093_HB0701sam003











                                     LRB093 05499 DRJ 20296 a

 1                     AMENDMENT TO HOUSE BILL 701

 2        AMENDMENT NO.     .  Amend House Bill  701  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.   The State Finance Act is amended by adding
 5    Sections 5.620, 5.621, and 6z-56 and changing Section  8h  as
 6    follows:

 7        (30 ILCS 105/5.620 new)
 8        Sec. 5.620.  The Health Care Services Trust Fund.

 9        (30 ILCS 105/5.621 new)
10        Sec. 5.621.  The Health and Human Services Medicaid Trust
11    Fund.

12        (30 ILCS 105/6z-56 new)
13        Sec.  6z-56.  The  Health  Care  Services Trust Fund. The
14    Health Care Services  Trust  Fund  is  hereby  created  as  a
15    special fund in the State treasury.
16        The  Fund shall consist of moneys deposited, transferred,
17    or appropriated into the Fund from units of local  government
18    other than a county with a population greater than 3,000,000,
19    from  the  State,  from  federal  matching funds, or from any
20    other legal source.
 
                            -2-      LRB093 05499 DRJ 20296 a
 1        Subject to appropriation, the moneys in the Fund shall be
 2    used by the Department of Public  Aid  to  make  payments  to
 3    providers  of  services  covered  under the Medicaid or State
 4    Children's Health Insurance programs. Payments  may  be  made
 5    out  of  the  Fund  only  to  providers  located  within  the
 6    geographic  jurisdiction  of  units  of local government that
 7    make deposits, transfers, or appropriations into the Fund.
 8        The Department of Public Aid shall adopt rules concerning
 9    application for and disbursement of the moneys in the Fund.

10        (30 ILCS 105/8h)
11        Sec.   8h.   Transfers   to   General    Revenue    Fund.
12    Notwithstanding  any  other  State  law  to the contrary, the
13    Director of the Governor's Office of  Management  and  Budget
14    Bureau  of  the Budget may from time to time direct the State
15    Treasurer and Comptroller to transfer a  specified  sum  from
16    any  fund  held by the State Treasurer to the General Revenue
17    Fund in order to help defray the State's operating costs  for
18    the  fiscal year.  The total transfer under this Section from
19    any fund in any fiscal year shall not exceed the lesser of 8%
20    of the revenues to be deposited into  the  fund  during  that
21    year  or  25%  of  the  beginning  balance  in  the fund.  No
22    transfer may be made from a  fund  under  this  Section  that
23    would  have  the  effect of reducing the available balance in
24    the  fund  to  an  amount  less  than  the  amount  remaining
25    unexpended and unreserved from the total  appropriation  from
26    that  fund for that fiscal year.  This Section does not apply
27    to any funds that are restricted by federal law to a specific
28    use or to any funds  in  the  Motor  Fuel  Tax  Fund  or  the
29    Hospital  Provider Fund.  Notwithstanding any other provision
30    of this Section, the total transfer under this  Section  from
31    the  Road  Fund  or the State Construction Account Fund shall
32    not exceed 5% of the revenues to be deposited into  the  fund
33    during that year.
 
                            -3-      LRB093 05499 DRJ 20296 a
 1        In  determining  the  available  balance  in  a fund, the
 2    Director of the Governor's Office of  Management  and  Budget
 3    Bureau of the Budget may include receipts, transfers into the
 4    fund,  and other resources anticipated to be available in the
 5    fund in that fiscal year.
 6        The State Treasurer and Comptroller  shall  transfer  the
 7    amounts  designated  under  this  Section  as  soon as may be
 8    practicable after receiving the direction  to  transfer  from
 9    the  Director  of  the  Governor's  Office  of Management and
10    Budget Bureau of the Budget.
11    (Source: P.A. 93-32, eff. 6-20-03; revised 8-21-03.)

12        Section 10.  The Illinois Public Aid Code is  amended  by
13    changing  Sections 5-5.4, 5A-1, 5A-2, 5A-3, 5A-4, 5A-5, 5A-7,
14    5A-8, 5A-10, and 14-1 and by adding  Sections  5A-12,  5A-13,
15    and 5A-14 as follows:

16        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
17        Sec.  5-5.4.  Standards of Payment - Department of Public
18    Aid. The Department of Public Aid shall develop standards  of
19    payment  of skilled nursing and intermediate care services in
20    facilities providing such services under this Article which:
21        (1)  Provide  for  the  determination  of  a   facility's
22    payment for skilled nursing and intermediate care services on
23    a  prospective  basis. The amount of the payment rate for all
24    nursing facilities certified  by  the  Department  of  Public
25    Health  under  the Nursing Home Care Act as Intermediate Care
26    for the Developmentally Disabled facilities, Long  Term  Care
27    for  Under  Age 22 facilities, Skilled Nursing facilities, or
28    Intermediate Care facilities  under  the  medical  assistance
29    program  shall  be  prospectively established annually on the
30    basis  of  historical,  financial,   and   statistical   data
31    reflecting  actual  costs  from  prior  years, which shall be
32    applied to the current rate year and updated  for  inflation,
 
                            -4-      LRB093 05499 DRJ 20296 a
 1    except  that  the  capital cost element for newly constructed
 2    facilities  shall  be  based  upon  projected  budgets.   The
 3    annually established payment rate shall take effect on July 1
 4    in 1984 and subsequent years.  No rate increase and no update
 5    for inflation shall be provided on or after July 1, 1994  and
 6    before July 1, 2004, unless specifically provided for in this
 7    Section.
 8        For  facilities  licensed  by  the  Department  of Public
 9    Health under the Nursing Home Care Act as  Intermediate  Care
10    for the Developmentally Disabled facilities or Long Term Care
11    for  Under Age 22 facilities, the rates taking effect on July
12    1, 1998 shall include an  increase  of  3%.   For  facilities
13    licensed by the Department of Public Health under the Nursing
14    Home  Care  Act as Skilled Nursing facilities or Intermediate
15    Care facilities, the rates taking  effect  on  July  1,  1998
16    shall  include an increase of 3% plus $1.10 per resident-day,
17    as defined by the Department.
18        For facilities  licensed  by  the  Department  of  Public
19    Health  under  the Nursing Home Care Act as Intermediate Care
20    for the Developmentally Disabled facilities or Long Term Care
21    for Under Age 22 facilities, the rates taking effect on  July
22    1,  1999  shall  include  an  increase of 1.6% plus $3.00 per
23    resident-day, as defined by the Department.   For  facilities
24    licensed by the Department of Public Health under the Nursing
25    Home  Care  Act as Skilled Nursing facilities or Intermediate
26    Care facilities, the rates taking  effect  on  July  1,  1999
27    shall  include an increase of 1.6% and, for services provided
28    on or after October 1, 1999, shall be increased by $4.00  per
29    resident-day, as defined by the Department.
30        For  facilities  licensed  by  the  Department  of Public
31    Health under the Nursing Home Care Act as  Intermediate  Care
32    for the Developmentally Disabled facilities or Long Term Care
33    for  Under Age 22 facilities, the rates taking effect on July
34    1, 2000 shall include an increase of 2.5%  per  resident-day,
 
