SB2208ham002 93RD GENERAL ASSEMBLY

Rep. Gary Hannig

Filed: 7/24/2004

09300SB2208ham002 LRB093 15827 DRJ 52963 a

AMENDMENT TO SENATE BILL 2208

AMENDMENT NO. ______. Amend Senate Bill 2208, AS AMENDED, by replacing everything after the enacting clause with the following:

5		"Section 1. Short title. This Act may be cited as the
6		FY2005 Budget Implementation (Human Services) Act.

7		Section 5. Purpose. It is the purpose of this Act to make
8		changes in State programs that are necessary to implement the
9		Governor's FY2005 budget recommendations concerning human
10		services.

11		Section 7. The Illinois Administrative Procedure Act is
12		amended by changing Section 5-45 as follows:
13		(5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
14		Sec. 5-45. Emergency rulemaking.
15		(a) "Emergency" means the existence of any situation that
16		any agency finds reasonably constitutes a threat to the public
17		interest, safety, or welfare.
18		(b) If any agency finds that an emergency exists that
19		requires adoption of a rule upon fewer days than is required by
20		Section 5-40 and states in writing its reasons for that
21		finding, the agency may adopt an emergency rule without prior
22		notice or hearing upon filing a notice of emergency rulemaking

1		with the Secretary of State under Section 5-70. The notice
2		shall include the text of the emergency rule and shall be
3		published in the Illinois Register. Consent orders or other
4		court orders adopting settlements negotiated by an agency may
5		be adopted under this Section. Subject to applicable
6		constitutional or statutory provisions, an emergency rule
7		becomes effective immediately upon filing under Section 5-65 or
8		at a stated date less than 10 days thereafter. The agency's
9		finding and a statement of the specific reasons for the finding
10		shall be filed with the rule. The agency shall take reasonable
11		and appropriate measures to make emergency rules known to the
12		persons who may be affected by them.
13		(c) An emergency rule may be effective for a period of not
14		longer than 150 days, but the agency's authority to adopt an
15		identical rule under Section 5-40 is not precluded. No
16		emergency rule may be adopted more than once in any 24 month
17		period, except that this limitation on the number of emergency
18		rules that may be adopted in a 24 month period does not apply
19		to (i) emergency rules that make additions to and deletions
20		from the Drug Manual under Section 5-5.16 of the Illinois
21		Public Aid Code or the generic drug formulary under Section
22		3.14 of the Illinois Food, Drug and Cosmetic Act or (ii)
23		emergency rules adopted by the Pollution Control Board before
24		July 1, 1997 to implement portions of the Livestock Management
25		Facilities Act. Two or more emergency rules having
26		substantially the same purpose and effect shall be deemed to be
27		a single rule for purposes of this Section.
28		(d) In order to provide for the expeditious and timely
29		implementation of the State's fiscal year 1999 budget,
30		emergency rules to implement any provision of Public Act 90-587
31		or 90-588 or any other budget initiative for fiscal year 1999
32		may be adopted in accordance with this Section by the agency
33		charged with administering that provision or initiative,
34		except that the 24-month limitation on the adoption of

1		emergency rules and the provisions of Sections 5-115 and 5-125
2		do not apply to rules adopted under this subsection (d). The
3		adoption of emergency rules authorized by this subsection (d)
4		shall be deemed to be necessary for the public interest,
5		safety, and welfare.
6		(e) In order to provide for the expeditious and timely
7		implementation of the State's fiscal year 2000 budget,
8		emergency rules to implement any provision of this amendatory
9		Act of the 91st General Assembly or any other budget initiative
10		for fiscal year 2000 may be adopted in accordance with this
11		Section by the agency charged with administering that provision
12		or initiative, except that the 24-month limitation on the
13		adoption of emergency rules and the provisions of Sections
14		5-115 and 5-125 do not apply to rules adopted under this
15		subsection (e). The adoption of emergency rules authorized by
16		this subsection (e) shall be deemed to be necessary for the
17		public interest, safety, and welfare.
18		(f) In order to provide for the expeditious and timely
19		implementation of the State's fiscal year 2001 budget,
20		emergency rules to implement any provision of this amendatory
21		Act of the 91st General Assembly or any other budget initiative
22		for fiscal year 2001 may be adopted in accordance with this
23		Section by the agency charged with administering that provision
24		or initiative, except that the 24-month limitation on the
25		adoption of emergency rules and the provisions of Sections
26		5-115 and 5-125 do not apply to rules adopted under this
27		subsection (f). The adoption of emergency rules authorized by
28		this subsection (f) shall be deemed to be necessary for the
29		public interest, safety, and welfare.
30		(g) In order to provide for the expeditious and timely
31		implementation of the State's fiscal year 2002 budget,
32		emergency rules to implement any provision of this amendatory
33		Act of the 92nd General Assembly or any other budget initiative
34		for fiscal year 2002 may be adopted in accordance with this

1		Section by the agency charged with administering that provision
2		or initiative, except that the 24-month limitation on the
3		adoption of emergency rules and the provisions of Sections
4		5-115 and 5-125 do not apply to rules adopted under this
5		subsection (g). The adoption of emergency rules authorized by
6		this subsection (g) shall be deemed to be necessary for the
7		public interest, safety, and welfare.
8		(h) In order to provide for the expeditious and timely
9		implementation of the State's fiscal year 2003 budget,
10		emergency rules to implement any provision of this amendatory
11		Act of the 92nd General Assembly or any other budget initiative
12		for fiscal year 2003 may be adopted in accordance with this
13		Section by the agency charged with administering that provision
14		or initiative, except that the 24-month limitation on the
15		adoption of emergency rules and the provisions of Sections
16		5-115 and 5-125 do not apply to rules adopted under this
17		subsection (h). The adoption of emergency rules authorized by
18		this subsection (h) shall be deemed to be necessary for the
19		public interest, safety, and welfare.
20		(i) In order to provide for the expeditious and timely
21		implementation of the State's fiscal year 2004 budget,
22		emergency rules to implement any provision of this amendatory
23		Act of the 93rd General Assembly or any other budget initiative
24		for fiscal year 2004 may be adopted in accordance with this
25		Section by the agency charged with administering that provision
26		or initiative, except that the 24-month limitation on the
27		adoption of emergency rules and the provisions of Sections
28		5-115 and 5-125 do not apply to rules adopted under this
29		subsection (i). The adoption of emergency rules authorized by
30		this subsection (i) shall be deemed to be necessary for the
31		public interest, safety, and welfare.
32		(j) In order to provide for the expeditious and timely
33		implementation of the provisions of the State's fiscal year
34		2005 budget as provided under the Fiscal Year 2005 Budget

1		Implementation (Human Services) Act, emergency rules to
2		implement any provision of the Fiscal Year 2005 Budget
3		Implementation (Human Services) Act may be adopted in
4		accordance with this Section by the agency charged with
5		administering that provision, except that the 24-month
6		limitation on the adoption of emergency rules and the
7		provisions of Sections 5-115 and 5-125 do not apply to rules
8		adopted under this subsection (j). The Department of Public Aid
9		may also adopt rules under this subsection (j) necessary to
10		administer the Illinois Public Aid Code and the Children's
11		Health Insurance Program Act. The adoption of emergency rules
12		authorized by this subsection (j) shall be deemed to be
13		necessary for the public interest, safety, and welfare.
14		(Source: P.A. 92-10, eff. 6-11-01; 92-597, eff. 6-28-02; 93-20,
15		eff. 6-20-03.)

16		Section 10. The Mental Health and Developmental
17		Disabilities Administrative Act is amended by changing Section
18		18.4 and adding Section 18.5 as follows:
19		(20 ILCS 1705/18.4)
20		Sec. 18.4. Community Mental Health Medicaid Trust Fund;
21		reimbursement.
22		(a) The Community Mental Health Medicaid Trust Fund is
23		hereby created in the State Treasury.
24		(b) Except as otherwise provided in this Section, any Any
25		funds paid to the State by the federal government under Title
26		XIX or Title XXI of the Social Security Act for services
27		delivered by community mental health services providers, and
28		any interest earned thereon, shall be deposited directly into
29		the Community Mental Health Medicaid Trust Fund. Beginning with
30		State fiscal year 2005, the first $95,000,000 received by the
31		Department shall be deposited 26.3% into the General Revenue
32		Fund and 73.7% into the Community Mental Health Medicaid Trust

1		Fund. Amounts received in excess of $95,000,000 in any State
2		fiscal year shall be deposited 50% into the General Revenue
3		Fund and 50% into the Community Mental Health Medicaid Trust
4		Fund. The Department shall analyze the budgeting and
5		programmatic impact of this funding allocation and report to
6		the Governor and the General Assembly the results of this
7		analysis and any recommendations for change, no later than
8		December 31, 2005.
9		(c) The Department shall reimburse community mental health
10		services providers for Medicaid-reimbursed mental health
11		services provided to eligible individuals. Moneys in the
12		Community Mental Health Medicaid Trust Fund may be used for
13		that purpose.
14		(d) As used in this Section:
15		"Medicaid-reimbursed mental health services" means
16		services provided by a community mental health provider under
17		an agreement with the Department that is eligible for
18		reimbursement under the federal Title XIX program or Title XXI
19		program.
20		"Provider" means a community agency that is funded by the
21		Department to provide a Medicaid-reimbursed service.
22		"Services" means mental health services provided under one
23		of the following programs:
24		(1) Medicaid Clinic Option;
25		(2) Medicaid Rehabilitation Option;
26		(3) Targeted Case Management.
27		(Source: P.A. 92-597, eff. 6-28-02.)
28		(20 ILCS 1705/18.5 new)
29		Sec. 18.5. Community Developmental Disability Services
30		Medicaid Trust Fund; reimbursement.
31		(a) The Community Developmental Disability Services
32		Medicaid Trust Fund is hereby created in the State treasury.
33		(b) Any funds in excess of $16,700,000 in any fiscal year

1		paid to the State by the federal government under Title XIX or
2		Title XXI of the Social Security Act for services delivered by
3		community developmental disability services providers for
4		services relating to Developmental Training and Community
5		Integrated Living Arrangements as a result of the conversion of
6		such providers from a grant payment methodology to a
7		fee-for-service payment methodology, or any other funds paid to
8		the State for any subsequent revenue maximization initiatives
9		performed by such providers, and any interest earned thereon,
10		shall be deposited directly into the Community Developmental
11		Disability Services Medicaid Trust Fund. One-third of this
12		amount shall be used only to pay for Medicaid-reimbursed
13		community developmental disability services provided to
14		eligible individuals, and the remainder shall be transferred to
15		the General Revenue Fund.
16		(c) For purposes of this Section:
17		"Medicaid-reimbursed developmental disability services"
18		means services provided by a community developmental
19		disability provider under an agreement with the Department that
20		is eligible for reimbursement under the federal Title XIX
21		program or Title XXI program.
22		"Provider" means a qualified entity as defined in the
23		State's Home and Community-Based Services Waiver for Persons
24		with Developmental Disabilities that is funded by the
25		Department to provide a Medicaid-reimbursed service.
26		"Revenue maximization alternatives" do not include
27		increases in funds paid to the State as a result of growth in
28		spending through service expansion or rate increases.

29		Section 20. The State Finance Act is amended by changing
30		Sections 6z-58 and 25 and by adding Section 8.55 as follows:
31		(30 ILCS 105/6z-58)
32		Sec. 6z-58. The Family Care Fund.

