Illinois General Assembly - Full Text of SB3171
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Full Text of SB3171  98th General Assembly

SB3171enr 98TH GENERAL ASSEMBLY

  
  
  

 


 
SB3171 EnrolledLRB098 18157 KTG 53286 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 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.
17        (2) Cease payment for bed reserves in nursing
18    facilities and specialized mental health rehabilitation
19    facilities; for purposes of therapeutic home visits for
20    individuals scoring as TBI on the MDS 3.0, beginning June
21    1, 2015, the Department shall approve payments for bed
22    reserves in nursing facilities and specialized mental
23    health rehabilitation facilities that have at least a 90%

 

 

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1    occupancy level and at least 80% of their residents are
2    Medicaid eligible. Payment shall be at a daily rate of 75%
3    of an individual's current Medicaid per diem and shall not
4    exceed 10 days in a calendar month.
5        (2.5) Cease payment for bed reserves for purposes of
6    inpatient hospitalizations to intermediate care facilities
7    for persons with development disabilities, except in the
8    instance of residents who are under 21 years of age.
9        (3) Cease payment of the $10 per day add-on payment to
10    nursing facilities for certain residents with
11    developmental disabilities.
12    (b) After the application of subsection (a),
13notwithstanding any other provision of this Code to the
14contrary and to the extent permitted by federal law, on and
15after July 1, 2012, the rates of reimbursement for services and
16other payments provided under this Code shall further be
17reduced as follows:
18        (1) Rates or payments for physician services, dental
19    services, or community health center services reimbursed
20    through an encounter rate, and services provided under the
21    Medicaid Rehabilitation Option of the Illinois Title XIX
22    State Plan shall not be further reduced.
23        (2) Rates or payments, or the portion thereof, paid to
24    a provider that is operated by a unit of local government
25    or State University that provides the non-federal share of
26    such services shall not be further reduced.

 

 

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1        (3) Rates or payments for hospital services delivered
2    by a hospital defined as a Safety-Net Hospital under
3    Section 5-5e.1 of this Code shall not be further reduced.
4        (4) Rates or payments for hospital services delivered
5    by a Critical Access Hospital, which is an Illinois
6    hospital designated as a critical care hospital by the
7    Department of Public Health in accordance with 42 CFR 485,
8    Subpart F, shall not be further reduced.
9        (5) Rates or payments for Nursing Facility Services
10    shall only be further adjusted pursuant to Section 5-5.2 of
11    this Code.
12        (6) Rates or payments for services delivered by long
13    term care facilities licensed under the ID/DD Community
14    Care Act and developmental training services shall not be
15    further reduced.
16        (7) Rates or payments for services provided under
17    capitation rates shall be adjusted taking into
18    consideration the rates reduction and covered services
19    required by this amendatory Act of the 97th General
20    Assembly.
21        (8) For hospitals not previously described in this
22    subsection, the rates or payments for hospital services
23    shall be further reduced by 3.5%, except for payments
24    authorized under Section 5A-12.4 of this Code.
25        (9) For all other rates or payments for services
26    delivered by providers not specifically referenced in

 

 

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1    paragraphs (1) through (8), rates or payments shall be
2    further reduced by 2.7%.
3    (c) Any assessment imposed by this Code shall continue and
4nothing in this Section shall be construed to cause it to
5cease.
6    (d) Notwithstanding any other provision of this Code to the
7contrary, subject to federal approval under Title XIX of the
8Social Security Act, for dates of service on and after July 1,
92014, rates or payments for services provided for the purpose
10of transitioning children from a hospital to home placement or
11other appropriate setting by a children's community-based
12health care center authorized under the Alternative Health Care
13Delivery Act shall be $683 per day.
14    (e) Notwithstanding any other provision of this Code to the
15contrary, subject to federal approval under Title XIX of the
16Social Security Act, for dates of service on and after July 1,
172014, rates or payments for home health visits shall be $72.
18    (f) Notwithstanding any other provision of this Code to the
19contrary, subject to federal approval under Title XIX of the
20Social Security Act, for dates of service on and after July 1,
212014, rates or payments for the certified nursing assistant
22component of the home health agency rate shall be $20.
23(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13;
2498-651, eff. 6-16-14.)
 
25    Section 99. Effective date. This Act takes effect June 1,
262015.