                            -5-      LRB093 05499 DRJ 20296 a
 1    as defined by the Department.  For facilities licensed by the
 2    Department  of  Public Health under the Nursing Home Care Act
 3    as  Skilled   Nursing   facilities   or   Intermediate   Care
 4    facilities,  the  rates  taking  effect on July 1, 2000 shall
 5    include an increase of 2.5% per resident-day, as  defined  by
 6    the Department.
 7        For  facilities  licensed  by  the  Department  of Public
 8    Health under the Nursing Home Care  Act  as  skilled  nursing
 9    facilities  or  intermediate  care  facilities, a new payment
10    methodology must be implemented for the nursing component  of
11    the rate effective July 1, 2003. The Department of Public Aid
12    shall  develop  the new payment methodology using the Minimum
13    Data Set (MDS)  as  the  instrument  to  collect  information
14    concerning  nursing  home  resident  condition  necessary  to
15    compute  the rate. The Department of Public Aid shall develop
16    the new payment methodology  to  meet  the  unique  needs  of
17    Illinois  nursing  home  residents while remaining subject to
18    the  appropriations  provided  by  the  General  Assembly.  A
19    transition period from the payment methodology in  effect  on
20    June 30, 2003 to the payment methodology in effect on July 1,
21    2003  shall  be  provided  for a period not exceeding 2 years
22    after  implementation  of  the  new  payment  methodology  as
23    follows:
24             (A)  For a  facility  that  would  receive  a  lower
25        nursing  component  rate  per  patient  day under the new
26        system than the facility received effective on  the  date
27        immediately   preceding  the  date  that  the  Department
28        implements  the  new  payment  methodology,  the  nursing
29        component rate per patient day for the facility shall  be
30        held  at  the  level  in  effect  on the date immediately
31        preceding the date that the Department implements the new
32        payment methodology until a higher nursing component rate
33        of reimbursement is achieved by that facility.
34             (B)  For a facility  that  would  receive  a  higher
 
                            -6-      LRB093 05499 DRJ 20296 a
 1        nursing  component rate per patient day under the payment
 2        methodology in effect on July 1, 2003 than  the  facility
 3        received  effective on the date immediately preceding the
 4        date that  the  Department  implements  the  new  payment
 5        methodology,  the  nursing component rate per patient day
 6        for the facility shall be adjusted.
 7             (C)  Notwithstanding paragraphs  (A)  and  (B),  the
 8        nursing  component  rate per patient day for the facility
 9        shall be adjusted subject to appropriations  provided  by
10        the General Assembly.
11        For  facilities  licensed  by  the  Department  of Public
12    Health under the Nursing Home Care Act as  Intermediate  Care
13    for the Developmentally Disabled facilities or Long Term Care
14    for Under Age 22 facilities, the rates taking effect on March
15    1,  2001  shall  include  a  statewide  increase of 7.85%, as
16    defined by the Department.
17        For facilities  licensed  by  the  Department  of  Public
18    Health  under  the Nursing Home Care Act as Intermediate Care
19    for the Developmentally Disabled facilities or Long Term Care
20    for Under Age 22 facilities, the rates taking effect on April
21    1, 2002 shall  include  a  statewide  increase  of  2.0%,  as
22    defined  by  the Department. This increase terminates on July
23    1, 2002; beginning July 1, 2002 these rates  are  reduced  to
24    the  level  of  the  rates  in  effect  on March 31, 2002, as
25    defined by the Department.
26        For facilities  licensed  by  the  Department  of  Public
27    Health  under  the  Nursing  Home Care Act as skilled nursing
28    facilities or intermediate care facilities, the rates  taking
29    effect  on  July  1,  2001  shall  be computed using the most
30    recent cost reports on file with the Department of Public Aid
31    no later than April 1, 2000, updated for inflation to January
32    1, 2001.  For rates effective July 1, 2001 only, rates  shall
33    be  the  greater of the rate computed for July 1, 2001 or the
34    rate effective on June 30, 2001.
 
                            -7-      LRB093 05499 DRJ 20296 a
 1        Notwithstanding any other provision of this Section,  for
 2    facilities  licensed by the Department of Public Health under
 3    the Nursing Home Care Act as skilled  nursing  facilities  or
 4    intermediate  care  facilities, the Illinois Department shall
 5    determine by rule the rates taking effect on  July  1,  2002,
 6    which shall be 5.9% less than the rates in effect on June 30,
 7    2002.
 8        Notwithstanding  any other provision of this Section, for
 9    facilities licensed by the Department of Public Health  under
10    the  Nursing  Home  Care Act as skilled nursing facilities or
11    intermediate care facilities, the Illinois  Department  shall
12    determine  by  rule  the rates taking effect on July 1, 2003,
13    which shall be 3.0% less than the rates in effect on June 30,
14    2002. This rate shall take  effect  only  upon  approval  and
15    implementation  of  the  payment methodologies required under
16    Section 5A-12.
17        Rates established effective  each  July  1  shall  govern
18    payment  for  services  rendered throughout that fiscal year,
19    except that rates  established  on  July  1,  1996  shall  be
20    increased  by  6.8% for services provided on or after January
21    1, 1997.  Such rates will be based upon the rates  calculated
22    for the year beginning July 1, 1990, and for subsequent years
23    thereafter until June 30, 2001 shall be based on the facility
24    cost reports for the facility fiscal year ending at any point
25    in  time  during  the  previous calendar year, updated to the
26    midpoint of the rate year.  The cost report shall be on  file
27    with the Department no later than April 1 of the current rate
28    year.   Should the cost report not be on file by April 1, the
29    Department shall base the rate  on  the  latest  cost  report
30    filed  by  each  skilled  care facility and intermediate care
31    facility, updated to the midpoint of the current  rate  year.
32    In  determining rates for services rendered on and after July
33    1, 1985, fixed time shall not be computed at less than  zero.
34    The  Department shall not make any alterations of regulations
 
                            -8-      LRB093 05499 DRJ 20296 a
 1    which would reduce any component of the Medicaid  rate  to  a
 2    level  below what that component would have been utilizing in
 3    the rate effective on July 1, 1984.
 4        (2)  Shall take into account the actual costs incurred by
 5    facilities in providing services for  recipients  of  skilled
 6    nursing  and  intermediate  care  services  under the medical
 7    assistance program.
 8        (3)  Shall   take   into   account   the   medical    and
 9    psycho-social characteristics and needs of the patients.
10        (4)  Shall take into account the actual costs incurred by
11    facilities  in  meeting licensing and certification standards
12    imposed and prescribed by the State of Illinois, any  of  its
13    political  subdivisions  or  municipalities  and  by the U.S.
14    Department of Health and Human Services pursuant to Title XIX
15    of the Social Security Act.
16        The  Department  of  Public  Aid  shall  develop  precise
17    standards for payments to reimburse  nursing  facilities  for
18    any  utilization  of appropriate rehabilitative personnel for
19    the provision of rehabilitative services which is  authorized
20    by  federal regulations, including reimbursement for services
21    provided by qualified therapists or qualified assistants, and
22    which is in accordance with accepted professional  practices.
23    Reimbursement  also  may  be  made  for  utilization of other
24    supportive personnel under appropriate supervision.
25    (Source: P.A.  92-10,  eff.  6-11-01;  92-31,  eff.  6-28-01;
26    92-597,  eff.  6-28-02;  92-651,  eff.  7-11-02; 92-848, eff.
27    1-1-03; 93-20, eff. 6-20-03.)

