Rep. Greg Harris

Filed: 11/6/2014

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 3171

2    AMENDMENT NO. ______. Amend Senate Bill 3171 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5e as follows:
 
6    (305 ILCS 5/5-5e)
7    Sec. 5-5e. Adjusted rates of reimbursement.
8    (a) Rates or payments for services in effect on June 30,
92012 shall be adjusted and services shall be affected as
10required by any other provision of this amendatory Act of the
1197th General Assembly. In addition, the Department shall do the
12following:
13        (1) Delink the per diem rate paid for supportive living
14    facility services from the per diem rate paid for nursing
15    facility services, effective for services provided on or
16    after May 1, 2011.

 

 

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1        (2) Cease payment for bed reserves in nursing
2    facilities and specialized mental health rehabilitation
3    facilities; for purposes of therapeutic home visits for
4    individuals scoring as TBI on the MDS 3.0, beginning June
5    1, 2015, the Department shall approve payments for bed
6    reserves in nursing facilities and specialized mental
7    health rehabilitation facilities that have at least a 90%
8    occupancy level and at least 90% of their residents are
9    Medicaid eligible. Payment shall be at a daily rate of 75%
10    of an individual's current Medicaid per diem and shall not
11    exceed 10 days in a calendar month.
12        (2.5) Cease payment for bed reserves for purposes of
13    inpatient hospitalizations to intermediate care facilities
14    for persons with development disabilities, except in the
15    instance of residents who are under 21 years of age.
16        (3) Cease payment of the $10 per day add-on payment to
17    nursing facilities for certain residents with
18    developmental disabilities.
19    (b) After the application of subsection (a),
20notwithstanding any other provision of this Code to the
21contrary and to the extent permitted by federal law, on and
22after July 1, 2012, the rates of reimbursement for services and
23other payments provided under this Code shall further be
24reduced as follows:
25        (1) Rates or payments for physician services, dental
26    services, or community health center services reimbursed

 

 

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1    through an encounter rate, and services provided under the
2    Medicaid Rehabilitation Option of the Illinois Title XIX
3    State Plan shall not be further reduced.
4        (2) Rates or payments, or the portion thereof, paid to
5    a provider that is operated by a unit of local government
6    or State University that provides the non-federal share of
7    such services shall not be further reduced.
8        (3) Rates or payments for hospital services delivered
9    by a hospital defined as a Safety-Net Hospital under
10    Section 5-5e.1 of this Code shall not be further reduced.
11        (4) Rates or payments for hospital services delivered
12    by a Critical Access Hospital, which is an Illinois
13    hospital designated as a critical care hospital by the
14    Department of Public Health in accordance with 42 CFR 485,
15    Subpart F, shall not be further reduced.
16        (5) Rates or payments for Nursing Facility Services
17    shall only be further adjusted pursuant to Section 5-5.2 of
18    this Code.
19        (6) Rates or payments for services delivered by long
20    term care facilities licensed under the ID/DD Community
21    Care Act and developmental training services shall not be
22    further reduced.
23        (7) Rates or payments for services provided under
24    capitation rates shall be adjusted taking into
25    consideration the rates reduction and covered services
26    required by this amendatory Act of the 97th General

 

 

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1    Assembly.
2        (8) For hospitals not previously described in this
3    subsection, the rates or payments for hospital services
4    shall be further reduced by 3.5%, except for payments
5    authorized under Section 5A-12.4 of this Code.
6        (9) For all other rates or payments for services
7    delivered by providers not specifically referenced in
8    paragraphs (1) through (8), rates or payments shall be
9    further reduced by 2.7%.
10    (c) Any assessment imposed by this Code shall continue and
11nothing in this Section shall be construed to cause it to
12cease.
13    (d) Notwithstanding any other provision of this Code to the
14contrary, subject to federal approval under Title XIX of the
15Social Security Act, for dates of service on and after July 1,
162014, rates or payments for services provided for the purpose
17of transitioning children from a hospital to home placement or
18other appropriate setting by a children's community-based
19health care center authorized under the Alternative Health Care
20Delivery Act shall be $683 per day.
21    (e) Notwithstanding any other provision of this Code to the
22contrary, subject to federal approval under Title XIX of the
23Social Security Act, for dates of service on and after July 1,
242014, rates or payments for home health visits shall be $72.
25    (f) Notwithstanding any other provision of this Code to the
26contrary, subject to federal approval under Title XIX of the

 

 

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1Social Security Act, for dates of service on and after July 1,
22014, rates or payments for the certified nursing assistant
3component of the home health agency rate shall be $20.
4(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13;
598-651, eff. 6-16-14.)
 
6    Section 99. Effective date. This Act takes effect June 1,
72015.".