1		(a) There is created in the State treasury the Family Care
2		Fund. Interest earned by the Fund shall be credited to the
3		Fund.
4		(b) The Fund is created solely for the purposes of
5		receiving, investing, and distributing moneys in accordance
6		with (i) an approved waiver under the Social Security Act
7		resulting from the Family Care waiver request submitted by the
8		Illinois Department of Public Aid on February 15, 2002 and (ii)
9		an interagency agreement between the Department of Public Aid
10		and another agency of State government. The Fund shall consist
11		of:
12		(1) All federal financial participation moneys
13		received pursuant to the approved waiver, except for moneys
14		received pursuant to expenditures for medical services by
15		the Department of Public Aid from any other fund; and
16		(2) All other moneys received by the Fund from any
17		source, including interest thereon.
18		(c) Subject to appropriation, the moneys in the Fund shall
19		be disbursed for reimbursement of medical services and other
20		costs associated with persons receiving such services:
21		(1) under programs administered by the Department of
22		Public Aid; and
23		(2) pursuant to an interagency agreement, under
24		programs administered by another agency of State
25		government. under the waiver due to their relationship with
26		children receiving medical services pursuant to Article V
27		of the Illinois Public Aid Code or the Children's Health
28		Insurance Program Act.
29		(Source: P.A. 92-600, eff. 6-28-02; 93-20, eff. 6-20-03.)
30		(30 ILCS 105/8.55 new)
31		Sec. 8.55. Interfund transfers. On or after July 1, 2004
32		and until June 30, 2006, in addition to any other transfers
33		that may be provided for by law, at the direction of and upon

1		notification from the Director of Public Aid, the State
2		Comptroller shall direct and the State Treasurer shall transfer
3		amounts into the General Revenue Fund from the designated funds
4		not exceeding the following totals:
5		Hospital Provider Fund............................$36,000,000
6		Health and Human Services Medicaid Trust Fund...$124,000,000.
7		Transfers of moneys under this Section may not exceed a
8		total of $80,000,000 in any State fiscal year.
9		(30 ILCS 105/25) (from Ch. 127, par. 161)
10		Sec. 25. Fiscal year limitations.
11		(a) All appropriations shall be available for expenditure
12		for the fiscal year or for a lesser period if the Act making
13		that appropriation so specifies. A deficiency or emergency
14		appropriation shall be available for expenditure only through
15		June 30 of the year when the Act making that appropriation is
16		enacted unless that Act otherwise provides.
17		(b) Outstanding liabilities as of June 30, payable from
18		appropriations which have otherwise expired, may be paid out of
19		the expiring appropriations during the 2-month period ending at
20		the close of business on August 31. Any service involving
21		professional or artistic skills or any personal services by an
22		employee whose compensation is subject to income tax
23		withholding must be performed as of June 30 of the fiscal year
24		in order to be considered an "outstanding liability as of June
25		30" that is thereby eligible for payment out of the expiring
26		appropriation.
27		However, payment of tuition reimbursement claims under
28		Section 14-7.03 or 18-3 of the School Code may be made by the
29		State Board of Education from its appropriations for those
30		respective purposes for any fiscal year, even though the claims
31		reimbursed by the payment may be claims attributable to a prior
32		fiscal year, and payments may be made at the direction of the
33		State Superintendent of Education from the fund from which the

1		appropriation is made without regard to any fiscal year
2		limitations.
3		Medical payments may be made by the Department of Veterans'
4		Affairs from its appropriations for those purposes for any
5		fiscal year, without regard to the fact that the medical
6		services being compensated for by such payment may have been
7		rendered in a prior fiscal year.
8		Medical payments may be made by the Department of Public
9		Aid and medical payments and child care payments may be made by
10		the Department of Human Services (as successor to the
11		Department of Public Aid) from appropriations for those
12		purposes for any fiscal year, without regard to the fact that
13		the medical or child care services being compensated for by
14		such payment may have been rendered in a prior fiscal year; and
15		payments may be made at the direction of the Department of
16		Central Management Services from the Health Insurance Reserve
17		Fund and the Local Government Health Insurance Reserve Fund
18		without regard to any fiscal year limitations.
19		Medical payments may be made by the Department of Human
20		Services from its appropriations relating to substance abuse
21		treatment services for any fiscal year, without regard to the
22		fact that the medical services being compensated for by such
23		payment may have been rendered in a prior fiscal year, provided
24		the payments are made on a fee-for-service basis consistent
25		with requirements established for Medicaid reimbursement by
26		the Department of Public Aid.
27		Additionally, payments may be made by the Department of
28		Human Services from its appropriations, or any other State
29		agency from its appropriations with the approval of the
30		Department of Human Services, from the Immigration Reform and
31		Control Fund for purposes authorized pursuant to the
32		Immigration Reform and Control Act of 1986, without regard to
33		any fiscal year limitations.
34		Further, with respect to costs incurred in fiscal years

1		2002 and 2003 only, payments may be made by the State Treasurer
2		from its appropriations from the Capital Litigation Trust Fund
3		without regard to any fiscal year limitations.
4		Lease payments may be made by the Department of Central
5		Management Services under the sale and leaseback provisions of
6		Section 7.4 of the State Property Control Act with respect to
7		the James R. Thompson Center and the Elgin Mental Health Center
8		and surrounding land from appropriations for that purpose
9		without regard to any fiscal year limitations.
10		Lease payments may be made under the sale and leaseback
11		provisions of Section 7.5 of the State Property Control Act
12		with respect to the Illinois State Toll Highway Authority
13		headquarters building and surrounding land without regard to
14		any fiscal year limitations.
15		(c) Further, payments may be made by the Department of
16		Public Health and the Department of Human Services (acting as
17		successor to the Department of Public Health under the
18		Department of Human Services Act) from their respective
19		appropriations for grants for medical care to or on behalf of
20		persons suffering from chronic renal disease, persons
21		suffering from hemophilia, rape victims, and premature and
22		high-mortality risk infants and their mothers and for grants
23		for supplemental food supplies provided under the United States
24		Department of Agriculture Women, Infants and Children
25		Nutrition Program, for any fiscal year without regard to the
26		fact that the services being compensated for by such payment
27		may have been rendered in a prior fiscal year.
28		(d) The Department of Public Health and the Department of
29		Human Services (acting as successor to the Department of Public
30		Health under the Department of Human Services Act) shall each
31		annually submit to the State Comptroller, Senate President,
32		Senate Minority Leader, Speaker of the House, House Minority
33		Leader, and the respective Chairmen and Minority Spokesmen of
34		the Appropriations Committees of the Senate and the House, on

1		or before December 31, a report of fiscal year funds used to
2		pay for services provided in any prior fiscal year. This report
3		shall document by program or service category those
4		expenditures from the most recently completed fiscal year used
5		to pay for services provided in prior fiscal years.
6		(e) The Department of Public Aid, and the Department of
7		Human Services (acting as successor to the Department of Public
8		Aid), and the Department of Human Services making
9		fee-for-service payments relating to substance abuse treatment
10		services provided during a previous fiscal year shall each
11		annually submit to the State Comptroller, Senate President,
12		Senate Minority Leader, Speaker of the House, House Minority
13		Leader, the respective Chairmen and Minority Spokesmen of the
14		Appropriations Committees of the Senate and the House, on or
15		before November 30, a report that shall document by program or
16		service category those expenditures from the most recently
17		completed fiscal year used to pay for (i) services provided in
18		prior fiscal years and (ii) services for which claims were
19		received in prior fiscal years.
20		(f) The Department of Human Services (as successor to the
21		Department of Public Aid) shall annually submit to the State
22		Comptroller, Senate President, Senate Minority Leader, Speaker
23		of the House, House Minority Leader, and the respective
24		Chairmen and Minority Spokesmen of the Appropriations
25		Committees of the Senate and the House, on or before December
26		31, a report of fiscal year funds used to pay for services
27		(other than medical care) provided in any prior fiscal year.
28		This report shall document by program or service category those
29		expenditures from the most recently completed fiscal year used
30		to pay for services provided in prior fiscal years.
31		(g) In addition, each annual report required to be
32		submitted by the Department of Public Aid under subsection (e)
33		shall include the following information with respect to the
34		State's Medicaid program:

1		(1) Explanations of the exact causes of the variance
2		between the previous year's estimated and actual
3		liabilities.
4		(2) Factors affecting the Department of Public Aid's
5		liabilities, including but not limited to numbers of aid
6		recipients, levels of medical service utilization by aid
7		recipients, and inflation in the cost of medical services.
8		(3) The results of the Department's efforts to combat
9		fraud and abuse.
10		(h) As provided in Section 4 of the General Assembly
11		Compensation Act, any utility bill for service provided to a
12		General Assembly member's district office for a period
13		including portions of 2 consecutive fiscal years may be paid
14		from funds appropriated for such expenditure in either fiscal
15		year.
16		(i) An agency which administers a fund classified by the
17		Comptroller as an internal service fund may issue rules for:
18		(1) billing user agencies in advance based on estimated
19		charges for goods or services;
20		(2) issuing credits during the subsequent fiscal year
21		for all user agency payments received during the prior
22		fiscal year which were in excess of the final amounts owed
23		by the user agency for that period; and
24		(3) issuing catch-up billings to user agencies during
25		the subsequent fiscal year for amounts remaining due when
26		payments received from the user agency during the prior
27		fiscal year were less than the total amount owed for that
28		period.
29		User agencies are authorized to reimburse internal service
30		funds for catch-up billings by vouchers drawn against their
31		respective appropriations for the fiscal year in which the
32		catch-up billing was issued.
33		(Source: P.A. 92-885, eff. 1-13-03; 93-19, eff. 6-20-03.)