28        (305 ILCS 5/5A-1) (from Ch. 23, par. 5A-1)
29        Sec. 5A-1.  Definitions. As used in this Article,  unless
30    the context requires otherwise:
31        "Fund" means the Hospital Provider Fund.
32        "Hospital"  means  an  institution,  place,  building, or
33    agency located in this State that is subject to licensure  by
 
                            -9-      LRB093 05499 DRJ 20296 a
 1    the  Illinois  Department of Public Health under the Hospital
 2    Licensing  Act,  whether  public  or  private   and   whether
 3    organized for profit or not-for-profit.
 4        "Hospital  provider"  means  a  person  licensed  by  the
 5    Department  of Public Health to conduct, operate, or maintain
 6    a hospital, regardless of whether the person  is  a  Medicaid
 7    provider.  For purposes of this paragraph, "person" means any
 8    political  subdivision  of  the State, municipal corporation,
 9    individual, firm, partnership, corporation, company,  limited
10    liability  company,  association, joint stock association, or
11    trust, or a receiver, executor, trustee, guardian,  or  other
12    representative appointed by order of any court.
13        "Occupied  bed  days" means the sum of the number of days
14    that each bed was occupied by a patient for all  beds  during
15    calendar  year  2001.   Occupied  bed  days shall be computed
16    separately for each hospital  operated  or  maintained  by  a
17    hospital provider.
18        "Adjusted  gross  hospital  revenue"  shall be determined
19    separately  for  each  hospital   conducted,   operated,   or
20    maintained  by  a  hospital provider, and  means the hospital
21    provider's  total  gross  patient  revenues   less   Medicare
22    contractual  allowances,  but  does not include gross patient
23    revenue  (and  the  portion  of  any   Medicare   contractual
24    allowance  related  thereto)  from  skilled  or  intermediate
25    long-term  care services within the meaning of Title XVIII or
26    XIX of the Social Security Act.
27        "Intergovernmental transfer payment" means  the  payments
28    established  under  Section  15-3  of this Code, and includes
29    without limitation payments payable under  that  Section  for
30    July, August, and September of 1992.
31    (Source: P.A. 87-861; 88-88.)

32        (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
33        Sec. 5A-2.  Assessment; no local authorization to tax.
 
                            -10-     LRB093 05499 DRJ 20296 a
 1        (a)  Subject  to  Sections  5A-3  and  5A-10,  an  annual
 2    assessment  on inpatient services is imposed on each hospital
 3    provider for State fiscal years 2004 and 2005  in  an  amount
 4    equal  to  the  hospital's  occupied  bed  days multiplied by
 5    $84.19.
 6        The Department of Public Aid  shall  use  the  number  of
 7    occupied  bed days as reported by each hospital on the Annual
 8    Survey of Hospitals conducted by  the  Department  of  Public
 9    Health to calculate the hospital's annual assessment.  If the
10    sum  of a hospital's occupied bed days is not reported on the
11    Annual Survey of Hospitals, then the Department of Public Aid
12    may obtain the sum of  occupied  bed  days  from  any  source
13    available,  including, but not limited to, records maintained
14    by the hospital provider, which may be inspected at all times
15    during business hours of the day by the Department of  Public
16    Aid  or  its  duly  authorized  agents and employees. For the
17    privilege of engaging in the occupation of hospital provider,
18    an assessment is imposed upon each hospital provider for  the
19    State  fiscal  year  beginning  on July 1, 1993 and ending on
20    June 30, 1994, in an amount equal to 1.88% of the  provider's
21    adjusted  gross hospital revenue for the most recent calendar
22    year ending before the beginning of that State fiscal year.
23        Effective July 1, 1994 through June 30, 1996,  an  annual
24    assessment  is  imposed  upon  each  hospital  provider in an
25    amount  equal  to  the  provider's  adjusted  gross  hospital
26    revenue for the most recent calendar year ending  before  the
27    beginning  of  that  State  fiscal  year  multiplied  by  the
28    Provider's Savings Rate.
29        Effective  July  1,  1996  through  March  31,  1997,  an
30    assessment  is  imposed  upon  each  hospital  provider in an
31    amount equal to  three-fourths  of  the  provider's  adjusted
32    gross  hospital  revenue for calendar year 1995 multiplied by
33    the Provider's Savings Rate.  No assessment shall be  imposed
34    on or after April 1, 1997.
 
                            -11-     LRB093 05499 DRJ 20296 a
 1        Before July 1, 1995, the Provider's Savings Rate is 1.88%
 2    multiplied  by  a  fraction,  the  numerator  of which is the
 3    Maximum Section 5A-2 Contribution  minus  the  Cigarette  Tax
 4    Contribution,  and  the  denominator  of which is the Maximum
 5    Section 5A-2  Contribution.   Effective  July  1,  1995,  the
 6    Provider's  Savings  Rate  is 1.25% multiplied by a fraction,
 7    the  numerator  of  which  is  the   Maximum   Section   5A-2
 8    Contribution  minus  the  Cigarette Tax Contribution, and the
 9    denominator  of   which   is   the   Maximum   Section   5A-2
10    Contribution.
11        The  Cigarette  Tax  Contribution is the sum of the total
12    amount  deposited  in  the  Hospital  Provider  Fund  in  the
13    previous State fiscal year pursuant to Section  2(a)  of  the
14    Cigarette  Tax  Act,  plus  the total amount deposited in the
15    Hospital Provider Fund in  the  previous  State  fiscal  year
16    pursuant to Section 5A-3(c) of this Code.
17        The Maximum Section 5A-2 Contribution is the total amount
18    of  tax  imposed by this Section in the previous State fiscal
19    year on providers  subject  to  this  Act,  multiplied  by  a
20    fraction  the  numerator  of which is adjusted gross hospital
21    revenues reported to the Department by providers  subject  to
22    this   Act  for  the  previous  State  fiscal  year  and  the
23    denominator of which  is  adjusted  gross  hospital  revenues
24    reported  to  the Department by providers subject to this Act
25    for the State fiscal year immediately preceding the  previous
26    State fiscal year.
27        The  Department  shall  notify  hospital providers of the
28    Provider's  Savings  Rate  by  mailing  a  notice   to   each
29    provider's  last known address as reflected by the records of
30    the Illinois Department.
31        (b)  Nothing in this amendatory Act of the  93rd  General
32    Assembly  1995  shall be construed to authorize any home rule
33    unit or other unit of local government to license for revenue
34    or to impose a tax or assessment upon hospital  providers  or
 
                            -12-     LRB093 05499 DRJ 20296 a
 1    the  occupation  of hospital provider, or a tax or assessment
 2    measured by the income or earnings of a hospital provider.
 3        (c)  As  provided  in  Section  5A-14,  this  Section  is
 4    repealed on July 1, 2005.
 5    (Source:  P.A.  88-88;  89-21,  eff.  7-1-95;  89-499,   eff.
 6    6-28-96.)

