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Services. |
"Department" means the Illinois Department of Healthcare |
and Family Services. |
"Developmentally disabled care facility" means an |
intermediate care facility for the mentally retarded within the |
meaning of Title XIX of the Social Security Act, whether public |
or private and whether organized for profit or not-for-profit, |
but shall not include any facility operated by the State. |
"Developmentally disabled care provider" means a person |
conducting, operating, or maintaining a developmentally |
disabled care facility. For purposes of this definition, |
"person" means any political subdivision of the State, |
municipal corporation, individual, firm, partnership, |
corporation, company, limited liability company, association, |
joint stock association, or trust, or a receiver, executor, |
trustee, guardian, or other representative appointed by order |
of any court. |
"DHS" means the Illinois Department of Human Services. |
"Hospital" means an institution, place, building, or |
agency located in this State that is licensed as a general |
acute hospital by the Illinois Department of Public Health |
under the Hospital Licensing Act, whether public or private and |
whether organized for profit or not-for-profit. |
"Long term care facility" means (i) a skilled nursing or |
intermediate long term care facility, whether public or private |
and whether organized for profit or not-for-profit, that is |
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subject to licensure by the Illinois Department of Public |
Health under the Nursing Home Care Act, including a county |
nursing home directed and maintained under Section 5-1005 of |
the Counties Code, and (ii) a part of a hospital in which |
skilled or intermediate long term care services within the |
meaning of Title XVIII or XIX of the Social Security Act are |
provided; except that the term "long term care facility" does |
not include a facility operated solely as an intermediate care |
facility for the mentally retarded within the meaning of Title |
XIX of the Social Security Act. |
"Long term care provider" means (i) a person licensed by |
the Department of Public Health to operate and maintain a |
skilled nursing or intermediate long term care facility or (ii) |
a hospital provider that provides skilled or intermediate long |
term care services within the meaning of Title XVIII or XIX of |
the Social Security Act. For purposes of this definition, |
"person" means any political subdivision of the State, |
municipal corporation, individual, firm, partnership, |
corporation, company, limited liability company, association, |
joint stock association, or trust, or a receiver, executor, |
trustee, guardian, or other representative appointed by order |
of any court. |
"State-operated developmentally disabled care facility" |
means an intermediate care facility for the mentally retarded |
within the meaning of Title XIX of the Social Security Act |
operated by the State. |
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(c) Administration and deposit of Revenues. The Department |
shall coordinate the implementation of changes required by this |
amendatory Act of the 96th General Assembly amongst the various |
State and local government bodies that administer programs |
referred to in this Section. |
Revenues generated by program changes mandated by any |
provision in this Section, less reasonable administrative |
costs associated with the implementation of these program |
changes, shall be deposited into the Healthcare Provider Relief |
Fund. |
The Department shall issue a report to the General Assembly |
detailing the implementation progress of this amendatory Act of |
the 96th General Assembly as a part of the Department's Medical |
Programs annual report for fiscal years 2010 and 2011. |
(d) Acceleration of payment vouchers. To the extent |
practicable and permissible under federal law, the Department |
shall create all vouchers for long term care facilities and |
developmentally disabled care facilities for dates of service |
in the month in which the enhanced federal medical assistance |
percentage (FMAP) originally set forth in the American Recovery |
and Reinvestment Act (ARRA) expires and for dates of service in |
the month prior to that month and shall, no later than the 15th |
of the month in which the enhanced FMAP expires, submit these |
vouchers to the Comptroller for payment. |
The Department of Human Services shall create the necessary |
documentation for State-operated developmentally disabled care |
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facilities so that the necessary data for all dates of service |
before the expiration of the enhanced FMAP originally set forth |
in the ARRA can be adjudicated by the Department no later than |
the 15th of the month in which the enhanced FMAP expires. |
(e) Billing of DHS community Medicaid mental health |
services. No later than July 1, 2011, community Medicaid mental |
health services provided by a community-based provider must be |
billed directly to the Department. |
(f) DCFS Medicaid services. The Department shall work with |
DCFS to identify existing programs, pending qualifying |
services, that can be converted in an economically feasible |
manner to Medicaid in order to secure federal financial |
revenue. |
(g) Third Party Liability recoveries. The Department shall |
contract with a vendor to support the Department in |
coordinating benefits for Medicaid enrollees. The scope of work |
shall include, at a minimum, the identification of other |
insurance for Medicaid enrollees and the recovery of funds paid |
by the Department when another payer was liable. The vendor may |
be paid a percentage of actual cash recovered when practical |
and subject to federal law. |
(h) Public health departments.
The Department shall |
identify unreimbursed costs for persons covered by Medicaid who |
are served by the Chicago Department of Public Health. |
The Department shall assist the Chicago Department of |
Public Health in determining total unreimbursed costs |
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associated with the provision of healthcare services to |
Medicaid enrollees. |
The Department shall determine and draw the maximum |
allowable federal matching dollars associated with the cost of |
Chicago Department of Public Health services provided to |
Medicaid enrollees. |
(i) Acceleration of hospital-based payments.
The |
Department shall, by the 10th day of the month in which the |
enhanced FMAP originally set forth in the ARRA expires, create |
vouchers for all State fiscal year 2011 hospital payments |
exempt from the prompt payment requirements of the ARRA. The |
Department shall submit these vouchers to the Comptroller for |
payment.
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Section 10. The Community Services Act is amended by adding |
Section 4.8 as follows:
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(405 ILCS 30/4.8 new) |
Sec. 4.8. Payments for community Medicaid mental health |
services. |
(a) No later than July 1, 2011, community Medicaid mental |
health services provided by a community-based provider must be |
billed directly to the Department of Healthcare and Family |
Services. |
(b) For purposes of this Section: |
"Community Medicaid mental health services" means all |
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mental health services outlined in Section 132 of Title 59 of |
the Illinois Administrative Code that are funded through the |
Department of Human Services, eligible for federal financial |
participation, and provided by a community-based provider. |
"Community-based provider" means an entity enrolled as a |
provider pursuant to Sections 140.11 and 140.12 of Title 89 of |
the Illinois Administrative Code and certified to provide |
community Medicaid mental health services in accordance with |
Section 132 of Title 59 of the Illinois Administrative Code.
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Section 99. Effective date. This Act takes effect upon |
becoming law.
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