1		Section 22. The Illinois Income Tax Act is amended by
2		changing Section 917 as follows:
3		(35 ILCS 5/917) (from Ch. 120, par. 9-917)
4		Sec. 917. Confidentiality and information sharing.
5		(a) Confidentiality. Except as provided in this Section,
6		all information received by the Department from returns filed
7		under this Act, or from any investigation conducted under the
8		provisions of this Act, shall be confidential, except for
9		official purposes within the Department or pursuant to official
10		procedures for collection of any State tax or pursuant to an
11		investigation or audit by the Illinois State Scholarship
12		Commission of a delinquent student loan or monetary award or
13		enforcement of any civil or criminal penalty or sanction
14		imposed by this Act or by another statute imposing a State tax,
15		and any person who divulges any such information in any manner,
16		except for such purposes and pursuant to order of the Director
17		or in accordance with a proper judicial order, shall be guilty
18		of a Class A misdemeanor. However, the provisions of this
19		paragraph are not applicable to information furnished to a
20		licensed attorney representing the taxpayer where an appeal or
21		a protest has been filed on behalf of the taxpayer.
22		(b) Public information. Nothing contained in this Act shall
23		prevent the Director from publishing or making available to the
24		public the names and addresses of persons filing returns under
25		this Act, or from publishing or making available reasonable
26		statistics concerning the operation of the tax wherein the
27		contents of returns are grouped into aggregates in such a way
28		that the information contained in any individual return shall
29		not be disclosed.
30		(c) Governmental agencies. The Director may make available
31		to the Secretary of the Treasury of the United States or his
32		delegate, or the proper officer or his delegate of any other
33		state imposing a tax upon or measured by income, for

1		exclusively official purposes, information received by the
2		Department in the administration of this Act, but such
3		permission shall be granted only if the United States or such
4		other state, as the case may be, grants the Department
5		substantially similar privileges. The Director may exchange
6		information with the Illinois Department of Public Aid and the
7		Department of Human Services (acting as successor to the
8		Department of Public Aid under the Department of Human Services
9		Act) for the purpose of verifying sources and amounts of income
10		and for other purposes directly connected with the
11		administration of this Act and the Illinois Public Aid Code.
12		The Director may exchange information with the Director of the
13		Department of Employment Security for the purpose of verifying
14		sources and amounts of income and for other purposes directly
15		connected with the administration of this Act and Acts
16		administered by the Department of Employment Security. The
17		Director may make available to the Illinois Industrial
18		Commission information regarding employers for the purpose of
19		verifying the insurance coverage required under the Workers'
20		Compensation Act and Workers' Occupational Diseases Act. The
21		Director may exchange information with the Illinois Department
22		on Aging for the purpose of verifying sources and amounts of
23		income for purposes directly related to confirming eligibility
24		for participation in the programs of benefits authorized by the
25		Senior Citizens and Disabled Persons Property Tax Relief and
26		Pharmaceutical Assistance Act.
27		The Director may make available to any State agency,
28		including the Illinois Supreme Court, which licenses persons to
29		engage in any occupation, information that a person licensed by
30		such agency has failed to file returns under this Act or pay
31		the tax, penalty and interest shown therein, or has failed to
32		pay any final assessment of tax, penalty or interest due under
33		this Act. The Director may make available to any State agency,
34		including the Illinois Supreme Court, information regarding

1		whether a bidder, contractor, or an affiliate of a bidder or
2		contractor has failed to file returns under this Act or pay the
3		tax, penalty, and interest shown therein, or has failed to pay
4		any final assessment of tax, penalty, or interest due under
5		this Act, for the limited purpose of enforcing bidder and
6		contractor certifications. For purposes of this Section, the
7		term "affiliate" means any entity that (1) directly,
8		indirectly, or constructively controls another entity, (2) is
9		directly, indirectly, or constructively controlled by another
10		entity, or (3) is subject to the control of a common entity.
11		For purposes of this subsection (a), an entity controls another
12		entity if it owns, directly or individually, more than 10% of
13		the voting securities of that entity. As used in this
14		subsection (a), the term "voting security" means a security
15		that (1) confers upon the holder the right to vote for the
16		election of members of the board of directors or similar
17		governing body of the business or (2) is convertible into, or
18		entitles the holder to receive upon its exercise, a security
19		that confers such a right to vote. A general partnership
20		interest is a voting security.
21		The Director may make available to any State agency,
22		including the Illinois Supreme Court, units of local
23		government, and school districts, information regarding
24		whether a bidder or contractor is an affiliate of a person who
25		is not collecting and remitting Illinois Use taxes, for the
26		limited purpose of enforcing bidder and contractor
27		certifications.
28		The Director may also make available to the Secretary of
29		State information that a corporation which has been issued a
30		certificate of incorporation by the Secretary of State has
31		failed to file returns under this Act or pay the tax, penalty
32		and interest shown therein, or has failed to pay any final
33		assessment of tax, penalty or interest due under this Act. An
34		assessment is final when all proceedings in court for review of

1		such assessment have terminated or the time for the taking
2		thereof has expired without such proceedings being instituted.
3		For taxable years ending on or after December 31, 1987, the
4		Director may make available to the Director or principal
5		officer of any Department of the State of Illinois, information
6		that a person employed by such Department has failed to file
7		returns under this Act or pay the tax, penalty and interest
8		shown therein. For purposes of this paragraph, the word
9		"Department" shall have the same meaning as provided in Section
10		3 of the State Employees Group Insurance Act of 1971.
11		(d) The Director shall make available for public inspection
12		in the Department's principal office and for publication, at
13		cost, administrative decisions issued on or after January 1,
14		1995. These decisions are to be made available in a manner so
15		that the following taxpayer information is not disclosed:
16		(1) The names, addresses, and identification numbers
17		of the taxpayer, related entities, and employees.
18		(2) At the sole discretion of the Director, trade
19		secrets or other confidential information identified as
20		such by the taxpayer, no later than 30 days after receipt
21		of an administrative decision, by such means as the
22		Department shall provide by rule.
23		The Director shall determine the appropriate extent of the
24		deletions allowed in paragraph (2). In the event the taxpayer
25		does not submit deletions, the Director shall make only the
26		deletions specified in paragraph (1).
27		The Director shall make available for public inspection and
28		publication an administrative decision within 180 days after
29		the issuance of the administrative decision. The term
30		"administrative decision" has the same meaning as defined in
31		Section 3-101 of Article III of the Code of Civil Procedure.
32		Costs collected under this Section shall be paid into the Tax
33		Compliance and Administration Fund.
34		(e) Nothing contained in this Act shall prevent the

1		Director from divulging information to any person pursuant to a
2		request or authorization made by the taxpayer, by an authorized
3		representative of the taxpayer, or, in the case of information
4		related to a joint return, by the spouse filing the joint
5		return with the taxpayer.
6		(Source: P.A. 93-25, eff. 6-20-03.)

7		Section 25. The Nursing Home Care Act is amended by
8		changing Section 3-103 as follows:
9		(210 ILCS 45/3-103) (from Ch. 111 1/2, par. 4153-103)
10		Sec. 3-103. The procedure for obtaining a valid license
11		shall be as follows:
12		(1) Application to operate a facility shall be made to the
13		Department on forms furnished by the Department.
14		(2) All license applications shall be accompanied with an
15		application fee. The fee for an annual license shall be $995
16		based on the licensed capacity of the facility and shall be
17		determined as follows: 0-49 licensed beds, a flat fee of $500;
18		50-99 licensed beds, a flat fee of $750; and for any facility
19		with 100 or more licensed beds, a fee of $1,000 plus $10 per
20		licensed bed. Facilities that pay a fee or assessment pursuant
21		to Article V-C of the Illinois Public Aid Code shall be exempt
22		from the license fee imposed under this item (2). The fee for a
23		2-year license shall be double the fee for the annual license
24		set forth in the preceding sentence. The first $600,000 of such
25		fees collected each fiscal year shall be deposited with the
26		State Treasurer into the Long Term Care Monitor/Receiver Fund,
27		which has been created as a special fund in the State treasury.
28		Any such fees in excess of $600,000 collected in a fiscal year
29		shall be deposited into the General Revenue Fund. This special
30		fund is to be used by the Department for expenses related to
31		the appointment of monitors and receivers as contained in
32		Sections 3-501 through 3-517. At the end of each fiscal year,

1		any funds in excess of $1,000,000 held in the Long Term Care
2		Monitor/Receiver Fund shall be deposited in the State's General
3		Revenue Fund. The application shall be under oath and the
4		submission of false or misleading information shall be a Class
5		A misdemeanor. The application shall contain the following
6		information:
7		(a) The name and address of the applicant if an
8		individual, and if a firm, partnership, or association, of
9		every member thereof, and in the case of a corporation, the
10		name and address thereof and of its officers and its
11		registered agent, and in the case of a unit of local
12		government, the name and address of its chief executive
13		officer;
14		(b) The name and location of the facility for which a
15		license is sought;
16		(c) The name of the person or persons under whose
17		management or supervision the facility will be conducted;
18		(d) The number and type of residents for which
19		maintenance, personal care, or nursing is to be provided;
20		and
21		(e) Such information relating to the number,
22		experience, and training of the employees of the facility,
23		any management agreements for the operation of the
24		facility, and of the moral character of the applicant and
25		employees as the Department may deem necessary.
26		(3) Each initial application shall be accompanied by a
27		financial statement setting forth the financial condition of
28		the applicant and by a statement from the unit of local
29		government having zoning jurisdiction over the facility's
30		location stating that the location of the facility is not in
31		violation of a zoning ordinance. An initial application for a
32		new facility shall be accompanied by a permit as required by
33		the "Illinois Health Facilities Planning Act". After the
34		application is approved, the applicant shall advise the

1		Department every 6 months of any changes in the information
2		originally provided in the application.
3		(4) Other information necessary to determine the identity
4		and qualifications of an applicant to operate a facility in
5		accordance with this Act shall be included in the application
6		as required by the Department in regulations.
7		(Source: P.A. 93-32, eff. 7-1-03.)

8		Section 27. The Pharmacy Practice Act of 1987 is amended by
9		changing Section 25 as follows:
10		(225 ILCS 85/25) (from Ch. 111, par. 4145)
11		(Section scheduled to be repealed on January 1, 2008)
12		Sec. 25. No person shall compound, or sell or offer for
13		sale, or cause to be compounded, sold or offered for sale any
14		medicine or preparation under or by a name recognized in the
15		United States Pharmacopoeia National Formulary, for internal
16		or external use, which differs from the standard of strength,
17		quality or purity as determined by the test laid down in the
18		United States Pharmacopoeia National Formulary official at the
19		time of such compounding, sale or offering for sale. Nor shall
20		any person compound, sell or offer for sale, or cause to be
21		compounded, sold, or offered for sale, any drug, medicine,
22		poison, chemical or pharmaceutical preparation, the strength
23		or purity of which shall fall below the professed standard of
24		strength or purity under which it is sold. If the physician or
25		other authorized prescriber, when transmitting an oral or
26		written prescription, does not prohibit drug product
27		selection, a different brand name or nonbrand name drug product
28		of the same generic name may be dispensed by the pharmacist,
29		provided that the selected drug has a unit price less than the
30		drug product specified in the prescription and provided that
31		the selection is permitted, is not subject to review at a
32		meeting of the Technical Advisory Council, is not subject to a

1		hearing in accordance with this Section, or is not specifically
2		prohibited by the current Drug Product Selection Formulary
3		issued by the Department of Public Health pursuant to Section
4		3.14 of the Illinois Food, Drug and Cosmetics Act, as amended.
5		A generic drug determined to be therapeutically equivalent by
6		the United States Food and Drug Administration (FDA) shall be
7		available for substitution in Illinois in accordance with this
8		Act and the Illinois Food, Drug and Cosmetic Act, provided that
9		each manufacturer submits to the Director of the Department of
10		Public Health a notification containing product technical
11		bioequivalence information as a prerequisite to product
12		substitution when they have completed all required testing to
13		support FDA product approval and, in any event, the information
14		shall be submitted no later than 60 days prior to product
15		substitution in the State. If the Technical Advisory Council
16		finds that a generic drug product may have issues related to
17		the practice of medicine or the practice of pharmacy, the
18		Technical Advisory Council shall review the generic drug
19		product at its next regularly scheduled Technical Advisory
20		Council meeting. Following the Technical Advisory Council's
21		review and initial recommendation that a generic drug product
22		not be included in the Illinois Formulary, a hearing shall be
23		conducted in accordance with the rules of the Department of
24		Public Health and Article 10 of the Illinois Administrative
25		Procedure Act if requested by the manufacturer. The Technical
26		Advisory Council shall make its recommendation to the
27		Department of Public Health within 20 business days after the
28		public hearing. If the Department of Public Health, on the
29		recommendation of the Technical Advisory Council, determines
30		that, based upon a preponderance of the evidence, the drug is
31		not bioequivalent, not therapeutically equivalent, or could
32		cause clinically significant harm to the health or safety of
33		patients receiving that generic drug, the Department of Public
34		Health may prohibit the generic drug from substitution in the

