Rep. Frank J. Mautino

Filed: 4/28/2011

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1680

2    AMENDMENT NO. ______. Amend Senate Bill 1680 as follows:
 
3on page 1, line 5, by replacing "5A-2 and 5A-14" with "5A-2,
45A-3, 5A-5, 5A-8, 5A-10, and 5A-14"; and
 
5on page 4, by inserting immediately below line 23 the
6following:
 
7    "(305 ILCS 5/5A-3)  (from Ch. 23, par. 5A-3)
8    Sec. 5A-3. Exemptions.
9    (a) (Blank).
10    (b) A hospital provider that is a State agency, a State
11university, or a county with a population of 3,000,000 or more
12is exempt from the assessment imposed by Section 5A-2.
13    (b-2) A hospital provider that is a county with a
14population of less than 3,000,000 or a township, municipality,
15hospital district, or any other local governmental unit is

 

 

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1exempt from the assessment imposed by Section 5A-2.
2    (b-5) (Blank).
3    (b-10) For State fiscal years 2004 through 2016 2014, a
4hospital provider, described in Section 1903(w)(3)(F) of the
5Social Security Act, whose hospital does not charge for its
6services is exempt from the assessment imposed by Section 5A-2,
7unless the exemption is adjudged to be unconstitutional or
8otherwise invalid, in which case the hospital provider shall
9pay the assessment imposed by Section 5A-2.
10    (b-15) For State fiscal years 2004 and 2005, a hospital
11provider whose hospital is licensed by the Department of Public
12Health as a psychiatric hospital is exempt from the assessment
13imposed by Section 5A-2, unless the exemption is adjudged to be
14unconstitutional or otherwise invalid, in which case the
15hospital provider shall pay the assessment imposed by Section
165A-2.
17    (b-20) For State fiscal years 2004 and 2005, a hospital
18provider whose hospital is licensed by the Department of Public
19Health as a rehabilitation hospital is exempt from the
20assessment imposed by Section 5A-2, unless the exemption is
21adjudged to be unconstitutional or otherwise invalid, in which
22case the hospital provider shall pay the assessment imposed by
23Section 5A-2.
24    (b-25) For State fiscal years 2004 and 2005, a hospital
25provider whose hospital (i) is not a psychiatric hospital,
26rehabilitation hospital, or children's hospital and (ii) has an

 

 

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1average length of inpatient stay greater than 25 days is exempt
2from the assessment imposed by Section 5A-2, unless the
3exemption is adjudged to be unconstitutional or otherwise
4invalid, in which case the hospital provider shall pay the
5assessment imposed by Section 5A-2.
6    (c) (Blank).
7(Source: P.A. 95-859, eff. 8-19-08; 96-1530, eff. 2-16-11.)
 
8    (305 ILCS 5/5A-5)  (from Ch. 23, par. 5A-5)
9    Sec. 5A-5. Notice; penalty; maintenance of records.
10    (a) The Department of Healthcare and Family Services shall
11send a notice of assessment to every hospital provider subject
12to assessment under this Article. The notice of assessment
13shall notify the hospital of its assessment and shall be sent
14after receipt by the Department of notification from the
15Centers for Medicare and Medicaid Services of the U.S.
16Department of Health and Human Services that the payment
17methodologies required under Section 5A-12, Section 5A-12.1,
18or Section 5A-12.2, whichever is applicable for that fiscal
19year, and, if necessary, the waiver granted under 42 CFR 433.68
20have been approved. The notice shall be on a form prepared by
21the Illinois Department and shall state the following:
22        (1) The name of the hospital provider.
23        (2) The address of the hospital provider's principal
24    place of business from which the provider engages in the
25    occupation of hospital provider in this State, and the name

 

 

