Rep. Jay Hoffman

Filed: 11/16/2016

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1821

2    AMENDMENT NO. ______. Amend Senate Bill 1821 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Section 5A-5 and by adding Section 14-13 as follows:
 
6    (305 ILCS 5/5A-5)  (from Ch. 23, par. 5A-5)
7    Sec. 5A-5. Notice; penalty; maintenance of records.
8    (a) The Illinois Department shall send a notice of
9assessment to every hospital provider subject to assessment
10under this Article. The notice of assessment shall notify the
11hospital of its assessment and shall be sent after receipt by
12the Department of notification from the Centers for Medicare
13and Medicaid Services of the U.S. Department of Health and
14Human Services that the payment methodologies required under
15this Article and, if necessary, the waiver granted under 42 CFR
16433.68 have been approved. The notice shall be on a form

 

 

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1prepared by the Illinois Department and shall state the
2following:
3        (1) The name of the hospital provider.
4        (2) The address of the hospital provider's principal
5    place of business from which the provider engages in the
6    occupation of hospital provider in this State, and the name
7    and address of each hospital operated, conducted, or
8    maintained by the provider in this State.
9        (3) The occupied bed days, occupied bed days less
10    Medicare days, adjusted gross hospital revenue, or
11    outpatient gross revenue of the hospital provider
12    (whichever is applicable), the amount of assessment
13    imposed under Section 5A-2 for the State fiscal year for
14    which the notice is sent, and the amount of each
15    installment to be paid during the State fiscal year.
16        (4) (Blank).
17        (5) Other reasonable information as determined by the
18    Illinois Department.
19    (b) If a hospital provider conducts, operates, or maintains
20more than one hospital licensed by the Illinois Department of
21Public Health, the provider shall pay the assessment for each
22hospital separately.
23    (c) Notwithstanding any other provision in this Article, in
24the case of a person who ceases to conduct, operate, or
25maintain a hospital in respect of which the person is subject
26to assessment under this Article as a hospital provider, the

 

 

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1assessment for the State fiscal year in which the cessation
2occurs shall be adjusted by multiplying the assessment computed
3under Section 5A-2 by a fraction, the numerator of which is the
4number of days in the year during which the provider conducts,
5operates, or maintains the hospital and the denominator of
6which is 365. Immediately upon ceasing to conduct, operate, or
7maintain a hospital, the person shall pay the assessment for
8the year as so adjusted (to the extent not previously paid).
9    (d) Notwithstanding any other provision in this Article, a
10provider who commences conducting, operating, or maintaining a
11hospital, upon notice by the Illinois Department, shall pay the
12assessment computed under Section 5A-2 and subsection (e) in
13installments on the due dates stated in the notice and on the
14regular installment due dates for the State fiscal year
15occurring after the due dates of the initial notice.
16    (e) Notwithstanding any other provision in this Article,
17for State fiscal years 2009 through 2018, in the case of a
18hospital provider that did not conduct, operate, or maintain a
19hospital in 2005, the assessment for that State fiscal year
20shall be computed on the basis of hypothetical occupied bed
21days for the full calendar year as determined by the Illinois
22Department. Notwithstanding any other provision in this
23Article, for the portion of State fiscal year 2012 beginning
24June 10, 2012 through June 30, 2012, and for State fiscal years
252013 through 2018, in the case of a hospital provider that did
26not conduct, operate, or maintain a hospital in 2009, the

 

 

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1assessment under subsection (b-5) of Section 5A-2 for that
2State fiscal year shall be computed on the basis of
3hypothetical gross outpatient revenue for the full calendar
4year as determined by the Illinois Department. The Illinois
5Department is prohibited from increasing any assessment based
6upon hypothetical occupied bed days or hypothetical gross
7outpatient revenue under this Section once the initial
8assessment has been calculated by the Department and the
9hospital has been notified of the amount of the assessment
10based upon hypothetical occupied bed days or hypothetical gross
11outpatient revenue.
12    (f) Every hospital provider subject to assessment under
13this Article shall keep sufficient records to permit the
14determination of adjusted gross hospital revenue for the
15hospital's fiscal year. All such records shall be kept in the
16English language and shall, at all times during regular
17business hours of the day, be subject to inspection by the
18Illinois Department or its duly authorized agents and
19employees.
20    (g) The Illinois Department may, by rule, provide a
21hospital provider a reasonable opportunity to request a
22clarification or correction of any clerical or computational
23errors contained in the calculation of its assessment, but such
24corrections shall not extend to updating the cost report
25information used to calculate the assessment.
26    (h) (Blank).

 

 

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1(Source: P.A. 98-104, eff. 7-22-13; 98-463, eff. 8-16-13;
298-651, eff. 6-16-14; 98-756, eff. 7-16-14; 99-78, eff.
37-20-15.)
 
4    (305 ILCS 5/14-13 new)
5    Sec. 14-13. Treatment of newly licensed general acute care
6hospitals.
7    (a) For any general acute care hospital licensed by the
8Department of Public Health after January 1, 2008, the Illinois
9Department must calculate and pay enhanced payments for
10Medicaid services similar to enhanced Medicaid payments
11received by other general acute care hospitals.
12    (b) The Illinois Department may create new payments or
13increase other existing Medicaid reimbursement programs in
14order to meet the requirements of subsection (a).
15    (c) The Illinois Department may meet the requirements of
16this Section by increasing Medicaid payment amounts for a
17hospital within the same system or ownership structure as the
18newly licensed hospital.
19    (d) The Illinois Department must insert any new Medicaid
20inpatient methodology created under this Section in the
21Medicaid Facilitation and Utilization Payment section of the
22Illinois Medicaid State Plan.
23    (e) The Illinois Department must insert any new Medicaid
24outpatient methodology created under this Section in the
25Hospital Outpatient Assistance Adjustment Payments section of

 

 

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1the Illinois Medicaid State Plan.
2    (f) The Illinois Department may, by rule, specify the
3amount of funding to invest in the payments required by this
4Section if not otherwise specified below:
5        (1) For general acute care hospitals licensed after
6    January 1, 2008 and before January 1, 2016, the pool must
7    be $4,500,000 annually with no less than 2 years of this
8    amount distributed before July 1, 2018.
9        (2) For general acute care hospitals licensed after
10    January 1, 2016 and before July 1, 2016, the pool must be
11    $3,500,000 annually with no less than 2 years of this
12    amount distributed before July 1, 2018.
13        (3) For general acute care hospitals licensed on and
14    after July 1, 2016, the pool may be established by the
15    Illinois Department by rule.
16    (g) The Medicaid payments authorized under this Section
17shall continue so long as the payments under subsection (f) of
18Section 14-12 are in effect.".