 7        (305 ILCS 5/5A-3) (from Ch. 23, par. 5A-3)
 8        Sec. 5A-3.  Exemptions; intergovernmental transfers.
 9        (a)  Blank). A hospital provider which is a county with a
10    population    of    more    than    3,000,000    that   makes
11    intergovernmental transfer payments as  provided  in  Section
12    15-3 of this Code shall be exempt from the assessment imposed
13    by  Section  5A-2,  unless  the  exemption  is adjudged to be
14    unconstitutional or otherwise  invalid,  in  which  case  the
15    county  shall  pay the assessment imposed by Section 5A-2 for
16    all assessment periods beginning on or after  July  1,  1992,
17    and  the  assessment  so paid shall be creditable against the
18    intergovernmental transfer payments.
19        (b)  A hospital provider that is a State agency, a  State
20    university,  or  a  county  with a population of 3,000,000 or
21    more is exempt from the assessment imposed by Section 5A-2. A
22    hospital organized under the University of Illinois  Hospital
23    Act and exempt from the assessment imposed by Section 5A-2 is
24    hereby authorized to enter into an interagency agreement with
25    the  Illinois  Department  to make intergovernmental transfer
26    payments to the Illinois Department.  These payments shall be
27    deposited into the University of Illinois  Hospital  Services
28    Fund  or,  if  that  Fund  ceases  to exist, into the General
29    Revenue Fund.
30        (b-2)  A hospital  provider  that  is  a  county  with  a
31    population   of   less   than   3,000,000   or   a  township,
32    municipality,  hospital  district,   or   any   other   local
33    governmental  unit  is  exempt from the assessment imposed by
 
                            -13-     LRB093 05499 DRJ 20296 a
 1    Section 5A-2.
 2        (b-5)  (Blank). A hospital operated by the Department  of
 3    Human  Services in the course of performing its mental health
 4    and developmental disabilities functions is exempt  from  the
 5    assessment imposed by Section 5A-2.
 6        (b-10)  A  hospital  provider  whose  hospital  does  not
 7    charge for its services is exempt from the assessment imposed
 8    by  Section  5A-2,  unless  the  exemption  is adjudged to be
 9    unconstitutional or otherwise  invalid,  in  which  case  the
10    hospital provider shall pay the assessment imposed by Section
11    5A-2.
12        (b-15)  A hospital provider whose hospital is licensed by
13    the  Department of Public Health as a psychiatric hospital is
14    exempt from the assessment imposed by  Section  5A-2,  unless
15    the exemption is adjudged to be unconstitutional or otherwise
16    invalid,  in  which  case the hospital provider shall pay the
17    assessment imposed by Section 5A-2.
18        (b-20)  A hospital provider whose hospital is licensed by
19    the Department of Public Health as a rehabilitation  hospital
20    is exempt from the assessment imposed by Section 5A-2, unless
21    the exemption is adjudged to be unconstitutional or otherwise
22    invalid,  in  which  case the hospital provider shall pay the
23    assessment imposed by Section 5A-2.
24        (b-25)  A hospital provider whose hospital (i) is  not  a
25    psychiatric  hospital, rehabilitation hospital, or children's
26    hospital and (ii) has an average  length  of  inpatient  stay
27    greater than 25 days is exempt from the assessment imposed by
28    Section   5A-2,  unless  the  exemption  is  adjudged  to  be
29    unconstitutional or otherwise  invalid,  in  which  case  the
30    hospital provider shall pay the assessment imposed by Section
31    5A-2.
32        (c)  (Blank).   The   Illinois   Department   is   hereby
33    authorized  to  enter  into agreements with publicly owned or
34    operated  hospitals  to   make   intergovernmental   transfer
 
                            -14-     LRB093 05499 DRJ 20296 a
 1    payments to the Illinois Department.  These payments shall be
 2    deposited  into  the  Hospital Provider Fund, except that any
 3    payments arising under an agreement with a hospital organized
 4    under the  University  of  Illinois  Hospital  Act  shall  be
 5    deposited  into  the University of Illinois Hospital Services
 6    Fund, if that Fund exists.
 7    (Source:  P.A.  88-88;  88-554,  eff.  7-26-94;  89-21,  eff.
 8    7-1-95; 89-507, eff. 7-1-97.)

 9        (305 ILCS 5/5A-4) (from Ch. 23, par. 5A-4)
10        Sec. 5A-4.  Payment of assessment; penalty.
11        (a)  The annual assessment imposed by  Section  5A-2  for
12    State fiscal year 2004 shall be due and payable on June 18 of
13    the  year. The assessment imposed by Section 5A-2 for a State
14    fiscal year 2005  shall  be  due  and  payable  in  quarterly
15    installments, each equalling one-fourth of the assessment for
16    the  year,  on  July 19, October 19, January 18, and April 19
17    September 30, December 31, March 31, and May 31 of the  year;
18    except  that  for  the  period July 1, 1996 through March 31,
19    1997, the assessment imposed by Section 5A-2 for that  period
20    shall be due and payable in 3 equal installments on September
21    30,  December 31, and March 31 of that period. No installment
22    payment of an assessment imposed by Section 5A-2 shall be due
23    and payable, however, until after: (i) the hospital  provider
24    receives  written  notice  from  the Department of Public Aid
25    that the payment methodologies to  hospitals  required  under
26    Section  5A-12 have been approved by the Centers for Medicare
27    and Medicaid Services of the U.S. Department  of  Health  and
28    Human  Services  and  the  waiver under 42 CFR 433.68 for the
29    assessment imposed by Section 5A-2 has been  granted  by  the
30    Centers  for  Medicare  and  Medicaid  Services  of  the U.S.
31    Department  of  Health  and  Human  Services;  and  (ii)  the
32    hospital has received the  payments  required  under  Section
33    5A-12.
 
                            -15-     LRB093 05499 DRJ 20296 a
 1        (b)  The  Illinois  Department is authorized to establish
 2    delayed payment schedules for  hospital  providers  that  are
 3    unable  to  make  installment  payments  when  due under this
 4    Section due to financial difficulties, as determined  by  the
 5    Illinois Department.
 6        (c)  If  a hospital provider fails to pay the full amount
 7    of an installment when due (including any extensions  granted
 8    under  subsection  (b)),  there  shall,  unless waived by the
 9    Illinois Department for reasonable cause,  be  added  to  the
10    assessment imposed by Section 5A-2 a penalty assessment equal
11    to  the lesser of (i) 5% of the amount of the installment not
12    paid on or before the due date plus 5% of the portion thereof
13    remaining unpaid on the last day of each 30-day period  month
14    thereafter or (ii) 100% of the installment amount not paid on
15    or  before  the  due  date.  For purposes of this subsection,
16    payments will be credited first to unpaid installment amounts
17    (rather than to penalty or interest), beginning with the most
18    delinquent installments.
19    (Source: P.A. 88-88; 89-499, eff. 6-28-96.)

20        (305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)
21        Sec. 5A-5.  Notice  Reporting;  penalty;  maintenance  of
22    records.
23        (a)  After  December 31 of each year (except as otherwise
24    provided in this subsection), and on or before  March  31  of
25    the  succeeding year, the Department of Public Aid shall send
26    a notice of assessment to every hospital provider subject  to
27    assessment  under  this  Article shall file a return with the
28    Illinois Department.  The notice of assessment  shall  notify
29    the  hospital  of  its return shall report the adjusted gross
30    hospital revenue from the calendar year just ended and  shall
31    be  utilized  by  the  Illinois  Department  to calculate the
32    assessment for the State fiscal year commencing on  the  next
33    July  1,  except  that the notice return for the State fiscal
 
                            -16-     LRB093 05499 DRJ 20296 a
 1    year commencing July 1, 2003 1992 and the report  of  revenue
 2    for  calendar year 1991 shall be sent filed on or before June
 3    1, 2004 September 30, 1992.  The notice return shall be on  a
 4    form  prepared by the Illinois Department and shall state the
 5    following:
 6             (1)  The name of the hospital provider.
 7             (2)  The  address   of   the   hospital   provider's
 8        principal  place  of  business  from  which  the provider
 9        engages in the occupation of hospital  provider  in  this
10        State,   and  the  name  and  address  of  each  hospital
11        operated, conducted, or maintained  by  the  provider  in
12        this State.
13             (3)  The  occupied  bed days adjusted gross hospital
14        revenue of the hospital provider for  the  calendar  year
15        just  ended,  the  amount  of  assessment  imposed  under
16        Section  5A-2  for  the  State  fiscal year for which the
17        notice return is sent  filed,  and  the  amount  of  each
18        quarterly  installment to be paid during the State fiscal
19        year.
20             (4)  (Blank). The amount of penalty due, if any.
21             (5)  Other reasonable information as  determined  by
22        the Illinois Department requires.
23        (b)  If   a  hospital  provider  conducts,  operates,  or
24    maintains more than one hospital  licensed  by  the  Illinois
25    Department  of Public Health, the provider shall may not file
26    a single return covering all those hospitals, but shall  file
27    a separate return for each hospital and shall compute and pay
28    the assessment for each hospital separately.
29        (c)  Notwithstanding any other provision in this Article,
30    in  the  case  of a person who ceases to conduct, operate, or
31    maintain a hospital in respect of which the person is subject
32    to assessment under this Article as a hospital provider,  the
33    assessment  for  the State fiscal year in which the cessation
34    occurs  shall  be  adjusted  by  multiplying  the  assessment
 
