Full Text of SB2443 102nd General Assembly
SB2443 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 SB2443 Introduced 2/26/2021, by Sen. Mattie Hunter SYNOPSIS AS INTRODUCED: |
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Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the rates or payments for home health visits shall be as follows: $111 for dates of service from January 1, 2021 through December 31, 2021; and $131 for dates of service on and after January 1, 2022. Provides that the rates or payments for the certified nursing assistant component of the home health agency rate shall be as follows: $20 for dates of service prior to January
1, 2021; $25 for dates of service from January 1, 2021 through December 31, 2021; $30 for dates of service from January 1, 2022 through December 31, 2022; and $35 for dates of service on and after January 1, 2023. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| 1 | | AN ACT concerning public aid.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5e as follows: | 6 | | (305 ILCS 5/5-5e) | 7 | | Sec. 5-5e. Adjusted rates of reimbursement. | 8 | | (a) Rates or payments for services in effect on June 30, | 9 | | 2012 shall be adjusted and
services shall be affected as | 10 | | required by any other provision of Public Act 97-689. In | 11 | | addition, the Department shall do the following: | 12 | | (1) Delink the per diem rate paid for supportive | 13 | | living facility services from the per diem rate paid for | 14 | | nursing facility services, effective for services provided | 15 | | on or after May 1, 2011 and before July 1, 2019. | 16 | | (2) Cease payment for bed reserves in nursing | 17 | | facilities and specialized mental health rehabilitation | 18 | | facilities; for purposes of therapeutic home visits for | 19 | | individuals scoring as TBI on the MDS 3.0, beginning June | 20 | | 1, 2015, the Department shall approve payments for bed | 21 | | reserves in nursing facilities and specialized mental | 22 | | health rehabilitation facilities that have at least a 90% | 23 | | occupancy level and at least 80% of their residents are |
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| 1 | | Medicaid eligible. Payment shall be at a daily rate of 75% | 2 | | of an individual's current Medicaid per diem and shall not | 3 | | exceed 10 days in a calendar month. | 4 | | (2.5) Cease payment for bed reserves for purposes of | 5 | | inpatient hospitalizations to intermediate care facilities | 6 | | for persons with developmental disabilities, except in the | 7 | | instance of residents who are under 21 years of age. | 8 | | (3) Cease payment of the $10 per day add-on payment to | 9 | | nursing facilities for certain residents with | 10 | | developmental disabilities. | 11 | | (b) After the application of subsection (a), | 12 | | notwithstanding any other provision of this
Code to the | 13 | | contrary and to the extent permitted by federal law, on and | 14 | | after July 1,
2012, the rates of reimbursement for services | 15 | | and other payments provided under this
Code shall further be | 16 | | reduced as follows: | 17 | | (1) Rates or payments for physician services, dental | 18 | | services, or community health center services reimbursed | 19 | | through an encounter rate, and services provided under the | 20 | | Medicaid Rehabilitation Option of the Illinois Title XIX | 21 | | State Plan shall not be further reduced, except as | 22 | | provided in Section 5-5b.1. | 23 | | (2) Rates or payments, or the portion thereof, paid to | 24 | | a provider that is operated by a unit of local government | 25 | | or State University that provides the non-federal share of | 26 | | such services shall not be further reduced, except as |
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| 1 | | provided in Section 5-5b.1. | 2 | | (3) Rates or payments for hospital services delivered | 3 | | by a hospital defined as a Safety-Net Hospital under | 4 | | Section 5-5e.1 of this Code shall not be further reduced, | 5 | | except as provided in Section 5-5b.1. | 6 | | (4) Rates or payments for hospital services delivered | 7 | | by a Critical Access Hospital, which is an Illinois | 8 | | hospital designated as a critical care hospital by the | 9 | | Department of Public Health in accordance with 42 CFR 485, | 10 | | Subpart F, shall not be further reduced, except as | 11 | | provided in Section 5-5b.1. | 12 | | (5) Rates or payments for Nursing Facility Services | 13 | | shall only be further adjusted pursuant to Section 5-5.2 | 14 | | of this Code. | 15 | | (6) Rates or payments for services delivered by long | 16 | | term care facilities licensed under the ID/DD Community | 17 | | Care Act or the MC/DD Act and developmental training | 18 | | services shall not be further reduced. | 19 | | (7) Rates or payments for services provided under | 20 | | capitation rates shall be adjusted taking into | 21 | | consideration the rates reduction and covered services | 22 | | required by Public Act 97-689. | 23 | | (8) For hospitals not previously described in this | 24 | | subsection, the rates or payments for hospital services | 25 | | shall be further reduced by 3.5%, except for payments | 26 | | authorized under Section 5A-12.4 of this Code. |
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| 1 | | (9) For all other rates or payments for services | 2 | | delivered by providers not specifically referenced in | 3 | | paragraphs (1) through (8), rates or payments shall be | 4 | | further reduced by 2.7%. | 5 | | (c) Any assessment imposed by this Code shall continue and | 6 | | nothing in this Section shall be construed to cause it to | 7 | | cease.
| 8 | | (d) Notwithstanding any other provision of this Code to | 9 | | the contrary, subject to federal approval under Title XIX of | 10 | | the Social Security Act, for dates of service on and after July | 11 | | 1, 2014, rates or payments for services provided for the | 12 | | purpose of transitioning children from a hospital to home | 13 | | placement or other appropriate setting by a children's | 14 | | community-based health care center authorized under the | 15 | | Alternative Health Care Delivery Act shall be $683 per day. | 16 | | (e) (Blank). | 17 | | (f) (Blank). | 18 | | (g) Notwithstanding any other provision of this Code to | 19 | | the contrary, subject to federal approval under Title XIX of | 20 | | the Social Security Act, for dates of service from January 1, | 21 | | 2021 through December 31, 2021, rates or payments for home | 22 | | health visits shall be $111. For dates of service on and after | 23 | | January 1, 2022, rates or payments for home health visits | 24 | | shall be $131. | 25 | | (h) Notwithstanding any other provision of this Code to | 26 | | the contrary, subject to federal approval under Title XIX of |
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| 1 | | the Social Security Act, for dates of service prior to January | 2 | | 1, 2021, rates or payments for the certified nursing assistant | 3 | | component of the home health agency rate shall be $20. For | 4 | | dates of service from January 1, 2021 through December 31, | 5 | | 2021, rates or payments for the certified nursing assistant | 6 | | component of the home health agency rate shall be $25. For | 7 | | dates of service from January 1, 2022 through December 31, | 8 | | 2022, rates or payments for the certified nursing assistant | 9 | | component of the home health agency rate shall be $30. For | 10 | | dates of service on and after January 1, 2023, rates or | 11 | | payments for the certified nursing assistant component of the | 12 | | home health agency rate shall be $35. | 13 | | (Source: P.A. 101-10, eff. 6-5-19; 101-649, eff. 7-7-20.)
| 14 | | Section 99. Effective date. This Act takes effect upon | 15 | | becoming law.
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