102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB1422

 

Introduced 2/17/2021, by Rep. Emanuel Chris Welch

 

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

 

HB1422LRB102 03438 KTG 13451 b

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
14    to the facilities of these services subject to cost
15    ceilings 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
19    an assessment of the resident needs in the nursing
20    facilities.
21        (3) Ancillary Services, with the payment rate being
22    developed for each individual type of service. Payment
23    shall be made only when authorized under procedures

 

 

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

 

 

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1    rate reimbursement period effective July 1, 1987, the
2    Department shall be prohibited from establishing,
3    including, and implementing any depreciation factor in
4    calculating the capital cost element.
5        (2) Profit, with the actual amount being produced and
6    accruing to the providers in the form of a return on their
7    total investment, on the basis of their ability to
8    economically and efficiently deliver a type of service.
9    The method of payment may assure the opportunity for a
10    profit, but shall not guarantee or establish a specific
11    amount as a cost.
12    (c) The Illinois Department may implement the amendatory
13changes to this Section made by this amendatory Act of 1991
14through the use of emergency rules in accordance with the
15provisions of Section 5.02 of the Illinois Administrative
16Procedure Act. For purposes of the Illinois Administrative
17Procedure Act, the adoption of rules to implement the
18amendatory changes to this Section made by this amendatory Act
19of 1991 shall be deemed an emergency and necessary for the
20public interest, safety and welfare.
21    (d) No later than January 1, 2001, the Department of
22Public Aid shall file with the Joint Committee on
23Administrative Rules, pursuant to the Illinois Administrative
24Procedure Act, a proposed rule, or a proposed amendment to an
25existing rule, regarding payment for appropriate services,
26including assessment, care planning, discharge planning, and

 

 

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1treatment provided by nursing facilities to residents who have
2a serious mental illness.
3    (e) On and after July 1, 2012, the Department shall reduce
4any rate of reimbursement for services or other payments or
5alter any methodologies authorized by this Code to reduce any
6rate of reimbursement for services or other payments in
7accordance with Section 5-5e.
8(Source: P.A. 96-1123, eff. 1-1-11; 96-1530, eff. 2-16-11;
997-689, eff. 6-14-12.)