                            -17-     LRB093 05499 DRJ 20296 a
 1    computed under Section 5A-2 by a fraction, the  numerator  of
 2    which  is  the number of days months in the year during which
 3    the provider conducts, operates, or  maintains  the  hospital
 4    and  the  denominator  of  which is 365 12.  Immediately upon
 5    ceasing to conduct, operate,  or  maintain  a  hospital,  the
 6    person  shall  pay  file  a  final,  amended  return with the
 7    Illinois Department not more than 90 days after the cessation
 8    reflecting the adjustment and shall pay with the final return
 9    the assessment for the year as so adjusted (to the extent not
10    previously paid).
11        (d)  Notwithstanding any other provision in this Article,
12    a  provider   who   commences   conducting,   operating,   or
13    maintaining   a   hospital,   upon  notice  by  the  Illinois
14    Department, shall file an initial return for the State fiscal
15    year  in  which  the  commencement  occurs  within  90   days
16    thereafter  and  shall  pay  the  assessment  computed  under
17    Section  5A-2 and subsection (e) in equal installments on the
18    due dates stated in the notice date of the return and on  the
19    regular  installment  due  dates  for  the  State fiscal year
20    occurring after the due dates  date  of  the  initial  notice
21    return.
22        (e)  Notwithstanding any other provision in this Article,
23    in  the  case  of  a  hospital provider that did not conduct,
24    operate, or maintain a hospital throughout the calendar  year
25    2001  preceding  a State fiscal year, the assessment for that
26    State  fiscal  year  shall  be  computed  on  the  basis   of
27    hypothetical   occupied  bed  days  adjusted  gross  hospital
28    revenue for the full calendar year  as  determined  by  rules
29    adopted  by  the  Illinois  Department (which may be based on
30    annualization of the provider's actual revenues for a portion
31    of the calendar year, or revenues of  a  comparable  hospital
32    for the year, including revenues realized by a prior provider
33    from the same hospital during the year).
34        (f)  (Blank). In the case of a hospital provider existing
 
                            -18-     LRB093 05499 DRJ 20296 a
 1    as  a  corporation  or legal entity other than an individual,
 2    the return filed by it shall  be  signed  by  its  president,
 3    vice-president,  secretary,  or  treasurer or by its properly
 4    authorized agent.
 5        (g)  (Blank). If a hospital provider fails  to  file  its
 6    return  for  a State fiscal year on or before the due date of
 7    the return,  there  shall,  unless  waived  by  the  Illinois
 8    Department  for  reasonable cause, be added to the assessment
 9    imposed by Section 5A-2 for the State fiscal year  a  penalty
10    assessment  equal  to  25%  of the assessment imposed for the
11    year.
12        (h)  (Blank).  Every   hospital   provider   subject   to
13    assessment  under  this Article shall keep sufficient records
14    to  permit  the  determination  of  adjusted  gross  hospital
15    revenue on a calendar year basis.  All such records shall  be
16    kept  in  the English language and shall, at all times during
17    business hours of the day, be subject to  inspection  by  the
18    Illinois   Department  or  its  duly  authorized  agents  and
19    employees.
20    (Source: P.A. 87-861.)

21        (305 ILCS 5/5A-7) (from Ch. 23, par. 5A-7)
22        Sec. 5A-7. Administration; enforcement provisions.
23        (a)  To the extent practicable, the  Illinois  Department
24    shall  administer  and  enforce  this Article and collect the
25    assessments, interest, and penalty assessments imposed  under
26    this  Article using procedures employed in its administration
27    of this Code generally and, as it  deems  appropriate,  in  a
28    manner  similar  to  that  in which the Department of Revenue
29    administers and collects the retailers' occupation tax  under
30    the  Retailers'  Occupation  Tax  Act  ("ROTA").   Instead of
31    certificates of registration, the Illinois  Department  shall
32    establish  and  maintain  a listing of all hospital providers
33    appearing in the  licensing  records  of  the  Department  of
 
                            -19-     LRB093 05499 DRJ 20296 a
 1    Public   Health,  which  shall  show  each  provider's  name,
 2    principal place of business, and the name and address of each
 3    hospital operated, conducted, or maintained by  the  provider
 4    in   this   State.   In  addition,  the  following  specified
 5    provisions  of  the  Retailers'  Occupation   Tax   Act   are
 6    incorporated  by  reference into this Section except that the
 7    Illinois  Department  and  its  Director  (rather  than   the
 8    Department  of  Revenue  and its Director) and every hospital
 9    provider subject to assessment measured by occupied bed  days
10    adjusted  gross  hospital  revenue  and  to the return filing
11    requirements of this Article (rather than persons subject  to
12    retailers' occupation tax measured by gross receipts from the
13    sale  of  tangible  personal  property  at  retail and to the
14    return filing requirements of ROTA) shall  have  the  powers,
15    duties,  and  rights  specified  in these ROTA provisions, as
16    modified in this Section or by the Illinois Department  in  a
17    manner  consistent with this Article and except as manifestly
18    inconsistent with the other provisions of this Article:
19             (1)  ROTA, Section 4 (examination of return;  notice
20        of   correction;   evidence;   limitations;  protest  and
21        hearing), except that (i) the Illinois  Department  shall
22        issue   notices  of  assessment  liability  (rather  than
23        notices of tax liability as provided in ROTA, Section 4);
24        (ii) in the case of a fraudulent return or in the case of
25        an extended period agreed to by the  Illinois  Department
26        and  the  hospital  provider before the expiration of the
27        limitation period,  no  notice  of  assessment  liability
28        shall  be issued more than 3 years after the later of the
29        due date of the return required by Section  5A-5  or  the
30        date  the return (or an amended return) was filed (rather
31        within the period stated in ROTA, Section 4);  and  (iii)
32        the  penalty  provisions  of  ROTA,  Section  4 shall not
33        apply.
34             (2)  ROTA, Sec. 5 (failure to make  return;  failure
 
