103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5645

 

Introduced 2/9/2024, by Rep. Anna Moeller

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 45/3-401.1  from Ch. 111 1/2, par. 4153-401.1

    Amends the Nursing Home Care Act. Adds (in addition to other criteria) that if a resident fails to pay or has a late payment and the facility follows the federal discharge and transfer requirements, including the issuance of a notice of facility-initiated discharge, then a facility that participates in the Medical Assistance Program may refuse to retain as a resident any person who resides in a part of the facility that does not participate in the Medical Assistance Program and who is unable to pay for his or her care in the facility without medical assistance.


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A BILL FOR

 

HB5645LRB103 37000 CES 67115 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Nursing Home Care Act is amended by
5changing Section 3-401.1 as follows:
 
6    (210 ILCS 45/3-401.1)  (from Ch. 111 1/2, par. 4153-401.1)
7    Sec. 3-401.1. (a) A facility participating in the Medical
8Assistance Program is prohibited from failing or refusing to
9retain as a resident any person because he or she is a
10recipient of or an applicant for the Medical Assistance
11Program.
12    (a-5) A After the effective date of this amendatory Act of
131997, a facility of which only a distinct part is certified to
14participate in the Medical Assistance Program may refuse to
15retain as a resident any person who resides in a part of the
16facility that does not participate in the Medical Assistance
17Program and who is unable to pay for his or her care in the
18facility without Medical Assistance only if:
19        (1) the facility, no later than at the time of
20    admission and at the time of the resident's contract
21    renewal, explains to the resident (unless he or she is
22    incompetent), and to the resident's representative, and to
23    the person making payment on behalf of the resident for

 

 

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1    the resident's stay, in writing, that the facility may
2    discharge the resident if the resident is no longer able
3    to pay for his or her care in the facility without Medical
4    Assistance;
5        (2) the resident (unless he or she is incompetent),
6    the resident's representative, and the person making
7    payment on behalf of the resident for the resident's stay,
8    acknowledge in writing that they have received the written
9    explanation; .
10        (3) the resident fails to pay or has a late payment as
11    described in subsection (d) of this Act and the facility
12    follows the federal discharge and transfer requirements
13    including the issuance of a notice of facility-initiated
14    discharge as described in 45 CFR 483.15(c).
15    (a-10) For the purposes of this Section, a recipient or
16applicant shall be considered a resident in the facility
17during any hospital stay totaling 10 days or less following a
18hospital admission. The Department of Healthcare and Family
19Services shall recoup funds from a facility when, as a result
20of the facility's refusal to readmit a recipient after
21hospitalization for 10 days or less, the recipient incurs
22hospital bills in an amount greater than the amount that would
23have been paid by that Department (formerly the Illinois
24Department of Public Aid) for care of the recipient in the
25facility. The amount of the recoupment shall be the difference
26between the Department of Healthcare and Family Services'

 

 

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1(formerly the Illinois Department of Public Aid's) payment for
2hospital care and the amount that Department would have paid
3for care in the facility.
4    (b) A facility which violates this Section shall be guilty
5of a business offense and fined not less than $500 nor more
6than $1,000 for the first offense and not less than $1,000 nor
7more than $5,000 for each subsequent offense.
8(Source: P.A. 95-331, eff. 8-21-07.)