1		State. A decision by the Department of Public Health to
2		prohibit a drug product from substitution shall constitute a
3		final administrative decision within the meaning of Section
4		22.2 of the Illinois Food, Drug and Cosmetic Act and Section
5		3-101 of the Code of Civil Procedure, and shall be subject to
6		judicial review pursuant to the provisions of Article III of
7		the Administrative Review Law. A decision to prohibit a generic
8		drug from substitution must be accompanied by a written
9		detailed explanation of the basis for the decision. On the
10		prescription forms of prescribers, shall be placed a signature
11		line and the words "may substitute" and "may not substitute".
12		The prescriber, in his or her own handwriting, shall place a
13		mark beside either the "may substitute" or "may not substitute"
14		alternatives to guide the pharmacist in the dispensing of the
15		prescription. A prescriber placing a mark beside the "may
16		substitute" alternative or failing in his or her own
17		handwriting to place a mark beside either alternative
18		authorizes drug product selection in accordance with this Act.
19		Preprinted or rubber stamped marks, or other deviations from
20		the above prescription format shall not be permitted. The
21		prescriber shall sign the form in his or her own handwriting to
22		authorize the issuance of the prescription. When a person
23		presents a prescription to be dispensed, the pharmacist to whom
24		it is presented may inform the person if the pharmacy has
25		available a different brand name or nonbrand name of the same
26		generic drug prescribed and the price of the different brand
27		name or nonbrand name of the drug product. If the person
28		presenting the prescription is the one to whom the drug is to
29		be administered, the pharmacist may dispense the prescription
30		with the brand prescribed or a different brand name or nonbrand
31		name product of the same generic name that has been permitted
32		by the Department of Public Health, if the drug is of lesser
33		unit cost and the patient is informed and agrees to the
34		selection and the pharmacist shall enter such information into

1		the pharmacy record. If the person presenting the prescription
2		is someone other than the one to whom the drug is to be
3		administered the pharmacist shall not dispense the
4		prescription with a brand other than the one specified in the
5		prescription unless the pharmacist has the written or oral
6		authorization to select brands from the person to whom the drug
7		is to be administered or a parent, legal guardian or spouse of
8		that person.
9		In every case in which a selection is made as permitted by
10		the Illinois Food, Drug and Cosmetic Act, the pharmacist shall
11		indicate on the pharmacy record of the filled prescription the
12		name or other identification of the manufacturer of the drug
13		which has been dispensed.
14		The selection of any drug product by a pharmacist shall not
15		constitute evidence of negligence if the selected nonlegend
16		drug product was of the same dosage form and each of its active
17		ingredients did not vary by more than 1 percent from the active
18		ingredients of the prescribed, brand name, nonlegend drug
19		product or if the selected legend drug product was included in
20		the Illinois Drug Product Selection Formulary current at the
21		time the prescription was dispensed. Failure of a prescribing
22		physician to specify that drug product selection is prohibited
23		does not constitute evidence of negligence unless that
24		practitioner has reasonable cause to believe that the health
25		condition of the patient for whom the physician is prescribing
26		warrants the use of the brand name drug product and not
27		another.
28		The Department is authorized to employ an analyst or
29		chemist of recognized or approved standing whose duty it shall
30		be to examine into any claimed adulteration, illegal
31		substitution, improper selection, alteration, or other
32		violation hereof, and report the result of his investigation,
33		and if such report justify such action the Department shall
34		cause the offender to be prosecuted.

1		(Source: P.A. 91-766, eff. 9-1-00; 92-112, eff. 7-20-01.)

2		Section 30. The Illinois Public Aid Code is amended by
3		changing Sections 5-5, 5-5.4, 5A-2, 5A-4, 5A-5, 5A-7, and 5A-12
4		and adding Sections 5-5.4c and 12-10.7 as follows:
5		(305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
6		Sec. 5-5. Medical services. The Illinois Department, by
7		rule, shall determine the quantity and quality of and the rate
8		of reimbursement for the medical assistance for which payment
9		will be authorized, and the medical services to be provided,
10		which may include all or part of the following: (1) inpatient
11		hospital services; (2) outpatient hospital services; (3) other
12		laboratory and X-ray services; (4) skilled nursing home
13		services; (5) physicians' services whether furnished in the
14		office, the patient's home, a hospital, a skilled nursing home,
15		or elsewhere; (6) medical care, or any other type of remedial
16		care furnished by licensed practitioners; (7) home health care
17		services; (8) private duty nursing service; (9) clinic
18		services; (10) dental services; (11) physical therapy and
19		related services; (12) prescribed drugs, dentures, and
20		prosthetic devices; and eyeglasses prescribed by a physician
21		skilled in the diseases of the eye, or by an optometrist,
22		whichever the person may select; (13) other diagnostic,
23		screening, preventive, and rehabilitative services; (14)
24		transportation and such other expenses as may be necessary;
25		(15) medical treatment of sexual assault survivors, as defined
26		in Section 1a of the Sexual Assault Survivors Emergency
27		Treatment Act, for injuries sustained as a result of the sexual
28		assault, including examinations and laboratory tests to
29		discover evidence which may be used in criminal proceedings
30		arising from the sexual assault; (16) the diagnosis and
31		treatment of sickle cell anemia; and (17) any other medical
32		care, and any other type of remedial care recognized under the

1		laws of this State, but not including abortions, or induced
2		miscarriages or premature births, unless, in the opinion of a
3		physician, such procedures are necessary for the preservation
4		of the life of the woman seeking such treatment, or except an
5		induced premature birth intended to produce a live viable child
6		and such procedure is necessary for the health of the mother or
7		her unborn child. The Illinois Department, by rule, shall
8		prohibit any physician from providing medical assistance to
9		anyone eligible therefor under this Code where such physician
10		has been found guilty of performing an abortion procedure in a
11		wilful and wanton manner upon a woman who was not pregnant at
12		the time such abortion procedure was performed. The term "any
13		other type of remedial care" shall include nursing care and
14		nursing home service for persons who rely on treatment by
15		spiritual means alone through prayer for healing.
16		Notwithstanding any other provision of this Section, a
17		comprehensive tobacco use cessation program that includes
18		purchasing prescription drugs or prescription medical devices
19		approved by the Food and Drug administration shall be covered
20		under the medical assistance program under this Article for
21		persons who are otherwise eligible for assistance under this
22		Article.
23		Notwithstanding any other provision of this Code, the
24		Illinois Department may not require, as a condition of payment
25		for any laboratory test authorized under this Article, that a
26		physician's handwritten signature appear on the laboratory
27		test order form. The Illinois Department may, however, impose
28		other appropriate requirements regarding laboratory test order
29		documentation.
30		The Illinois Department of Public Aid shall provide the
31		following services to persons eligible for assistance under
32		this Article who are participating in education, training or
33		employment programs operated by the Department of Human
34		Services as successor to the Department of Public Aid:

1		(1) dental services, which shall include but not be
2		limited to prosthodontics; and
3		(2) eyeglasses prescribed by a physician skilled in the
4		diseases of the eye, or by an optometrist, whichever the
5		person may select.
6		The Illinois Department, by rule, may distinguish and
7		classify the medical services to be provided only in accordance
8		with the classes of persons designated in Section 5-2.
9		The Illinois Department shall authorize the provision of,
10		and shall authorize payment for, screening by low-dose
11		mammography for the presence of occult breast cancer for women
12		35 years of age or older who are eligible for medical
13		assistance under this Article, as follows: a baseline mammogram
14		for women 35 to 39 years of age and an annual mammogram for
15		women 40 years of age or older. All screenings shall include a
16		physical breast exam, instruction on self-examination and
17		information regarding the frequency of self-examination and
18		its value as a preventative tool. As used in this Section,
19		"low-dose mammography" means the x-ray examination of the
20		breast using equipment dedicated specifically for mammography,
21		including the x-ray tube, filter, compression device, image
22		receptor, and cassettes, with an average radiation exposure
23		delivery of less than one rad mid-breast, with 2 views for each
24		breast.
25		Any medical or health care provider shall immediately
26		recommend, to any pregnant woman who is being provided prenatal
27		services and is suspected of drug abuse or is addicted as
28		defined in the Alcoholism and Other Drug Abuse and Dependency
29		Act, referral to a local substance abuse treatment provider
30		licensed by the Department of Human Services or to a licensed
31		hospital which provides substance abuse treatment services.
32		The Department of Public Aid shall assure coverage for the cost
33		of treatment of the drug abuse or addiction for pregnant
34		recipients in accordance with the Illinois Medicaid Program in

1		conjunction with the Department of Human Services.
2		All medical providers providing medical assistance to
3		pregnant women under this Code shall receive information from
4		the Department on the availability of services under the Drug
5		Free Families with a Future or any comparable program providing
6		case management services for addicted women, including
7		information on appropriate referrals for other social services
8		that may be needed by addicted women in addition to treatment
9		for addiction.
10		The Illinois Department, in cooperation with the
11		Departments of Human Services (as successor to the Department
12		of Alcoholism and Substance Abuse) and Public Health, through a
13		public awareness campaign, may provide information concerning
14		treatment for alcoholism and drug abuse and addiction, prenatal
15		health care, and other pertinent programs directed at reducing
16		the number of drug-affected infants born to recipients of
17		medical assistance.
18		Neither the Illinois Department of Public Aid nor the
19		Department of Human Services shall sanction the recipient
20		solely on the basis of her substance abuse.
21		The Illinois Department shall establish such regulations
22		governing the dispensing of health services under this Article
23		as it shall deem appropriate. The Department should seek the
24		advice of formal professional advisory committees appointed by
25		the Director of the Illinois Department for the purpose of
26		providing regular advice on policy and administrative matters,
27		information dissemination and educational activities for
28		medical and health care providers, and consistency in
29		procedures to the Illinois Department.
30		The Illinois Department may develop and contract with
31		Partnerships of medical providers to arrange medical services
32		for persons eligible under Section 5-2 of this Code.
33		Implementation of this Section may be by demonstration projects
34		in certain geographic areas. The Partnership shall be

1		represented by a sponsor organization. The Department, by rule,
2		shall develop qualifications for sponsors of Partnerships.
3		Nothing in this Section shall be construed to require that the
4		sponsor organization be a medical organization.
5		The sponsor must negotiate formal written contracts with
6		medical providers for physician services, inpatient and
7		outpatient hospital care, home health services, treatment for
8		alcoholism and substance abuse, and other services determined
9		necessary by the Illinois Department by rule for delivery by
10		Partnerships. Physician services must include prenatal and
11		obstetrical care. The Illinois Department shall reimburse
12		medical services delivered by Partnership providers to clients
13		in target areas according to provisions of this Article and the
14		Illinois Health Finance Reform Act, except that:
15		(1) Physicians participating in a Partnership and
16		providing certain services, which shall be determined by
17		the Illinois Department, to persons in areas covered by the
18		Partnership may receive an additional surcharge for such
19		services.
20		(2) The Department may elect to consider and negotiate
21		financial incentives to encourage the development of
22		Partnerships and the efficient delivery of medical care.
23		(3) Persons receiving medical services through
24		Partnerships may receive medical and case management
25		services above the level usually offered through the
26		medical assistance program.
27		Medical providers shall be required to meet certain
28		qualifications to participate in Partnerships to ensure the
29		delivery of high quality medical services. These
30		qualifications shall be determined by rule of the Illinois
31		Department and may be higher than qualifications for
32		participation in the medical assistance program. Partnership
33		sponsors may prescribe reasonable additional qualifications
34		for participation by medical providers, only with the prior