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1    and address of each hospital operated, conducted, or
2    maintained by the provider in this State.
3        (3) The occupied bed days, occupied bed days less
4    Medicare days, or adjusted gross hospital revenue of the
5    hospital provider (whichever is applicable), the amount of
6    assessment imposed under Section 5A-2 for the State fiscal
7    year for which the notice is sent, and the amount of each
8    installment to be paid during the State fiscal year.
9        (4) (Blank).
10        (5) Other reasonable information as determined by the
11    Illinois Department.
12    (b) If a hospital provider conducts, operates, or maintains
13more than one hospital licensed by the Illinois Department of
14Public Health, the provider shall pay the assessment for each
15hospital separately.
16    (c) Notwithstanding any other provision in this Article, in
17the case of a person who ceases to conduct, operate, or
18maintain a hospital in respect of which the person is subject
19to assessment under this Article as a hospital provider, the
20assessment for the State fiscal year in which the cessation
21occurs shall be adjusted by multiplying the assessment computed
22under Section 5A-2 by a fraction, the numerator of which is the
23number of days in the year during which the provider conducts,
24operates, or maintains the hospital and the denominator of
25which is 365. Immediately upon ceasing to conduct, operate, or
26maintain a hospital, the person shall pay the assessment for

 

 

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1the year as so adjusted (to the extent not previously paid).
2    (d) Notwithstanding any other provision in this Article, a
3provider who commences conducting, operating, or maintaining a
4hospital, upon notice by the Illinois Department, shall pay the
5assessment computed under Section 5A-2 and subsection (e) in
6installments on the due dates stated in the notice and on the
7regular installment due dates for the State fiscal year
8occurring after the due dates of the initial notice.
9    (e) Notwithstanding any other provision in this Article,
10for State fiscal years 2004 and 2005, in the case of a hospital
11provider that did not conduct, operate, or maintain a hospital
12throughout calendar year 2001, the assessment for that State
13fiscal year shall be computed on the basis of hypothetical
14occupied bed days for the full calendar year as determined by
15the Illinois Department. Notwithstanding any other provision
16in this Article, for State fiscal years 2006 through 2008, in
17the case of a hospital provider that did not conduct, operate,
18or maintain a hospital in 2003, the assessment for that State
19fiscal year shall be computed on the basis of hypothetical
20adjusted gross hospital revenue for the hospital's first full
21fiscal year as determined by the Illinois Department (which may
22be based on annualization of the provider's actual revenues for
23a portion of the year, or revenues of a comparable hospital for
24the year, including revenues realized by a prior provider of
25the same hospital during the year). Notwithstanding any other
26provision in this Article, for State fiscal years 2009 through

 

 

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12016 2014, in the case of a hospital provider that did not
2conduct, operate, or maintain a hospital in 2005, the
3assessment for that State fiscal year shall be computed on the
4basis of hypothetical occupied bed days for the full calendar
5year as determined by the Illinois Department.
6    (f) Every hospital provider subject to assessment under
7this Article shall keep sufficient records to permit the
8determination of adjusted gross hospital revenue for the
9hospital's fiscal year. All such records shall be kept in the
10English language and shall, at all times during regular
11business hours of the day, be subject to inspection by the
12Illinois Department or its duly authorized agents and
13employees.
14    (g) The Illinois Department may, by rule, provide a
15hospital provider a reasonable opportunity to request a
16clarification or correction of any clerical or computational
17errors contained in the calculation of its assessment, but such
18corrections shall not extend to updating the cost report
19information used to calculate the assessment.
20    (h) (Blank).
21(Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08;
2296-1530, eff. 2-16-11.)
 
23    (305 ILCS 5/5A-8)  (from Ch. 23, par. 5A-8)
24    Sec. 5A-8. Hospital Provider Fund.
25    (a) There is created in the State Treasury the Hospital

 

 

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1Provider Fund. Interest earned by the Fund shall be credited to
2the Fund. The Fund shall not be used to replace any moneys
3appropriated to the Medicaid program by the General Assembly.
4    (b) The Fund is created for the purpose of receiving moneys
5in accordance with Section 5A-6 and disbursing moneys only for
6the following purposes, notwithstanding any other provision of
7law:
8        (1) For making payments to hospitals as required under
9    Articles V, V-A, VI, and XIV of this Code, under the
10    Children's Health Insurance Program Act, under the
11    Covering ALL KIDS Health Insurance Act, and under the
12    Senior Citizens and Disabled Persons Property Tax Relief
13    and Pharmaceutical Assistance Act.
14        (2) For the reimbursement of moneys collected by the
15    Illinois Department from hospitals or hospital providers
16    through error or mistake in performing the activities
17    authorized under this Article and Article V of this Code.
18        (3) For payment of administrative expenses incurred by
19    the Illinois Department or its agent in performing the
20    activities authorized by this Article.
21        (4) For payments of any amounts which are reimbursable
22    to the federal government for payments from this Fund which
23    are required to be paid by State warrant.
24        (5) For making transfers, as those transfers are
25    authorized in the proceedings authorizing debt under the
26    Short Term Borrowing Act, but transfers made under this

