103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3244

 

Introduced 2/17/2023, by Rep. Justin Slaughter

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5e.1

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the rate of reimbursement for inpatient psychiatric services for safety-net hospitals shall be no less than $800 per day.


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A BILL FOR

 

HB3244LRB103 28467 KTG 54848 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 5-5e.1 as follows:
 
6    (305 ILCS 5/5-5e.1)
7    Sec. 5-5e.1. Safety-Net Hospitals.
8    (a) A Safety-Net Hospital is an Illinois hospital that:
9        (1) is licensed by the Department of Public Health as
10    a general acute care or pediatric hospital; and
11        (2) is a disproportionate share hospital, as described
12    in Section 1923 of the federal Social Security Act, as
13    determined by the Department; and
14        (3) meets one of the following:
15            (A) has a MIUR of at least 40% and a charity
16        percent of at least 4%; or
17            (B) has a MIUR of at least 50%.
18    (b) Definitions. As used in this Section:
19        (1) "Charity percent" means the ratio of (i) the
20    hospital's charity charges for services provided to
21    individuals without health insurance or another source of
22    third party coverage to (ii) the Illinois total hospital
23    charges, each as reported on the hospital's OBRA form.

 

 

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1        (2) "MIUR" means Medicaid Inpatient Utilization Rate
2    and is defined as a fraction, the numerator of which is the
3    number of a hospital's inpatient days provided in the
4    hospital's fiscal year ending 3 years prior to the rate
5    year, to patients who, for such days, were eligible for
6    Medicaid under Title XIX of the federal Social Security
7    Act, 42 USC 1396a et seq., excluding those persons
8    eligible for medical assistance pursuant to 42 U.S.C.
9    1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
10    Section 5-2 of this Article, and the denominator of which
11    is the total number of the hospital's inpatient days in
12    that same period, excluding those persons eligible for
13    medical assistance pursuant to 42 U.S.C.
14    1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
15    Section 5-2 of this Article.
16        (3) "OBRA form" means form HFS-3834, OBRA '93 data
17    collection form, for the rate year.
18        (4) "Rate year" means the 12-month period beginning on
19    October 1.
20    (c) Beginning July 1, 2012 and ending on December 31,
212026, a hospital that would have qualified for the rate year
22beginning October 1, 2011 or October 1, 2012 shall be a
23Safety-Net Hospital.
24    (c-5) Beginning July 1, 2020 and ending on December 31,
252026, a hospital that would have qualified for the rate year
26beginning October 1, 2020 and was designated a federal rural

 

 

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1referral center under 42 CFR 412.96 as of October 1, 2020 shall
2be a Safety-Net Hospital.
3    (c-6) The rate of reimbursement for inpatient psychiatric
4services for safety-net hospitals shall be no less than $800
5per day.
6    (d) No later than August 15 preceding the rate year, each
7hospital shall submit the OBRA form to the Department. Prior
8to October 1, the Department shall notify each hospital
9whether it has qualified as a Safety-Net Hospital.
10    (e) The Department may promulgate rules in order to
11implement this Section.
12    (f) Nothing in this Section shall be construed as limiting
13the ability of the Department to include the Safety-Net
14Hospitals in the hospital rate reform mandated by Section
1514-11 of this Code and implemented under Section 14-12 of this
16Code and by administrative rulemaking.
17(Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21;
18102-886, eff. 5-17-22.)