1		written approval of the Illinois Department.
2		Nothing in this Section shall limit the free choice of
3		practitioners, hospitals, and other providers of medical
4		services by clients. In order to ensure patient freedom of
5		choice, the Illinois Department shall immediately promulgate
6		all rules and take all other necessary actions so that provided
7		services may be accessed from therapeutically certified
8		optometrists to the full extent of the Illinois Optometric
9		Practice Act of 1987 without discriminating between service
10		providers.
11		The Department shall apply for a waiver from the United
12		States Health Care Financing Administration to allow for the
13		implementation of Partnerships under this Section.
14		The Illinois Department shall require health care
15		providers to maintain records that document the medical care
16		and services provided to recipients of Medical Assistance under
17		this Article. The Illinois Department shall require health care
18		providers to make available, when authorized by the patient, in
19		writing, the medical records in a timely fashion to other
20		health care providers who are treating or serving persons
21		eligible for Medical Assistance under this Article. All
22		dispensers of medical services shall be required to maintain
23		and retain business and professional records sufficient to
24		fully and accurately document the nature, scope, details and
25		receipt of the health care provided to persons eligible for
26		medical assistance under this Code, in accordance with
27		regulations promulgated by the Illinois Department. The rules
28		and regulations shall require that proof of the receipt of
29		prescription drugs, dentures, prosthetic devices and
30		eyeglasses by eligible persons under this Section accompany
31		each claim for reimbursement submitted by the dispenser of such
32		medical services. No such claims for reimbursement shall be
33		approved for payment by the Illinois Department without such
34		proof of receipt, unless the Illinois Department shall have put

1		into effect and shall be operating a system of post-payment
2		audit and review which shall, on a sampling basis, be deemed
3		adequate by the Illinois Department to assure that such drugs,
4		dentures, prosthetic devices and eyeglasses for which payment
5		is being made are actually being received by eligible
6		recipients. Within 90 days after the effective date of this
7		amendatory Act of 1984, the Illinois Department shall establish
8		a current list of acquisition costs for all prosthetic devices
9		and any other items recognized as medical equipment and
10		supplies reimbursable under this Article and shall update such
11		list on a quarterly basis, except that the acquisition costs of
12		all prescription drugs shall be updated no less frequently than
13		every 30 days as required by Section 5-5.12.
14		The rules and regulations of the Illinois Department shall
15		require that a written statement including the required opinion
16		of a physician shall accompany any claim for reimbursement for
17		abortions, or induced miscarriages or premature births. This
18		statement shall indicate what procedures were used in providing
19		such medical services.
20		The Illinois Department shall require all dispensers of
21		medical services, other than an individual practitioner or
22		group of practitioners, desiring to participate in the Medical
23		Assistance program established under this Article to disclose
24		all financial, beneficial, ownership, equity, surety or other
25		interests in any and all firms, corporations, partnerships,
26		associations, business enterprises, joint ventures, agencies,
27		institutions or other legal entities providing any form of
28		health care services in this State under this Article.
29		The Illinois Department may require that all dispensers of
30		medical services desiring to participate in the medical
31		assistance program established under this Article disclose,
32		under such terms and conditions as the Illinois Department may
33		by rule establish, all inquiries from clients and attorneys
34		regarding medical bills paid by the Illinois Department, which

1		inquiries could indicate potential existence of claims or liens
2		for the Illinois Department.
3		Enrollment of a vendor that provides non-emergency medical
4		transportation, defined by the Department by rule, shall be
5		conditional for 180 days. During that time, the Department of
6		Public Aid may terminate the vendor's eligibility to
7		participate in the medical assistance program without cause.
8		That termination of eligibility is not subject to the
9		Department's hearing process.
10		The Illinois Department shall establish policies,
11		procedures, standards and criteria by rule for the acquisition,
12		repair and replacement of orthotic and prosthetic devices and
13		durable medical equipment. Such rules shall provide, but not be
14		limited to, the following services: (1) immediate repair or
15		replacement of such devices by recipients without medical
16		authorization; and (2) rental, lease, purchase or
17		lease-purchase of durable medical equipment in a
18		cost-effective manner, taking into consideration the
19		recipient's medical prognosis, the extent of the recipient's
20		needs, and the requirements and costs for maintaining such
21		equipment. Such rules shall enable a recipient to temporarily
22		acquire and use alternative or substitute devices or equipment
23		pending repairs or replacements of any device or equipment
24		previously authorized for such recipient by the Department.
25		Rules under clause (2) above shall not provide for purchase or
26		lease-purchase of durable medical equipment or supplies used
27		for the purpose of oxygen delivery and respiratory care.
28		The Department shall execute, relative to the nursing home
29		prescreening project, written inter-agency agreements with the
30		Department of Human Services and the Department on Aging, to
31		effect the following: (i) intake procedures and common
32		eligibility criteria for those persons who are receiving
33		non-institutional services; and (ii) the establishment and
34		development of non-institutional services in areas of the State

1		where they are not currently available or are undeveloped.
2		The Illinois Department shall develop and operate, in
3		cooperation with other State Departments and agencies and in
4		compliance with applicable federal laws and regulations,
5		appropriate and effective systems of health care evaluation and
6		programs for monitoring of utilization of health care services
7		and facilities, as it affects persons eligible for medical
8		assistance under this Code.
9		The Illinois Department shall report annually to the
10		General Assembly, no later than the second Friday in April of
11		1979 and each year thereafter, in regard to:
12		(a) actual statistics and trends in utilization of
13		medical services by public aid recipients;
14		(b) actual statistics and trends in the provision of
15		the various medical services by medical vendors;
16		(c) current rate structures and proposed changes in
17		those rate structures for the various medical vendors; and
18		(d) efforts at utilization review and control by the
19		Illinois Department.
20		The period covered by each report shall be the 3 years
21		ending on the June 30 prior to the report. The report shall
22		include suggested legislation for consideration by the General
23		Assembly. The filing of one copy of the report with the
24		Speaker, one copy with the Minority Leader and one copy with
25		the Clerk of the House of Representatives, one copy with the
26		President, one copy with the Minority Leader and one copy with
27		the Secretary of the Senate, one copy with the Legislative
28		Research Unit, and such additional copies with the State
29		Government Report Distribution Center for the General Assembly
30		as is required under paragraph (t) of Section 7 of the State
31		Library Act shall be deemed sufficient to comply with this
32		Section.
33		(Source: P.A. 92-16, eff. 6-28-01; 92-651, eff. 7-11-02;
34		92-789, eff. 8-6-02; 93-632, eff. 2-1-04.)

1		(305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
2		Sec. 5-5.4. Standards of Payment - Department of Public
3		Aid. The Department of Public Aid shall develop standards of
4		payment of skilled nursing and intermediate care services in
5		facilities providing such services under this Article which:
6		(1) Provide for the determination of a facility's payment
7		for skilled nursing and intermediate care services on a
8		prospective basis. The amount of the payment rate for all
9		nursing facilities certified by the Department of Public Health
10		under the Nursing Home Care Act as Intermediate Care for the
11		Developmentally Disabled facilities, Long Term Care for Under
12		Age 22 facilities, Skilled Nursing facilities, or Intermediate
13		Care facilities under the medical assistance program shall be
14		prospectively established annually on the basis of historical,
15		financial, and statistical data reflecting actual costs from
16		prior years, which shall be applied to the current rate year
17		and updated for inflation, except that the capital cost element
18		for newly constructed facilities shall be based upon projected
19		budgets. The annually established payment rate shall take
20		effect on July 1 in 1984 and subsequent years. No rate increase
21		and no update for inflation shall be provided on or after July
22		1, 1994 and before July 1, 2005 2004, unless specifically
23		provided for in this Section. The changes made by this
24		amendatory Act of the 93rd General Assembly extending the
25		duration of the prohibition against a rate increase or update
26		for inflation are effective retroactive to July 1, 2004.
27		For facilities licensed by the Department of Public Health
28		under the Nursing Home Care Act as Intermediate Care for the
29		Developmentally Disabled facilities or Long Term Care for Under
30		Age 22 facilities, the rates taking effect on July 1, 1998
31		shall include an increase of 3%. For facilities licensed by the
32		Department of Public Health under the Nursing Home Care Act as
33		Skilled Nursing facilities or Intermediate Care facilities,

1		the rates taking effect on July 1, 1998 shall include an
2		increase of 3% plus $1.10 per resident-day, as defined by the
3		Department.
4		For facilities licensed by the Department of Public Health
5		under the Nursing Home Care Act as Intermediate Care for the
6		Developmentally Disabled facilities or Long Term Care for Under
7		Age 22 facilities, the rates taking effect on July 1, 1999
8		shall include an increase of 1.6% plus $3.00 per resident-day,
9		as defined by the Department. For facilities licensed by the
10		Department of Public Health under the Nursing Home Care Act as
11		Skilled Nursing facilities or Intermediate Care facilities,
12		the rates taking effect on July 1, 1999 shall include an
13		increase of 1.6% and, for services provided on or after October
14		1, 1999, shall be increased by $4.00 per resident-day, as
15		defined by the Department.
16		For facilities licensed by the Department of Public Health
17		under the Nursing Home Care Act as Intermediate Care for the
18		Developmentally Disabled facilities or Long Term Care for Under
19		Age 22 facilities, the rates taking effect on July 1, 2000
20		shall include an increase of 2.5% per resident-day, as defined
21		by the Department. For facilities licensed by the Department of
22		Public Health under the Nursing Home Care Act as Skilled
23		Nursing facilities or Intermediate Care facilities, the rates
24		taking effect on July 1, 2000 shall include an increase of 2.5%
25		per resident-day, as defined by the Department.
26		For facilities licensed by the Department of Public Health
27		under the Nursing Home Care Act as skilled nursing facilities
28		or intermediate care facilities, a new payment methodology must
29		be implemented for the nursing component of the rate effective
30		July 1, 2003. The Department of Public Aid shall develop the
31		new payment methodology using the Minimum Data Set (MDS) as the
32		instrument to collect information concerning nursing home
33		resident condition necessary to compute the rate. The
34		Department of Public Aid shall develop the new payment

1		methodology to meet the unique needs of Illinois nursing home
2		residents while remaining subject to the appropriations
3		provided by the General Assembly. A transition period from the
4		payment methodology in effect on June 30, 2003 to the payment
5		methodology in effect on July 1, 2003 shall be provided for a
6		period not exceeding 2 years after implementation of the new
7		payment methodology as follows:
8		(A) For a facility that would receive a lower nursing
9		component rate per patient day under the new system than
10		the facility received effective on the date immediately
11		preceding the date that the Department implements the new
12		payment methodology, the nursing component rate per
13		patient day for the facility shall be held at the level in
14		effect on the date immediately preceding the date that the
15		Department implements the new payment methodology until a
16		higher nursing component rate of reimbursement is achieved
17		by that facility.
18		(B) For a facility that would receive a higher nursing
19		component rate per patient day under the payment
20		methodology in effect on July 1, 2003 than the facility
21		received effective on the date immediately preceding the
22		date that the Department implements the new payment
23		methodology, the nursing component rate per patient day for
24		the facility shall be adjusted.
25		(C) Notwithstanding paragraphs (A) and (B), the
26		nursing component rate per patient day for the facility
27		shall be adjusted subject to appropriations provided by the
28		General Assembly.
29		For facilities licensed by the Department of Public Health
30		under the Nursing Home Care Act as Intermediate Care for the
31		Developmentally Disabled facilities or Long Term Care for Under
32		Age 22 facilities, the rates taking effect on March 1, 2001
33		shall include a statewide increase of 7.85%, as defined by the
34		Department.