 

 

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1    paragraph (5) shall not exceed the principal amount of debt
2    issued in anticipation of the receipt by the State of
3    moneys to be deposited into the Fund.
4        (6) For making transfers to any other fund in the State
5    treasury, but transfers made under this paragraph (6) shall
6    not exceed the amount transferred previously from that
7    other fund into the Hospital Provider Fund.
8        (6.5) For making transfers to the Healthcare Provider
9    Relief Fund, except that transfers made under this
10    paragraph (6.5) shall not exceed $60,000,000 in the
11    aggregate.
12        (7) For State fiscal years 2004 and 2005 for making
13    transfers to the Health and Human Services Medicaid Trust
14    Fund, including 20% of the moneys received from hospital
15    providers under Section 5A-4 and transferred into the
16    Hospital Provider Fund under Section 5A-6. For State fiscal
17    year 2006 for making transfers to the Health and Human
18    Services Medicaid Trust Fund of up to $130,000,000 per year
19    of the moneys received from hospital providers under
20    Section 5A-4 and transferred into the Hospital Provider
21    Fund under Section 5A-6. Transfers under this paragraph
22    shall be made within 7 days after the payments have been
23    received pursuant to the schedule of payments provided in
24    subsection (a) of Section 5A-4.
25        (7.5) For State fiscal year 2007 for making transfers
26    of the moneys received from hospital providers under

 

 

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1    Section 5A-4 and transferred into the Hospital Provider
2    Fund under Section 5A-6 to the designated funds not
3    exceeding the following amounts in that State fiscal year:
4        Health and Human Services
5            Medicaid Trust Fund................. $20,000,000
6        Long-Term Care Provider Fund............ $30,000,000
7        General Revenue Fund................... $80,000,000.
8        Transfers under this paragraph shall be made within 7
9    days after the payments have been received pursuant to the
10    schedule of payments provided in subsection (a) of Section
11    5A-4.
12        (7.8) For State fiscal year 2008, for making transfers
13    of the moneys received from hospital providers under
14    Section 5A-4 and transferred into the Hospital Provider
15    Fund under Section 5A-6 to the designated funds not
16    exceeding the following amounts in that State fiscal year:
17        Health and Human Services
18            Medicaid Trust Fund..................$40,000,000
19        Long-Term Care Provider Fund..............$60,000,000
20        General Revenue Fund...................$160,000,000.
21        Transfers under this paragraph shall be made within 7
22    days after the payments have been received pursuant to the
23    schedule of payments provided in subsection (a) of Section
24    5A-4.
25        (7.9) For State fiscal years 2009 through 2016 2014,
26    for making transfers of the moneys received from hospital

 

 

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1    providers under Section 5A-4 and transferred into the
2    Hospital Provider Fund under Section 5A-6 to the designated
3    funds not exceeding the following amounts in that State
4    fiscal year:
5        Health and Human Services
6            Medicaid Trust Fund...................$20,000,000
7        Long Term Care Provider Fund..............$30,000,000
8        General Revenue Fund.....................$80,000,000.
9        Except as provided under this paragraph, transfers
10    under this paragraph shall be made within 7 business days
11    after the payments have been received pursuant to the
12    schedule of payments provided in subsection (a) of Section
13    5A-4. For State fiscal year 2009, transfers to the General
14    Revenue Fund under this paragraph shall be made on or
15    before June 30, 2009, as sufficient funds become available
16    in the Hospital Provider Fund to both make the transfers
17    and continue hospital payments.
18        (8) For making refunds to hospital providers pursuant
19    to Section 5A-10.
20    Disbursements from the Fund, other than transfers
21authorized under paragraphs (5) and (6) of this subsection,
22shall be by warrants drawn by the State Comptroller upon
23receipt of vouchers duly executed and certified by the Illinois
24Department.
25    (c) The Fund shall consist of the following:
26        (1) All moneys collected or received by the Illinois

 

 

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1    Department from the hospital provider assessment imposed
2    by this Article.
3        (2) All federal matching funds received by the Illinois
4    Department as a result of expenditures made by the Illinois
5    Department that are attributable to moneys deposited in the
6    Fund.
7        (3) Any interest or penalty levied in conjunction with
8    the administration of this Article.
9        (4) Moneys transferred from another fund in the State
10    treasury.
11        (5) All other moneys received for the Fund from any
12    other source, including interest earned thereon.
13    (d) (Blank).
14(Source: P.A. 95-707, eff. 1-11-08; 95-859, eff. 8-19-08; 96-3,
15eff. 2-27-09; 96-45, eff. 7-15-09; 96-821, eff. 11-20-09;
1696-1530, eff. 2-16-11.)
 
