, 2016, the pool may be established by the Illinois Department by rule.

(g) The Medicaid payments authorized under this Section shall continue so long as the payments under subsection (f) of Section 14-12 are in effect.".