1		For facilities licensed by the Department of Public Health
2		under the Nursing Home Care Act as Intermediate Care for the
3		Developmentally Disabled facilities or Long Term Care for Under
4		Age 22 facilities, the rates taking effect on April 1, 2002
5		shall include a statewide increase of 2.0%, as defined by the
6		Department. This increase terminates on July 1, 2002; beginning
7		July 1, 2002 these rates are reduced to the level of the rates
8		in effect on March 31, 2002, as defined by the Department.
9		For facilities licensed by the Department of Public Health
10		under the Nursing Home Care Act as skilled nursing facilities
11		or intermediate care facilities, the rates taking effect on
12		July 1, 2001 shall be computed using the most recent cost
13		reports on file with the Department of Public Aid no later than
14		April 1, 2000, updated for inflation to January 1, 2001. For
15		rates effective July 1, 2001 only, rates shall be the greater
16		of the rate computed for July 1, 2001 or the rate effective on
17		June 30, 2001.
18		Notwithstanding any other provision of this Section, for
19		facilities licensed by the Department of Public Health under
20		the Nursing Home Care Act as skilled nursing facilities or
21		intermediate care facilities, the Illinois Department shall
22		determine by rule the rates taking effect on July 1, 2002,
23		which shall be 5.9% less than the rates in effect on June 30,
24		2002.
25		Notwithstanding any other provision of this Section, for
26		facilities licensed by the Department of Public Health under
27		the Nursing Home Care Act as skilled nursing facilities or
28		intermediate care facilities, if the payment methodologies
29		required under Section 5A-12 and the waiver granted under 42
30		CFR 433.68 are approved by the United States Centers for
31		Medicare and Medicaid Services, the Illinois Department shall
32		determine by rule the rates taking effect on July 1, 2004 2003,
33		which shall be 3.0% greater less than the rates in effect on
34		June 30, 2004 2002. These rates This rate shall take effect

1		only upon approval and implementation of the payment
2		methodologies required under Section 5A-12.
3		Notwithstanding any other provisions of this Section, for
4		facilities licensed by the Department of Public Health under
5		the Nursing Home Care Act as skilled nursing facilities or
6		intermediate care facilities, the rates taking effect on
7		January 1, 2005 shall be 3% more than the rates in effect on
8		December 31, 2004.
9		For facilities licensed by the Department of Public Health
10		under the Nursing Home Care Act as Intermediate Care for the
11		Developmentally Disabled facilities or as long-term care
12		facilities for residents under 22 years of age, the rates
13		taking effect on July 1, 2003 shall include a statewide
14		increase of 4%, as defined by the Department.
15		Rates established effective each July 1 shall govern
16		payment for services rendered throughout that fiscal year,
17		except that rates established on July 1, 1996 shall be
18		increased by 6.8% for services provided on or after January 1,
19		1997. Such rates will be based upon the rates calculated for
20		the year beginning July 1, 1990, and for subsequent years
21		thereafter until June 30, 2001 shall be based on the facility
22		cost reports for the facility fiscal year ending at any point
23		in time during the previous calendar year, updated to the
24		midpoint of the rate year. The cost report shall be on file
25		with the Department no later than April 1 of the current rate
26		year. Should the cost report not be on file by April 1, the
27		Department shall base the rate on the latest cost report filed
28		by each skilled care facility and intermediate care facility,
29		updated to the midpoint of the current rate year. In
30		determining rates for services rendered on and after July 1,
31		1985, fixed time shall not be computed at less than zero. The
32		Department shall not make any alterations of regulations which
33		would reduce any component of the Medicaid rate to a level
34		below what that component would have been utilizing in the rate

1		effective on July 1, 1984.
2		(2) Shall take into account the actual costs incurred by
3		facilities in providing services for recipients of skilled
4		nursing and intermediate care services under the medical
5		assistance program.
6		(3) Shall take into account the medical and psycho-social
7		characteristics and needs of the patients.
8		(4) Shall take into account the actual costs incurred by
9		facilities in meeting licensing and certification standards
10		imposed and prescribed by the State of Illinois, any of its
11		political subdivisions or municipalities and by the U.S.
12		Department of Health and Human Services pursuant to Title XIX
13		of the Social Security Act.
14		The Department of Public Aid shall develop precise
15		standards for payments to reimburse nursing facilities for any
16		utilization of appropriate rehabilitative personnel for the
17		provision of rehabilitative services which is authorized by
18		federal regulations, including reimbursement for services
19		provided by qualified therapists or qualified assistants, and
20		which is in accordance with accepted professional practices.
21		Reimbursement also may be made for utilization of other
22		supportive personnel under appropriate supervision.
23		(Source: P.A. 92-10, eff. 6-11-01; 92-31, eff. 6-28-01; 92-597,
24		eff. 6-28-02; 92-651, eff. 7-11-02; 92-848, eff. 1-1-03; 93-20,
25		eff. 6-20-03; 93-649, eff. 1-8-04; 93-659, eff. 2-3-04; revised
26		2-3-04.)
27		(305 ILCS 5/5-5.4c new)
28		Sec. 5-5.4c. Bed reserves; approval. The Department of
29		Public Aid shall approve bed reserves at a daily rate of 75% of
30		an individual's current Medicaid per diem, for nursing
31		facilities 90% or more of whose residents are Medicaid
32		recipients and that have occupancy levels of at least 93% for
33		resident bed reserves not exceeding 10 days.

1		(305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
2		(Section scheduled to be repealed on July 1, 2005)
3		Sec. 5A-2. Assessment; no local authorization to tax.
4		(a) Subject to Sections 5A-3 and 5A-10, an annual
5		assessment on inpatient services is imposed on each hospital
6		provider in an amount equal to the hospital's occupied bed days
7		multiplied by $84.19 for State fiscal years 2004 and 2005, if
8		the payment methodologies required under 5A-12 and the waiver
9		granted under 42 CFR 433.68 are approved with an effective date
10		prior to July 1, 2004; or the assessment will be imposed for
11		fiscal year 2005 only, if the payment methodologies required
12		under Section 5A-12 and the waiver granted under 42 CFR 433.68
13		are approved with an effective date on or after July 1, 2004 in
14		an amount equal to the hospital's occupied bed days multiplied
15		by $84.19.
16		The Department of Public Aid shall use the number of
17		occupied bed days as reported by each hospital on the Annual
18		Survey of Hospitals conducted by the Department of Public
19		Health to calculate the hospital's annual assessment. If the
20		sum of a hospital's occupied bed days is not reported on the
21		Annual Survey of Hospitals or if there are data errors in the
22		reported sum of a hospital's occupied bed days as determined by
23		the Department of Public Aid, then the Department of Public Aid
24		may obtain the sum of occupied bed days from any source
25		available, including, but not limited to, records maintained by
26		the hospital provider, which may be inspected at all times
27		during business hours of the day by the Department of Public
28		Aid or its duly authorized agents and employees.
29		(b) Nothing in this amendatory Act of the 93rd General
30		Assembly shall be construed to authorize any home rule unit or
31		other unit of local government to license for revenue or to
32		impose a tax or assessment upon hospital providers or the
33		occupation of hospital provider, or a tax or assessment

1		measured by the income or earnings of a hospital provider.
2		(c) As provided in Section 5A-14, this Section is repealed
3		on July 1, 2005.
4		(Source: P.A. 93-659, eff. 2-3-04.)
5		(305 ILCS 5/5A-4) (from Ch. 23, par. 5A-4)
6		Sec. 5A-4. Payment of assessment; penalty.
7		(a) The annual assessment imposed by Section 5A-2 for State
8		fiscal year 2004 shall be due and payable on June 18 of the
9		year. The assessment imposed by Section 5A-2 for State fiscal
10		year 2005 shall be due and payable in quarterly installments,
11		each equalling one-fourth of the assessment for the year, on
12		July 19, October 19, January 18, and April 19 of the year. No
13		installment payment of an assessment imposed by Section 5A-2
14		shall be due and payable, however, until after: (i) the
15		hospital provider receives written notice from the Department
16		of Public Aid that the payment methodologies to hospitals
17		required under Section 5A-12 have been approved by the Centers
18		for Medicare and Medicaid Services of the U.S. Department of
19		Health and Human Services and the waiver under 42 CFR 433.68
20		for the assessment imposed by Section 5A-2 has been granted by
21		the Centers for Medicare and Medicaid Services of the U.S.
22		Department of Health and Human Services; and (ii) the hospital
23		has received the payments required under Section 5A-12. Upon
24		notification to the Department of approval of the payment
25		methodologies required under Section 5A-12 and the waiver
26		granted under 42 CFR 433.68, all quarterly installments
27		otherwise due under Section 5A-2 prior to the date of
28		notification shall be due and payable to the Department within
29		30 days of the date of notification.
30		(b) The Illinois Department is authorized to establish
31		delayed payment schedules for hospital providers that are
32		unable to make installment payments when due under this Section
33		due to financial difficulties, as determined by the Illinois

1		Department.
2		(c) If a hospital provider fails to pay the full amount of
3		an installment when due (including any extensions granted under
4		subsection (b)), there shall, unless waived by the Illinois
5		Department for reasonable cause, be added to the assessment
6		imposed by Section 5A-2 a penalty assessment equal to the
7		lesser of (i) 5% of the amount of the installment not paid on
8		or before the due date plus 5% of the portion thereof remaining
9		unpaid on the last day of each 30-day period thereafter or (ii)
10		100% of the installment amount not paid on or before the due
11		date. For purposes of this subsection, payments will be
12		credited first to unpaid installment amounts (rather than to
13		penalty or interest), beginning with the most delinquent
14		installments.
15		(Source: P.A. 93-659, eff. 2-3-04.)
16		(305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)
17		Sec. 5A-5. Notice; penalty; maintenance of records.
18		(a) After December 31 of each year (except as otherwise
19		provided in this subsection), and on or before March 31 of the
20		succeeding year, the The Department of Public Aid shall send a
21		notice of assessment to every hospital provider subject to
22		assessment under this Article. The notice of assessment shall
23		notify the hospital of its assessment and for the State fiscal
24		year commencing on the next July 1, except that the notice for
25		the State fiscal year commencing July 1, 2003 shall be sent
26		within 14 days of receipt by the Department of notification
27		from the Centers for Medicare and Medicaid Services of the U.S.
28		Department of Health and Human Services that the payment
29		methodologies required under Section 5A-12 and the waiver
30		granted under 42 CFR 433.68 have been approved on or before
31		June 1, 2004. The notice shall be on a form prepared by the
32		Illinois Department and shall state the following:
33		(1) The name of the hospital provider.

