104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4846
 
Introduced , by Rep. Lindsey LaPointe
 
SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5e.1
    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a safety-net hospital includes a behavioral health safety-net provider that: (i) is licensed or certified by the Department of Human Services, or otherwise authorized under State law, to provide behavioral health or substance use disorder treatment services; (ii) meets specified federal requirements for being designated a disproportionate share hospital, as defined by the Department of Healthcare and Family Services; (iii) accepts admissions 24 hours a day, 7 days a week, with no blackout periods; (iv) accepts patients who only need mental health or substance use disorder treatment; and (v) has a MIUR of at least 40% and a charity percent of at least 4%, or a MIUR of at least 50%.


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A BILL FOR
 
HB4846LRB104 19791 KTG 33241 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois, 
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by 
5changing Section 5-5e.1 as follows:
 
6    (305 ILCS 5/5-5e.1)
7    Sec. 5-5e.1. Safety-Net Hospitals.
8    (a) A Safety-Net Hospital is an Illinois hospital that:
9        (1) is licensed by the Department of Public Health as 
10    a general acute care or pediatric hospital; and
11        (2) is a disproportionate share hospital, as described 
12    in Section 1923 of the federal Social Security Act, as 
13    determined by the Department; and
14        (3) meets one of the following:
15            (A) has a MIUR of at least 40% and a charity 
16        percent of at least 4%; or
17            (B) has a MIUR of at least 50%.
18    (a-5) "Safety-Net Hospital" includes a behavioral health 
19safety-net provider. A behavioral health safety-net provider 
20is a provider that:
21        (1) is licensed or certified by the Department of 
22    Human Services, or otherwise authorized under State law, 
23    to provide behavioral health or substance use disorder 
 
 
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1    treatment services;
2        (2) meets the requirements of subsection (b) of 
3    Section 1923 of the federal Social Security Act for being 
4    designated a disproportionate share hospital, as defined 
5    by the Department of Healthcare and Family Services;
6        (3) accepts admissions 24 hours a day, 7 days a week, 
7    with no blackout periods;
8        (4) accepts patients who only need mental health or 
9    substance use disorder treatment, and do not need 
10    hospitalization or medical assistance for any other 
11    reason; and
12        (5) meets one of the following:
13            (A) has a MIUR of at least 40% and a charity 
14        percent of at least 4%; or
15            (B) has a MIUR of at least 50%.
16    (b) Definitions. As used in this Section:
17        (1) "Charity percent" means the ratio of (i) the 
18    hospital's charity charges for services provided to 
19    individuals without health insurance or another source of 
20    third party coverage to (ii) the Illinois total hospital 
21    charges, each as reported on the hospital's OBRA form.
22        (2) "MIUR" means Medicaid Inpatient Utilization Rate 
23    and is defined as a fraction, the numerator of which is the 
24    number of a hospital's inpatient days provided in the 
25    hospital's fiscal year ending 3 years prior to the rate 
26    year, to patients who, for such days, were eligible for 
 
 
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1    Medicaid under Title XIX of the federal Social Security 
2    Act, 42 USC 1396a et seq., excluding those persons 
3    eligible for medical assistance pursuant to 42 U.S.C. 
4    1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of 
5    Section 5-2 of this Article, and the denominator of which 
6    is the total number of the hospital's inpatient days in 
7    that same period, excluding those persons eligible for 
8    medical assistance pursuant to 42 U.S.C. 
9    1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of 
10    Section 5-2 of this Article.
11        (3) "OBRA form" means form HFS-3834, OBRA '93 data 
12    collection form, for the rate year.
13        (4) "Rate year" means the 12-month period beginning on 
14    October 1.
15    (c) Beginning July 1, 2012 and ending on December 31, 
162026, a hospital that would have qualified for the rate year 
17beginning October 1, 2011 or October 1, 2012 shall be a 
18Safety-Net Hospital.
19    (c-5) Beginning July 1, 2020 and ending on December 31, 
202026, a hospital that would have qualified for the rate year 
21beginning October 1, 2020 and was designated a federal rural 
22referral center under 42 CFR 412.96 as of October 1, 2020 shall 
23be a Safety-Net Hospital. 
24    (d) No later than August 15 preceding the rate year, each 
25hospital shall submit the OBRA form to the Department. Prior 
26to October 1, the Department shall notify each hospital 
 
 
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1whether it has qualified as a Safety-Net Hospital.
2    (e) The Department may promulgate rules in order to 
3implement this Section.
4    (f) Nothing in this Section shall be construed as limiting 
5the ability of the Department to include the Safety-Net 
6Hospitals in the hospital rate reform mandated by Section 
714-11 of this Code and implemented under Section 14-12 of this 
8Code and by administrative rulemaking. 
9(Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21; 
10102-886, eff. 5-17-22.)