                            -20-     LRB093 05499 DRJ 20296 a
 1        to  pay assessment), except that the penalty and interest
 2        provisions of ROTA, Section 5 shall not apply.
 3             (3)  ROTA,    Section    5a    (lien;    attachment;
 4        termination; notice; protest; review;  release  of  lien;
 5        status of lien).
 6             (4)  ROTA,  Section  5b  (State  lien notices; State
 7        lien index; duties of recorder and registrar of titles).
 8             (5)  ROTA,  Section  5c   (liens;   certificate   of
 9        release).
10             (6)  ROTA,  Section  5d  (Department not required to
11        furnish bond; claim to property attached or levied upon).
12             (7)  ROTA,  Section  5e   (foreclosure   on   liens;
13        enforcement).
14             (8)  ROTA,  Section 5f (demand for payment; levy and
15        sale of property; limitation).
16             (9)  ROTA,   Section   5g   (sale    of    property;
17        redemption).
18             (10)  ROTA,  Section  5j (sales on transfers outside
19        usual course of business; report; payment of  assessment;
20        rights  and  duties  of  purchaser; penalty), except that
21        notice shall be provided to the  Illinois  Department  as
22        specified by rule.
23             (11)  ROTA, Section 6 (erroneous payments; credit or
24        refund),  provided  that  (i) the Illinois Department may
25        only apply an  amount  otherwise  subject  to  credit  or
26        refund  to  a  liability arising under this Article; (ii)
27        except in the case of an extended period agreed to by the
28        Illinois Department and the hospital provider before  the
29        expiration  of this limitation period, a claim for credit
30        or refund must be filed no more than 3  years  after  the
31        due  date  of the return required by Section 5A-5 (rather
32        than the time limitation stated in ROTA, Section 6);  and
33        (iii) credits or refunds shall not bear interest.
34             (12)  ROTA,   Section   6a  (claims  for  credit  or
 
                            -21-     LRB093 05499 DRJ 20296 a
 1        refund).
 2             (13)  ROTA, Section 6b (tentative  determination  of
 3        claim; notice; hearing; review), provided that a hospital
 4        provider or its representative shall have 60 days (rather
 5        than 20 days)  within which to file a protest and request
 6        for  hearing  in response to a tentative determination of
 7        claim.
 8             (14)  ROTA,  Section  6c  (finality   of   tentative
 9        determinations).
10             (15)  ROTA,    Section    8    (investigations   and
11        hearings).
12             (16)  ROTA, Section 9 (witness; immunity).
13             (17)  ROTA,  Section  10  (issuance  of   subpoenas;
14        attendance   of   witnesses;   production  of  books  and
15        records).
16             (18)  ROTA, Section  11  (information  confidential;
17        exceptions).
18             (19)  ROTA,   Section  12  (rules  and  regulations;
19        hearing; appeals), except that a hospital provider  shall
20        not be required to file a bond or be subject to a lien in
21        lieu  thereof  in  order  to  seek court review under the
22        Administrative  Review  Law  of  a  final  assessment  or
23        revised final assessment or the equivalent thereof issued
24        by the Illinois Department under this Article.
25        (b)  In addition to any other  remedy  provided  for  and
26    without   sending  a  notice  of  assessment  liability,  the
27    Illinois Department  may  collect  an  unpaid  assessment  by
28    withholding,  as payment of the assessment, reimbursements or
29    other amounts otherwise payable by the Illinois Department to
30    the provider.
31    (Source: P.A. 87-861.)

32        (305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
33        Sec. 5A-8.  Hospital Provider Fund.
 
                            -22-     LRB093 05499 DRJ 20296 a
 1        (a)  There is created in the State Treasury the  Hospital
 2    Provider  Fund. Interest earned by the Fund shall be credited
 3    to the Fund.  The Fund shall  not  be  used  to  replace  any
 4    moneys  appropriated  to  the Medicaid program by the General
 5    Assembly.
 6        (b)  The Fund is created for  the  purpose  of  receiving
 7    moneys  in accordance with Section 5A-6 and disbursing moneys
 8    only for the following purposes,  notwithstanding  any  other
 9    provision of law as follows:
10             (1)  For  making  payments  to hospitals as required
11        under Articles V, VI, and XIV  hospital  inpatient  care,
12        hospital  ambulatory  care,  and  disproportionate  share
13        hospital  distributive  expenditures made under Title XIX
14        of the Social Security Act and Article V of this Code and
15        under the Children's Health Insurance Program Act.
16             (2)  For the reimbursement of  moneys  collected  by
17        the   Illinois  Department  from  hospitals  or  hospital
18        providers through error  or  mistake  in  performing  the
19        activities authorized under this Article and Article V of
20        this  Code and for making required payments under Section
21        14-9 of this Code if there are no  moneys  available  for
22        those payments in the Hospital Services Trust Fund.
23             (3)  For payment of administrative expenses incurred
24        by the Illinois Department or its agent in performing the
25        activities authorized by this Article.
26             (4)  For   payments   of   any   amounts  which  are
27        reimbursable to the federal government for payments  from
28        this Fund which are required to be paid by State warrant.
29             (5)  For  making transfers to the General Obligation
30        Bond Retirement and Interest Fund, as those transfers are
31        authorized in the proceedings authorizing debt under  the
32        Short  Term  Borrowing Act, but transfers made under this
33        paragraph (5)  shall not exceed the principal  amount  of
34        debt  issued  in anticipation of the receipt by the State
 
                            -23-     LRB093 05499 DRJ 20296 a
 1        of moneys to be deposited into the Fund.
 2             (6)  For making transfers to any other fund  in  the
 3        State  treasury,  but transfers made under this paragraph
 4        (6) shall not exceed the  amount  transferred  previously
 5        from that other fund into the Hospital Provider Fund.
 6             (7)  For  making  transfers  to the Health and Human
 7        Services Medicaid Trust Fund, including 20% of the moneys
 8        received from hospital providers under Section  5A-4  and
 9        transferred into the Hospital Provider Fund under Section
10        5A-6. Transfers under this paragraph shall be made within
11        7  days after the payments have been received pursuant to
12        the schedule of payments provided in  subsection  (a)  of
13        Section 5A-4.
14             (8)  For   making   refunds  to  hospital  providers
15        pursuant to Section 5A-10.
16        Disbursements  from  the  Fund,  other   than   transfers
17    authorized under paragraphs (5) and (6) of this subsection to
18    the  General  Obligation  Bond  Retirement and Interest Fund,
19    shall be by warrants drawn  by  the  State  Comptroller  upon
20    receipt  of  vouchers  duly  executed  and  certified  by the
21    Illinois Department.
22        (c)  The Fund shall consist of the following:
23             (1)  All  moneys  collected  or  received   by   the
24        Illinois Department from the hospital provider assessment
25        imposed by this Article.
26             (2)  All  federal  matching  funds  received  by the
27        Illinois Department as a result of expenditures  made  by
28        the  Illinois  Department that are attributable to moneys
29        deposited in the Fund.
30             (3)  Any interest or penalty levied  in  conjunction
31        with the administration of this Article.
32             (4)  Moneys  transferred  from  another  fund in the
33        State treasury. Any  balance  in  the  Hospital  Services
34        Trust  Fund  in the State Treasury.  The balance shall be
 
                            -24-     LRB093 05499 DRJ 20296 a
 1        transferred  to  the  Fund  upon  certification  by   the
 2        Illinois  Department to the State Comptroller that all of
 3        the disbursements required by  Section  14-2(b)  of  this
 4        Code have been made.
 5             (5)  All other moneys received for the Fund from any
 6        other source, including interest earned thereon.
 7        (d)  (Blank). The Fund shall cease to exist on October 1,
 8    1999.   Any  balance  in  the  Fund  as of that date shall be
 9    transferred to the General Revenue  Fund.   Any  moneys  that
10    otherwise  would  be paid into the Fund on or after that date
11    shall be  deposited  into  the  General  Revenue  Fund.   Any
12    disbursements  on  or after that date that otherwise would be
13    made from  the  Fund  may  be  appropriated  by  the  General
14    Assembly from the General Revenue Fund.
15    (Source: P.A. 89-626, eff. 8-9-96; 90-587, eff. 7-1-98.)

