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(305 ILCS 5/5-5.7) (from Ch. 23, par. 5-5.7)
Sec. 5-5.7. Cost reports - audits. The Department of Healthcare and Family Services shall
work with the Department of Public Health to use cost report information
currently being collected under provisions of the Nursing Home Care
Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, and the MC/DD Act. The Department of Healthcare and Family Services may, in conjunction with the Department of Public Health,
develop in accordance with generally accepted accounting principles a
uniform chart of accounts which each facility providing services under the
medical assistance program shall adopt, after a reasonable period.
Facilities licensed under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, or the MC/DD Act
and providers of adult developmental training services certified by the
Department of Human Services pursuant to
Section 15.2 of the Mental Health and Developmental Disabilities Administrative
Act which provide
services to clients eligible for
medical assistance under this Article are responsible for submitting the
required annual cost report to the Department of Healthcare and Family Services.
The Department of Healthcare and Family Services
shall audit the financial and statistical
records of each provider participating in the medical assistance program
as a nursing facility, a specialized mental health rehabilitation facility, or an ICF/DD over a 3 year period,
beginning with the close of the first cost reporting year. Following the
end of this 3-year term, audits of the financial and statistical records
will be performed each year in at least 20% of the facilities participating
in the medical assistance program with at least 10% being selected on a
random sample basis, and the remainder selected on the basis of exceptional
profiles. All audits shall be conducted in accordance with generally accepted
auditing standards.
The Department of Healthcare and Family Services
shall establish prospective payment rates
for categories or levels of services within each licensure class, in order to more appropriately recognize the
individual needs of patients in nursing facilities.
The Department of Healthcare and Family Services
shall provide, during the process of
establishing the payment rate for nursing facility, specialized mental health rehabilitation facility, or ICF/DD
services, or when a substantial change in rates is proposed, an opportunity
for public review and comment on the proposed rates prior to their becoming
effective.
(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
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