Sen. Don Harmon
Filed: 3/14/2019
 
 

 

 

 
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1
AMENDMENT TO SENATE BILL 42




2    AMENDMENT NO. ______. Amend Senate Bill 42 by replacing 
3everything after the enacting clause with the following:

 
4    "Section 1. Short title. This Act may be cited as the 
5Nursing Home Medicaid Reimbursement Reform Act.
 
6    Section 5. Purposes. The purposes of this Act include:
7        (1) Establishing a framework for the provision of care 
8    to
frail elderly residents of facilities licensed under the

9    Nursing Home Care Act.
10        (2) Ensuring the coordination of regulation and

11    reimbursement for nursing home residents.
12        (3) Bolstering the viability of career paths for 
13    employees
of nursing homes.
14        (4) Strengthening the nursing home provider community.
15        (5) Supporting the highest possible quality of

16    resident-centered services and care.
 
 
 
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1    Section 10. Definitions. As used in this Act:
2    "Facility" has the same meaning ascribed to that term under 
3the Nursing Home Care Act.
4    "Medical assistance" means health care benefits provided 
5under Article V of the Illinois Public Aid Code.
6    "Medical Assistance Program" means the Medical Assistance 
7Program administered by the Department of Healthcare and Family 
8Services in accordance with Article V of the Illinois Public 
9Aid Code.

10    "Resident" has the same meaning ascribed to that term under 
11the Nursing Home Care Act.

 
12    Section 15. Resident rights. 
13    (a) Notwithstanding any other provision of law or

14regulation, it shall be a matter of State policy that all

15residents of facilities licensed under the Nursing Home Care

16Act who meet the financial requirements for medical assistance

17shall be guaranteed the rights specified in this Section. Every

18financially qualified resident with a determination of need

19score of 29 or greater shall be guaranteed the right to:
20        (1) select the facility in which he or she receives 
21    care;
22        (2) participate fully in the development of his or her

23    individualized care plan; and
24        (3) be informed in advance of any changes to his or her

 
 
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1    individualized care plan or to the status of his or her

2    nursing home stay.
3    (b) All medical treatment and services deemed medically

4necessary by a physician licensed to practice medicine in all

5of its branches, including the provision of prescription drugs

6not covered under a qualified Medicare Part D Prescription Drug

7Plan, shall be presumed to be available for any resident who is

8eligible for medical assistance and shall qualify for

9reimbursement under the Medical Assistance Program.
10    (c) Any medical services provided, as specified in this 
11Act, to a resident
of a facility licensed under the Nursing 
12Home Care Act  shall be reimbursed based on an aggregate rate 
13composed of nursing, support, and capital components. The 
14facility shall also be reimbursed an amount that equals the 
15facility's actual real
estate tax bill, if applicable.
16    (d) Any additional funds contained in the State Fiscal Year 
172020 budget in excess of those expended in the State Fiscal 
18Year 2019 budget shall be distributed by statute. 
19    (e)  All reimbursement payments for services covered under 
20this Section are due and payable on the last day of each month 
21for all claims submitted during the preceding calendar month.


 
22    Section 99. Effective date. This Act takes effect upon 
23becoming law.".