1		(2) The address of the hospital provider's principal
2		place of business from which the provider engages in the
3		occupation of hospital provider in this State, and the name
4		and address of each hospital operated, conducted, or
5		maintained by the provider in this State.
6		(3) The occupied bed days of the hospital provider, the
7		amount of assessment imposed under Section 5A-2 for the
8		State fiscal year for which the notice is sent, and the
9		amount of each quarterly installment to be paid during the
10		State fiscal year.
11		(4) (Blank).
12		(5) Other reasonable information as determined by the
13		Illinois Department.
14		(b) If a hospital provider conducts, operates, or maintains
15		more than one hospital licensed by the Illinois Department of
16		Public Health, the provider shall pay the assessment for each
17		hospital separately.
18		(c) Notwithstanding any other provision in this Article, in
19		the case of a person who ceases to conduct, operate, or
20		maintain a hospital in respect of which the person is subject
21		to assessment under this Article as a hospital provider, the
22		assessment for the State fiscal year in which the cessation
23		occurs shall be adjusted by multiplying the assessment computed
24		under Section 5A-2 by a fraction, the numerator of which is the
25		number of days in the year during which the provider conducts,
26		operates, or maintains the hospital and the denominator of
27		which is 365. Immediately upon ceasing to conduct, operate, or
28		maintain a hospital, the person shall pay the assessment for
29		the year as so adjusted (to the extent not previously paid).
30		(d) Notwithstanding any other provision in this Article, a
31		provider who commences conducting, operating, or maintaining a
32		hospital, upon notice by the Illinois Department, shall pay the
33		assessment computed under Section 5A-2 and subsection (e) in
34		installments on the due dates stated in the notice and on the

1		regular installment due dates for the State fiscal year
2		occurring after the due dates of the initial notice.
3		(e) Notwithstanding any other provision in this Article, in
4		the case of a hospital provider that did not conduct, operate,
5		or maintain a hospital throughout calendar year 2001, the
6		assessment for that State fiscal year shall be computed on the
7		basis of hypothetical occupied bed days for the full calendar
8		year as determined by the Illinois Department.
9		(f) (Blank).
10		(g) (Blank).
11		(h) (Blank).
12		(Source: P.A. 93-659, eff. 2-3-04.)
13		(305 ILCS 5/5A-7) (from Ch. 23, par. 5A-7)
14		Sec. 5A-7. Administration; enforcement provisions.
15		(a) The Illinois Department shall establish and maintain a
16		listing of all hospital providers appearing in the licensing
17		records of the Illinois Department of Public Health, which
18		shall show each provider's name and principal place of business
19		and the name and address of each hospital operated, conducted,
20		or maintained by the provider in this State. The Illinois
21		Department shall administer and enforce this Article and
22		collect the assessments and penalty assessments imposed under
23		this Article using procedures employed in its administration of
24		this Code generally. The Illinois Department, its Director, and
25		every hospital provider subject to assessment measured by
26		occupied bed days shall have the following powers, duties, and
27		rights:
28		(1) The Illinois Department may initiate either
29		administrative or judicial proceedings, or both, to
30		enforce provisions of this Article. Administrative
31		enforcement proceedings initiated hereunder shall be
32		governed by the Illinois Department's administrative
33		rules. Judicial enforcement proceedings initiated

1		hereunder shall be governed by the rules of procedure
2		applicable in the courts of this State.
3		(2) No proceedings for collection, refund, credit, or
4		other adjustment of an assessment amount shall be issued
5		more than 3 years after the due date of the assessment,
6		except in the case of an extended period agreed to in
7		writing by the Illinois Department and the hospital
8		provider before the expiration of this limitation period.
9		(3) Any unpaid assessment under this Article shall
10		become a lien upon the assets of the hospital upon which it
11		was assessed. If any hospital provider, outside the usual
12		course of its business, sells or transfers the major part
13		of any one or more of (A) the real property and
14		improvements, (B) the machinery and equipment, or (C) the
15		furniture or fixtures, of any hospital that is subject to
16		the provisions of this Article, the seller or transferor
17		shall pay the Illinois Department the amount of any
18		assessment, assessment penalty, and interest (if any) due
19		from it under this Article up to the date of the sale or
20		transfer. If the seller or transferor fails to pay any
21		assessment, assessment penalty, and interest (if any) due,
22		the purchaser or transferee of such asset shall be liable
23		for the amount of the assessment, penalties, and interest
24		(if any) up to the amount of the reasonable value of the
25		property acquired by the purchaser or transferee. The
26		purchaser or transferee shall continue to be liable until
27		the purchaser or transferee pays the full amount of the
28		assessment, penalties, and interest (if any) up to the
29		amount of the reasonable value of the property acquired by
30		the purchaser or transferee or until the purchaser or
31		transferee receives from the Illinois Department a
32		certificate showing that such assessment, penalty, and
33		interest have been paid or a certificate from the Illinois
34		Department showing that no assessment, penalty, or

1		interest is due from the seller or transferor under this
2		Article.
3		(4) Payments under this Article are not subject to the
4		Illinois Prompt Payment Act. Credits or refunds shall not
5		bear interest.
6		(b) In addition to any other remedy provided for and
7		without sending a notice of assessment liability, the Illinois
8		Department may collect an unpaid assessment by withholding, as
9		payment of the assessment, reimbursements or other amounts
10		otherwise payable by the Illinois Department to the hospital
11		provider.
12		(a) To the extent practicable, the Illinois Department
13		shall administer and enforce this Article and collect the
14		assessments, interest, and penalty assessments imposed under
15		this Article using procedures employed in its administration of
16		this Code generally and, as it deems appropriate, in a manner
17		similar to that in which the Department of Revenue administers
18		and collects the retailers' occupation tax under the Retailers'
19		Occupation Tax Act ("ROTA"). Instead of certificates of
20		registration, the Illinois Department shall establish and
21		maintain a listing of all hospital providers appearing in the
22		licensing records of the Department of Public Health, which
23		shall show each provider's name, principal place of business,
24		and the name and address of each hospital operated, conducted,
25		or maintained by the provider in this State. In addition, the
26		following specified provisions of the Retailers' Occupation
27		Tax Act are incorporated by reference into this Section except
28		that the Illinois Department and its Director (rather than the
29		Department of Revenue and its Director) and every hospital
30		provider subject to assessment measured by occupied bed days
31		(rather than persons subject to retailers' occupation tax
32		measured by gross receipts from the sale of tangible personal
33		property at retail) shall have the powers, duties, and rights
34		specified in these ROTA provisions, as modified in this Section

1		or by the Illinois Department in a manner consistent with this
2		Article and except as manifestly inconsistent with the other
3		provisions of this Article:
4		(1) ROTA, Section 4 (examination of return; notice of
5		correction; evidence; limitations; protest and hearing),
6		except that (i) the Illinois Department shall issue notices
7		of assessment liability (rather than notices of tax
8		liability as provided in ROTA, Section 4); (ii) in the case
9		of a fraudulent return or in the case of an extended period
10		agreed to by the Illinois Department and the hospital
11		provider before the expiration of the limitation period, no
12		notice of assessment liability shall be issued more than 3
13		years after the later of the due date of the return
14		required by Section 5A-5 or the date the return (or an
15		amended return) was filed (rather within the period stated
16		in ROTA, Section 4); and (iii) the penalty provisions of
17		ROTA, Section 4 shall not apply.
18		(2) ROTA, Sec. 5 (failure to make return; failure to
19		pay assessment), except that the penalty and interest
20		provisions of ROTA, Section 5 shall not apply.
21		(3) ROTA, Section 5a (lien; attachment; termination;
22		notice; protest; review; release of lien; status of lien).
23		(4) ROTA, Section 5b (State lien notices; State lien
24		index; duties of recorder and registrar of titles).
25		(5) ROTA, Section 5c (liens; certificate of release).
26		(6) ROTA, Section 5d (Department not required to
27		furnish bond; claim to property attached or levied upon).
28		(7) ROTA, Section 5e (foreclosure on liens;
29		enforcement).
30		(8) ROTA, Section 5f (demand for payment; levy and sale
31		of property; limitation).
32		(9) ROTA, Section 5g (sale of property; redemption).
33		(10) ROTA, Section 5j (sales on transfers outside usual
34		course of business; report; payment of assessment; rights

1		and duties of purchaser; penalty), except that notice shall
2		be provided to the Illinois Department as specified by
3		rule.
4		(11) ROTA, Section 6 (erroneous payments; credit or
5		refund), provided that (i) the Illinois Department may only
6		apply an amount otherwise subject to credit or refund to a
7		liability arising under this Article; (ii) except in the
8		case of an extended period agreed to by the Illinois
9		Department and the hospital provider before the expiration
10		of this limitation period, a claim for credit or refund
11		must be filed no more than 3 years after the due date of
12		the return required by Section 5A-5 (rather than the time
13		limitation stated in ROTA, Section 6); and (iii) credits or
14		refunds shall not bear interest.
15		(12) ROTA, Section 6a (claims for credit or refund).
16		(13) ROTA, Section 6b (tentative determination of
17		claim; notice; hearing; review), provided that a hospital
18		provider or its representative shall have 60 days (rather
19		than 20 days) within which to file a protest and request
20		for hearing in response to a tentative determination of
21		claim.
22		(14) ROTA, Section 6c (finality of tentative
23		determinations).
24		(15) ROTA, Section 8 (investigations and hearings).
25		(16) ROTA, Section 9 (witness; immunity).
26		(17) ROTA, Section 10 (issuance of subpoenas;
27		attendance of witnesses; production of books and records).
28		(18) ROTA, Section 11 (information confidential;
29		exceptions).
30		(19) ROTA, Section 12 (rules and regulations; hearing;
31		appeals), except that a hospital provider shall not be
32		required to file a bond or be subject to a lien in lieu
33		thereof in order to seek court review under the
34		Administrative Review Law of a final assessment or revised

1		final assessment or the equivalent thereof issued by the
2		Illinois Department under this Article.
3		(b) In addition to any other remedy provided for and
4		without sending a notice of assessment liability, the Illinois
5		Department may collect an unpaid assessment by withholding, as
6		payment of the assessment, reimbursements or other amounts
7		otherwise payable by the Illinois Department to the provider.
8		(Source: P.A. 93-659, eff. 2-3-04.)
9		(305 ILCS 5/5A-12)
10		(Section scheduled to be repealed on July 1, 2005)
11		Sec. 5A-12. Hospital access improvement payments.
12		(a) To improve access to hospital services, for hospital
13		services rendered on or after June 1, 2004, the Department of
14		Public Aid shall make payments to hospitals as set forth in
15		this Section, except for hospitals described in subsection (b)
16		of Section 5A-3. These payments shall be paid on a quarterly
17		basis. For State fiscal year 2004, if the effective date of the
18		approval of the payment methodology required under this Section
19		and the waiver granted under 42 CFR 433.68 by the Centers for
20		Medicare and Medicaid Services of the U.S. Department of Health
21		and Human Services is prior to July 1, 2004, the Department
22		shall pay the total amounts required for fiscal year 2004 under
23		this Section within 25 days of the latest notification ; these
24		amounts shall be paid on or before June 15 of the year. No
25		payment shall be made for State fiscal year 2004 if the
26		effective date of the approval is on or after July 1, 2004. In
27		State fiscal year 2005 subsequent State fiscal years, the total
28		amounts required under this Section shall be paid in 4 equal
29		installments on or before July 15, October 15, January 14, and
30		April 15 of the year, except that if the date of notification
31		of the approval of the payment methodologies required under
32		this Section and the waiver granted under 42 CFR 433.68 is on
33		or after July 1, 2004, the sum of amounts required under this