16        (305 ILCS 5/5A-10) (from Ch. 23, par. 5A-10)
17        Sec. 5A-10. Applicability.
18        (a)  The  assessment  imposed  by  Section 5A-2 shall not
19    take effect or shall cease to  be  imposed,  and  any  moneys
20    remaining in the Fund shall be refunded to hospital providers
21    in proportion to the amounts paid by them, if:
22             (1)  the  sum of the appropriations for State fiscal
23        years 2004 and 2005 from the  General  Revenue  Fund  for
24        hospital payments under the medical assistance program is
25        less than $4,500,000,000; or
26             (2)  the  Department  of Public Aid makes changes in
27        its  rules  that  reduce  the   hospital   inpatient   or
28        outpatient  payment  rates,  including adjustment payment
29        rates, in effect on October 1, 2003, except for hospitals
30        described in subsection (b) of Section  5A-3  and  except
31        for  changes  in  outpatient payment rates made to comply
32        with  the  federal  Health  Insurance   Portability   and
33        Accountability  Act,  so  long  as  those  changes do not
 
                            -25-     LRB093 05499 DRJ 20296 a
 1        reduce aggregate expenditures below the  amount  expended
 2        in State fiscal year 2003 for such services; or
 3             (3)  the   payments   to  hospitals  required  under
 4        Section 5A-12 are changed or are not eligible for federal
 5        matching funds under Title  XIX  or  XXI  of  the  Social
 6        Security Act.
 7        (b)  The  assessment  imposed  by  Section 5A-2 shall not
 8    take effect or shall cease to be imposed if the assessment is
 9    determined to be an  impermissible  tax  amount  of  matching
10    federal  funds  under Title XIX of the Social Security Act is
11    eliminated  or  significantly  reduced  on  account  of   the
12    assessment.   Moneys  in  the  Hospital Provider Fund derived
13    from assessments imposed prior thereto shall be disbursed  in
14    accordance  with  Section 5A-8 to the extent federal matching
15    is  not  reduced  due  to  the  impermissibility  of  by  the
16    assessments, and any remaining moneys  assessments  shall  be
17    refunded  to  hospital providers in proportion to the amounts
18    paid by them.
19    (Source: P.A. 87-861.)

20        (305 ILCS 5/5A-12 new)
21        Sec. 5A-12.  Hospital access improvement payments.
22        (a)  To improve access to hospital services, for hospital
23    services rendered on or after June 1, 2004, the Department of
24    Public Aid shall make payments to hospitals as set  forth  in
25    this  Section,  except  for hospitals described in subsection
26    (b) of Section 5A-3.  These  payments  shall  be  paid  on  a
27    quarterly  basis.  For State fiscal year 2004, the Department
28    shall pay the total  amounts  required  under  this  Section;
29    these amounts shall be paid on or before June 15 of the year.
30    In  subsequent State fiscal years, the total amounts required
31    under this Section shall be paid in 4 equal  installments  on
32    or  before  July  15, October 15, January 14, and April 15 of
33    the year.  Payments  under  this  Section  are  not  due  and
 
                            -26-     LRB093 05499 DRJ 20296 a
 1    payable,  however,  until  (i) the methodologies described in
 2    this Section are approved by the  federal  government  in  an
 3    appropriate State Plan amendment, (ii) the assessment imposed
 4    under  this  Article  is  determined  to be a permissible tax
 5    under Title XIX of the Social Security  Act,  and  (iii)  the
 6    assessment is in effect.
 7        (b)  High  volume  payment. In addition to rates paid for
 8    inpatient hospital services, the  Department  of  Public  Aid
 9    shall  pay, to each Illinois hospital that provided more than
10    20,000 Medicaid inpatient days of care  during  State  fiscal
11    year  2001  (except for hospitals that qualify for adjustment
12    payments  under  Section  5-5.02  for  the  12-month   period
13    beginning  on  October  1,  2002),  $190  for  each  Medicaid
14    inpatient  day  of  care  provided during that fiscal year. A
15    hospital that provided less than  30,000  Medicaid  inpatient
16    days  of care during that period, however, is not entitled to
17    receive more than $3,500,000 per year in such payments.
18        (c)  Medicaid inpatient utilization rate  adjustment.  In
19    addition  to  rates paid for inpatient hospital services, the
20    Department of Public Aid shall  pay  each  Illinois  hospital
21    (except  for  hospitals  described in Section 5A-3), for each
22    Medicaid inpatient day of care provided during  State  fiscal
23    year   2001,  an  amount  equal  to  the  product  of  $57.25
24    multiplied by the quotient of 1 divided  by  the  greater  of
25    1.6%  or  the  hospital's Medicaid inpatient utilization rate
26    (as used to determine  eligibility  for  adjustment  payments
27    under  Section  5-5.02  for  the 12-month period beginning on
28    October 1, 2002). The total payments under this subsection to
29    a hospital may not exceed $10,500,000 annually.
30        (d)  Psychiatric base rate adjustment.
31             (1)  In  addition  to  rates  paid   for   inpatient
32        psychiatric  services, the Department of Public Aid shall
33        pay each Illinois general  acute  care  hospital  with  a
34        distinct   part-psychiatric   unit,   for  each  Medicaid
 
                            -27-     LRB093 05499 DRJ 20296 a
 1        inpatient psychiatric  day  of  care  provided  in  State
 2        fiscal  year  2001,  an  amount  equal  to  $400 less the
 3        hospital's   per-diem   rate   for   Medicaid   inpatient
 4        psychiatric services as in effect on October 1, 2003.  In
 5        no event, however, shall that amount be less than zero.
 6             (2)  For distinct part-psychiatric units of Illinois
 7        general  acute  care  hospitals, except for all hospitals
 8        excluded in Section 5A-3, whose inpatient  per-diem  rate
 9        as in effect on October 1, 2003 is greater than $400, the
10        Department  shall  pay,  in addition to any other amounts
11        authorized  under  this  Code,  $25  for  each   Medicaid
12        inpatient  psychiatric  day  of  care  provided  in State
13        fiscal year 2001.
14        (e)  Supplemental tertiary care adjustment.  In  addition
15    to  rates  paid  for  inpatient  services,  the Department of
16    Public Aid shall pay to each Illinois hospital  eligible  for
17    tertiary  care  adjustment  payments  under 89 Ill. Adm. Code
18    148.296,  as  in  effect  for  State  fiscal  year  2003,   a
19    supplemental  tertiary  care  adjustment payment equal to the
20    tertiary care adjustment payment required under 89 Ill.  Adm.
21    Code 148.296, as in effect for State fiscal year 2003.
22        (f)  Medicaid  outpatient utilization rate adjustment. In
23    addition to rates paid for outpatient hospital services,  the
24    Department  of  Public  Aid  shall pay each Illinois hospital
25    (except for hospitals described in Section 5A-3),  an  amount
26    equal  to  the  product of 2.45% multiplied by the hospital's
27    Medicaid outpatient charges multiplied by the quotient  of  1
28    divided  by  the  greater  of 1.6% or the hospital's Medicaid
29    outpatient utilization rate. The total  payments  under  this
30    subsection to a hospital may not exceed $6,750,000 annually.
31        For purposes of this subsection:
32        "Medicaid  outpatient  charges"  means  the  charges  for
33    outpatient  services  provided to Medicaid patients for State
34    fiscal year 2001 as submitted by the hospital  on  the  UB-92
 