17    (305 ILCS 5/5A-10)  (from Ch. 23, par. 5A-10)
18    Sec. 5A-10. Applicability.
19    (a) The assessment imposed by Section 5A-2 shall not take
20effect or shall cease to be imposed, and any moneys remaining
21in the Fund shall be refunded to hospital providers in
22proportion to the amounts paid by them, if:
23        (1) The sum of the appropriations for State fiscal
24    years 2004 and 2005 from the General Revenue Fund for
25    hospital payments under the medical assistance program is

 

 

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1    less than $4,500,000,000 or the appropriation for each of
2    State fiscal years 2006, 2007 and 2008 from the General
3    Revenue Fund for hospital payments under the medical
4    assistance program is less than $2,500,000,000 increased
5    annually to reflect any increase in the number of
6    recipients, or the annual appropriation for State fiscal
7    years 2009 through 2016 2014, from the General Revenue Fund
8    combined with the Hospital Provider Fund as authorized in
9    Section 5A-8 for hospital payments under the medical
10    assistance program, is less than the amount appropriated
11    for State fiscal year 2009, adjusted annually to reflect
12    any change in the number of recipients, excluding State
13    fiscal year 2009 supplemental appropriations made
14    necessary by the enactment of the American Recovery and
15    Reinvestment Act of 2009; or
16        (2) For State fiscal years prior to State fiscal year
17    2009, the Department of Healthcare and Family Services
18    (formerly Department of Public Aid) makes changes in its
19    rules that reduce the hospital inpatient or outpatient
20    payment rates, including adjustment payment rates, in
21    effect on October 1, 2004, except for hospitals described
22    in subsection (b) of Section 5A-3 and except for changes in
23    the methodology for calculating outlier payments to
24    hospitals for exceptionally costly stays, so long as those
25    changes do not reduce aggregate expenditures below the
26    amount expended in State fiscal year 2005 for such

 

 

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1    services; or
2        (2.1) For State fiscal years 2009 through 2016 2014,
3    the Department of Healthcare and Family Services adopts any
4    administrative rule change to reduce payment rates or
5    alters any payment methodology that reduces any payment
6    rates made to operating hospitals under the approved Title
7    XIX or Title XXI State plan in effect January 1, 2008
8    except for:
9            (A) any changes for hospitals described in
10        subsection (b) of Section 5A-3; or
11            (B) any rates for payments made under this Article
12        V-A; or
13            (C) any changes proposed in State plan amendment
14        transmittal numbers 08-01, 08-02, 08-04, 08-06, and
15        08-07; or
16            (D) in relation to any admissions on or after
17        January 1, 2011, a modification in the methodology for
18        calculating outlier payments to hospitals for
19        exceptionally costly stays, for hospitals reimbursed
20        under the diagnosis-related grouping methodology;
21        provided that the Department shall be limited to one
22        such modification during the 36-month period after the
23        effective date of this amendatory Act of the 96th
24        General Assembly; or
25        (3) The payments to hospitals required under Section
26    5A-12 or Section 5A-12.2 are changed or are not eligible

 

 

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1    for federal matching funds under Title XIX or XXI of the
2    Social Security Act.
3    (b) The assessment imposed by Section 5A-2 shall not take
4effect or shall cease to be imposed if the assessment is
5determined to be an impermissible tax under Title XIX of the
6Social Security Act. Moneys in the Hospital Provider Fund
7derived from assessments imposed prior thereto shall be
8disbursed in accordance with Section 5A-8 to the extent federal
9financial participation is not reduced due to the
10impermissibility of the assessments, and any remaining moneys
11shall be refunded to hospital providers in proportion to the
12amounts paid by them.
13(Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08; 96-8,
14eff. 4-28-09; 96-1530, eff. 2-16-11.)"; and
 
15on page 5, line 4, by replacing "2013" with "2016 2013".