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Public Act 92-0031
SB608 Enrolled LRB9203291DJgc
AN ACT in relation to public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5-5.4 as follows:
(305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
Sec. 5-5.4. Standards of Payment - Department of Public
Aid. The Department of Public Aid shall develop standards of
payment of skilled nursing and intermediate care services in
facilities providing such services under this Article which:
(1) Provides for the determination of a facility's
payment for skilled nursing and intermediate care services on
a prospective basis. The amount of the payment rate for all
nursing facilities certified under the medical assistance
program shall be prospectively established annually on the
basis of historical, financial, and statistical data
reflecting actual costs from prior years, which shall be
applied to the current rate year and updated for inflation,
except that the capital cost element for newly constructed
facilities shall be based upon projected budgets. The
annually established payment rate shall take effect on July 1
in 1984 and subsequent years. Rate increases shall be
provided annually thereafter on July 1 in 1984 and on each
subsequent July 1 in the following years, except that no rate
increase and no update for inflation shall be provided on or
after July 1, 1994 and before July 1, 2002 July 1, 2001,
unless specifically provided for in this Section.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 1998 shall include an increase of 3%. For facilities
licensed by the Department of Public Health under the Nursing
Home Care Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking effect on July 1, 1998
shall include an increase of 3% plus $1.10 per resident-day,
as defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 1999 shall include an increase of 1.6% plus $3.00 per
resident-day, as defined by the Department. For facilities
licensed by the Department of Public Health under the Nursing
Home Care Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking effect on July 1, 1999
shall include an increase of 1.6% and, for services provided
on or after October 1, 1999, shall be increased by $4.00 per
resident-day, as defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 2000 shall include an increase of 2.5% per resident-day,
as defined by the Department. For facilities licensed by the
Department of Public Health under the Nursing Home Care Act
as Skilled Nursing facilities or Intermediate Care
facilities, the rates taking effect on July 1, 2000 shall
include an increase of 2.5% per resident-day, as defined by
the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as skilled nursing
facilities or intermediate care facilities, the rates taking
effect on July 1, 2001, and each subsequent year thereafter,
shall be computed using the most recent cost reports on file
with the Department of Public Aid no later than April 1, 2000
updated for inflation to January 1, 2001. For rates
effective July 1, 2001 only, rates shall be the greater of
the rate computed for July 1, 2001 or the rate effective on
June 30, 2001.
Rates established effective each July 1 shall govern
payment for services rendered throughout that fiscal year,
except that rates established on July 1, 1996 shall be
increased by 6.8% for services provided on or after January
1, 1997. Such rates will be based upon the rates calculated
for the year beginning July 1, 1990, and for subsequent years
thereafter until June 30, 2001 shall be based on the facility
cost reports for the facility fiscal year ending at any point
in time during the previous calendar year, updated to the
midpoint of the rate year. The cost report shall be on file
with the Department no later than April 1 of the current rate
year. Should the cost report not be on file by April 1, the
Department shall base the rate on the latest cost report
filed by each skilled care facility and intermediate care
facility, updated to the midpoint of the current rate year.
In determining rates for services rendered on and after July
1, 1985, fixed time shall not be computed at less than zero.
The Department shall not make any alterations of regulations
which would reduce any component of the Medicaid rate to a
level below what that component would have been utilizing in
the rate effective on July 1, 1984.
(2) Shall take into account the actual costs incurred by
facilities in providing services for recipients of skilled
nursing and intermediate care services under the medical
assistance program.
(3) Shall take into account the medical and
psycho-social characteristics and needs of the patients.
(4) Shall take into account the actual costs incurred by
facilities in meeting licensing and certification standards
imposed and prescribed by the State of Illinois, any of its
political subdivisions or municipalities and by the U.S.
Department of Health and Human Services pursuant to Title XIX
of the Social Security Act.
The Department of Public Aid shall develop precise
standards for payments to reimburse nursing facilities for
any utilization of appropriate rehabilitative personnel for
the provision of rehabilitative services which is authorized
by federal regulations, including reimbursement for services
provided by qualified therapists or qualified assistants, and
which is in accordance with accepted professional practices.
Reimbursement also may be made for utilization of other
supportive personnel under appropriate supervision.
(Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24,
eff. 7-1-99; 91-712, eff. 7-1-00.)
Section 99. Effective date. This Act takes effect upon
becoming law.
Passed in the General Assembly May 10, 2001.
Approved June 28, 2001.
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