                            -28-     LRB093 05499 DRJ 20296 a
 1    billing  form  or  under the ambulatory procedure listing and
 2    adjudicated by the Department of  Public  Aid  on  or  before
 3    September 12, 2003.
 4        "Medicaid  outpatient utilization rate" means a fraction,
 5    the numerator of which is the hospital's Medicaid  outpatient
 6    charges  and  the denominator of which is the total number of
 7    the  hospital's  charges  for  outpatient  services  for  the
 8    hospital's fiscal year ending in 2001.
 9        (g)  State outpatient service adjustment. In addition  to
10    rates  paid  for outpatient hospital services, the Department
11    of Public Aid shall pay  each  Illinois  hospital  an  amount
12    equal  to  the  product of 75.5% multiplied by the hospital's
13    Medicaid outpatient services submitted to the  Department  on
14    the  UB-92 billing form for State fiscal year 2001 multiplied
15    by the hospital's outpatient access fraction.
16        For  purposes  of  this  subsection,  "outpatient  access
17    fraction" means a fraction, the numerator  of  which  is  the
18    hospital's  Medicaid  payments  for  outpatient  services for
19    ambulatory  procedure  listing  services  submitted  to   the
20    Department  on  the  UB-92 billing form for State fiscal year
21    2001, and the denominator of which is the hospital's Medicaid
22    outpatient services submitted to the Department on the  UB-92
23    billing form for State fiscal year 2001.
24        The  total  payments  under this subsection to a hospital
25    may not exceed $3,000,000 annually.
26        (h)  Rural hospital outpatient adjustment. In addition to
27    rates paid for outpatient hospital services,  the  Department
28    of  Public  Aid  shall  pay  each  Illinois rural hospital an
29    amount equal to the product of $14,500,000 multiplied by  the
30    rural hospital outpatient adjustment fraction.
31        For   purposes   of   this  subsection,  "rural  hospital
32    outpatient  adjustment  fraction"  means  a   fraction,   the
33    numerator  of  which  is  the  hospital's Medicaid visits for
34    outpatient services for ambulatory procedure listing services
 
                            -29-     LRB093 05499 DRJ 20296 a
 1    submitted to the Department on the  UB-92  billing  form  for
 2    State  fiscal  year 2001, and the denominator of which is the
 3    total Medicaid visits for outpatient services for  ambulatory
 4    procedure  listing  services for all Illinois rural hospitals
 5    submitted to the Department on the  UB-92  billing  form  for
 6    State fiscal year 2001.
 7        For purposes of this subsection, "rural hospital" has the
 8    same  meaning as in 89 Ill. Adm. Code 148.25, as in effect on
 9    September 30, 2003.
10        (i)  Merged/closed hospital adjustment. If  any  hospital
11    files  a  combined Medicaid cost report with another hospital
12    after January 1, 2001,  and  if  that  hospital  subsequently
13    closes,  then except for the payments described in subsection
14    (e), all payments described in  the  various  subsections  of
15    this  Section  shall,  before  the  application of the annual
16    limitation amount  specified  in  each  such  subsection,  be
17    multiplied  by  a  fraction,  the  numerator  of which is the
18    number of occupied bed days attributable to the open hospital
19    and the denominator of which is the  sum  of  the  number  of
20    occupied  bed  days  of  each  open  hospital and each closed
21    hospital. For purposes  of  this  subsection,  "occupied  bed
22    days"  has  the  same  meaning  as  the  term  is  defined in
23    subsection (a) of Section 5A-2.
24        (j)  For purposes of this Section,  the  terms  "Medicaid
25    days",  "Medicaid  charges",  and  "Medicaid services" do not
26    include any days, charges, or services for which Medicare was
27    liable for payment.
28        (k)  As  provided  in  Section  5A-14,  this  Section  is
29    repealed on July 1, 2005.

30        (305 ILCS 5/5A-13 new)
31        Sec.  5A-13.  Emergency  rulemaking.  The  Department  of
32    Public Aid  may  adopt  rules  necessary  to  implement  this
33    amendatory  Act  of the 93rd General Assembly through the use
 
                            -30-     LRB093 05499 DRJ 20296 a
 1    of emergency rulemaking in accordance with  Section  5-45  of
 2    the  Illinois  Administrative  Procedure Act. For purposes of
 3    that Act, the General Assembly finds  that  the  adoption  of
 4    rules  to  implement  this amendatory Act of the 93rd General
 5    Assembly is deemed an emergency and necessary for the  public
 6    interest, safety, and welfare.

 7        (305 ILCS 5/5A-14 new)
 8        Sec. 5A-14. Repeal of assessments and disbursements.
 9        (a)  Section 5A-2 is repealed on July 1, 2005.
10        (b)  Section 5A-12 is repealed on July 1, 2005.

11        (305 ILCS 5/14-1) (from Ch. 23, par. 14-1)
12        Sec. 14-1.  Definitions.  As used in this Article, unless
13    the context requires otherwise:
14        "Fund" means the Hospital Services Trust Fund.
15        "Estimated  Rate  Year  Utilization" means the hospital's
16    projected utilization for the State fiscal year in which  the
17    fee is due (for example, fiscal year 1992 for fees imposed in
18    State  fiscal year 1992, fiscal year 1993 for fees imposed in
19    State fiscal year 1993, and so forth).
20        "Gross Receipts" means all payments for medical  services
21    delivered  under  Title  XIX  of  the Social Security Act and
22    Articles V, VI, and VII of this Code and shall mean  any  and
23    all  payments  made by the Illinois Department, or a Division
24    thereof, to a Medical Assistance Program  provider  certified
25    to  participate  in  the Illinois Medical Assistance Program,
26    for services rendered eligible for Medical  Assistance  under
27    Articles  V,  VI  and VII of this Code, State regulations and
28    the federal Medicaid Program as defined in Title XIX  of  the
29    Social Security Act and federal regulations.
30        "Hospital"  means  any  institution,  place, building, or
31    agency, public or private, whether organized  for  profit  or
32    not-for-profit,  which is located in the State and is subject
 
                            -31-     LRB093 05499 DRJ 20296 a
 1    to licensure by the  Illinois  Department  of  Public  Health
 2    under  the  Hospital Licensing Act or any institution, place,
 3    building, or agency, public or private, whether organized for
 4    profit  or  not-for-profit,  which   meets   all   comparable
 5    conditions  and requirements of the Hospital Licensing Act in
 6    effect for the state in which it is located, and is  required
 7    to submit cost reports to the Illinois Department under Title
 8    89,  Part 148, of the Illinois Administrative Code, but shall
 9    not include the University of Illinois Hospital as defined in
10    the University of Illinois Hospital Act or a county  hospital
11    in a county of over 3 million population.
12        "Total  Medicaid Base Year Spending" means the hospital's
13    State fiscal year 1991 weighted  average  payment  rates,  as
14    defined  by  rule, excluding payments under Section 5-5.02 of
15    this Code, reduced by 5% and  multiplied  by  the  hospital's
16    estimated rate year utilization.
17    (Source: P.A. 87-13.)

18        (305 ILCS 5/Art. V-D rep.)
19        (305 ILCS 5/14-2 rep.)
20        (305 ILCS 5/14-3 rep.)
21        (305 ILCS 5/14-4 rep.)
22        (305 ILCS 5/14-5 rep.)
23        (305 ILCS 5/14-6 rep.)
24        (305 ILCS 5/14-7 rep.)
25        (305 ILCS 5/14-9 rep.)
26        (305 ILCS 5/14-10 rep.)
27        Section  11.  The  Illinois Public Aid Code is amended by
28    repealing Article V-D and Sections 14-2,  14-3,  14-4,  14-5,
29    14-6, 14-7, 14-9, and 14-10.

30        Section  99.  Effective date.  This Act takes effect upon
31    becoming law.".