1		Section prior to the date of notification shall be paid within
2		25 days of the date of the last notification. Payments under
3		this Section are not due and payable, however, until (i) the
4		methodologies described in this Section are approved by the
5		federal government in an appropriate State Plan amendment, (ii)
6		the assessment imposed under this Article is determined to be a
7		permissible tax under Title XIX of the Social Security Act, and
8		(iii) the assessment is in effect.
9		(b) High volume payment. In addition to rates paid for
10		inpatient hospital services, the Department of Public Aid shall
11		pay, to each Illinois hospital that provided more than 20,000
12		Medicaid inpatient days of care during State fiscal year 2001
13		(except for hospitals that qualify for adjustment payments
14		under Section 5-5.02 for the 12-month period beginning on
15		October 1, 2002), $190 for each Medicaid inpatient day of care
16		provided during that fiscal year. A hospital that provided less
17		than 30,000 Medicaid inpatient days of care during that period,
18		however, is not entitled to receive more than $3,500,000 per
19		year in such payments.
20		(c) Medicaid inpatient utilization rate adjustment. In
21		addition to rates paid for inpatient hospital services, the
22		Department of Public Aid shall pay each Illinois hospital
23		(except for hospitals described in Section 5A-3), for each
24		Medicaid inpatient day of care provided during State fiscal
25		year 2001, an amount equal to the product of $57.25 multiplied
26		by the quotient of 1 divided by the greater of 1.6% or the
27		hospital's Medicaid inpatient utilization rate (as used to
28		determine eligibility for adjustment payments under Section
29		5-5.02 for the 12-month period beginning on October 1, 2002).
30		The total payments under this subsection to a hospital may not
31		exceed $10,500,000 annually.
32		(d) Psychiatric base rate adjustment.
33		(1) In addition to rates paid for inpatient psychiatric
34		services, the Department of Public Aid shall pay each

1		Illinois general acute care hospital with a distinct
2		part-psychiatric unit, for each Medicaid inpatient
3		psychiatric day of care provided in State fiscal year 2001,
4		an amount equal to $400 less the hospital's per-diem rate
5		for Medicaid inpatient psychiatric services as in effect on
6		October 1, 2003. In no event, however, shall that amount be
7		less than zero.
8		(2) For distinct part-psychiatric units of Illinois
9		general acute care hospitals, except for all hospitals
10		excluded in Section 5A-3, whose inpatient per-diem rate as
11		in effect on October 1, 2003 is greater than $400, the
12		Department shall pay, in addition to any other amounts
13		authorized under this Code, $25 for each Medicaid inpatient
14		psychiatric day of care provided in State fiscal year 2001.
15		(e) Supplemental tertiary care adjustment. In addition to
16		rates paid for inpatient services, the Department of Public Aid
17		shall pay to each Illinois hospital eligible for tertiary care
18		adjustment payments under 89 Ill. Adm. Code 148.296, as in
19		effect for State fiscal year 2003, a supplemental tertiary care
20		adjustment payment equal to the tertiary care adjustment
21		payment required under 89 Ill. Adm. Code 148.296, as in effect
22		for State fiscal year 2003.
23		(f) Medicaid outpatient utilization rate adjustment. In
24		addition to rates paid for outpatient hospital services, the
25		Department of Public Aid shall pay each Illinois hospital
26		(except for hospitals described in Section 5A-3), an amount
27		equal to the product of 2.45% multiplied by the hospital's
28		Medicaid outpatient charges multiplied by the quotient of 1
29		divided by the greater of 1.6% or the hospital's Medicaid
30		outpatient utilization rate. The total payments under this
31		subsection to a hospital may not exceed $6,750,000 annually.
32		For purposes of this subsection:
33		"Medicaid outpatient charges" means the charges for
34		outpatient services provided to Medicaid patients for State

1		fiscal year 2001 as submitted by the hospital on the UB-92
2		billing form or under the ambulatory procedure listing and
3		adjudicated by the Department of Public Aid on or before
4		September 12, 2003.
5		"Medicaid outpatient utilization rate" means a fraction,
6		the numerator of which is the hospital's Medicaid outpatient
7		charges and the denominator of which is the total number of the
8		hospital's charges for outpatient services for the hospital's
9		fiscal year ending in 2001.
10		(g) State outpatient service adjustment. In addition to
11		rates paid for outpatient hospital services, the Department of
12		Public Aid shall pay each Illinois hospital an amount equal to
13		the product of 75.5% multiplied by the hospital's Medicaid
14		outpatient services submitted to the Department on the UB-92
15		billing form for State fiscal year 2001 multiplied by the
16		hospital's outpatient access fraction.
17		For purposes of this subsection, "outpatient access
18		fraction" means a fraction, the numerator of which is the
19		hospital's Medicaid payments for outpatient services for
20		ambulatory procedure listing services submitted to the
21		Department on the UB-92 billing form for State fiscal year
22		2001, and the denominator of which is the hospital's Medicaid
23		outpatient services submitted to the Department on the UB-92
24		billing form for State fiscal year 2001.
25		The total payments under this subsection to a hospital may
26		not exceed $3,000,000 annually.
27		(h) Rural hospital outpatient adjustment. In addition to
28		rates paid for outpatient hospital services, the Department of
29		Public Aid shall pay each Illinois rural hospital an amount
30		equal to the product of $14,500,000 multiplied by the rural
31		hospital outpatient adjustment fraction.
32		For purposes of this subsection, "rural hospital
33		outpatient adjustment fraction" means a fraction, the
34		numerator of which is the hospital's Medicaid visits for

1		outpatient services for ambulatory procedure listing services
2		submitted to the Department on the UB-92 billing form for State
3		fiscal year 2001, and the denominator of which is the total
4		Medicaid visits for outpatient services for ambulatory
5		procedure listing services for all Illinois rural hospitals
6		submitted to the Department on the UB-92 billing form for State
7		fiscal year 2001.
8		For purposes of this subsection, "rural hospital" has the
9		same meaning as in 89 Ill. Adm. Code 148.25, as in effect on
10		September 30, 2003.
11		(i) Merged/closed hospital adjustment. If any hospital
12		files a combined Medicaid cost report with another hospital
13		after January 1, 2001, and if that hospital subsequently
14		closes, then except for the payments described in subsection
15		(e), all payments described in the various subsections of this
16		Section shall, before the application of the annual limitation
17		amount specified in each such subsection, be multiplied by a
18		fraction, the numerator of which is the number of occupied bed
19		days attributable to the open hospital and the denominator of
20		which is the sum of the number of occupied bed days of each
21		open hospital and each closed hospital. For purposes of this
22		subsection, "occupied bed days" has the same meaning as the
23		term is defined in 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 repealed
29		on July 1, 2005.
30		(Source: P.A. 93-659, eff. 2-3-04.)

31		(305 ILCS 5/12-10.7 new)
32		Sec. 12-10.7. The Health and Human Services Medicaid Trust
33		Fund.

1		(a) The Health and Human Services Medicaid Trust Fund shall
2		consist of (i) moneys appropriated or transferred into the
3		Fund, pursuant to statute, (ii) federal financial
4		participation moneys received pursuant to expenditures from
5		the Fund, and (iii) the interest earned on moneys in the Fund.
6		(b) Subject to appropriation, the moneys in the Fund shall
7		be used by a State agency for such purposes as that agency may,
8		by the appropriation language, be directed.

9		Section 35. The Senior Citizens and Disabled Persons
10		Property Tax Relief and Pharmaceutical Assistance Act is
11		amended by changing Section 6 as follows:
12		(320 ILCS 25/6) (from Ch. 67 1/2, par. 406)
13		Sec. 6. Administration.
14		(a) In general. Upon receipt of a timely filed claim, the
15		Department shall determine whether the claimant is a person
16		entitled to a grant under this Act and the amount of grant to
17		which he is entitled under this Act. The Department may require
18		the claimant to furnish reasonable proof of the statements of
19		domicile, household income, rent paid, property taxes accrued
20		and other matters on which entitlement is based, and may
21		withhold payment of a grant until such additional proof is
22		furnished.
23		(b) Rental determination. If the Department finds that the
24		gross rent used in the computation by a claimant of rent
25		constituting property taxes accrued exceeds the fair rental
26		value for the right to occupy that residence, the Department
27		may determine the fair rental value for that residence and
28		recompute rent constituting property taxes accrued
29		accordingly.
30		(c) Fraudulent claims. The Department shall deny claims
31		which have been fraudulently prepared or when it finds that the
32		claimant has acquired title to his residence or has paid rent

1		for his residence primarily for the purpose of receiving a
2		grant under this Act.
3		(d) Pharmaceutical Assistance. The Department shall allow
4		all pharmacies licensed under the Pharmacy Practice Act of 1987
5		to participate as authorized pharmacies unless they have been
6		removed from that status for cause pursuant to the terms of
7		this Section. The Director of the Department may enter into a
8		written contract with any State agency, instrumentality or
9		political subdivision, or a fiscal intermediary for the purpose
10		of making payments to authorized pharmacies for covered
11		prescription drugs and coordinating the program of
12		pharmaceutical assistance established by this Act with other
13		programs that provide payment for covered prescription drugs.
14		Such agreement shall establish procedures for properly
15		contracting for pharmacy services, validating reimbursement
16		claims, validating compliance of dispensing pharmacists with
17		the contracts for participation required under this Section,
18		validating the reasonable costs of covered prescription drugs,
19		and otherwise providing for the effective administration of
20		this Act.
21		The Department shall promulgate rules and regulations to
22		implement and administer the program of pharmaceutical
23		assistance required by this Act, which shall include the
24		following:
25		(1) Execution of contracts with pharmacies to dispense
26		covered prescription drugs. Such contracts shall stipulate
27		terms and conditions for authorized pharmacies
28		participation and the rights of the State to terminate such
29		participation for breach of such contract or for violation
30		of this Act or related rules and regulations of the
31		Department;
32		(2) Establishment of maximum limits on the size of
33		prescriptions, new or refilled, which shall be in amounts
34		sufficient for 34 days, except as otherwise specified by

1		rule for medical or utilization control reasons;
2		(3) Establishment of liens upon any and all causes of
3		action which accrue to a beneficiary as a result of
4		injuries for which covered prescription drugs are directly
5		or indirectly required and for which the Director made
6		payment or became liable for under this Act;
7		(4) Charge or collection of payments from third parties
8		or private plans of assistance, or from other programs of
9		public assistance for any claim that is properly chargeable
10		under the assignment of benefits executed by beneficiaries
11		as a requirement of eligibility for the pharmaceutical
12		assistance identification card under this Act;
13		(4.5) Provision for automatic enrollment of
14		beneficiaries into a Medicare Discount Card program
15		authorized under the federal Medicare Modernization Act of
16		2003 (P.L. 108-391) to coordinate coverage including
17		Medicare Transitional Assistance;
18		(5) Inspection of appropriate records and audit of
19		participating authorized pharmacies to ensure contract
20		compliance, and to determine any fraudulent transactions
21		or practices under this Act;
22		(6) Annual determination of the reasonable costs of
23		covered prescription drugs for which payments are made
24		under this Act, as provided in Section 3.16;
25		(7) Payment to pharmacies under this Act in accordance
26		with the State Prompt Payment Act.
27		The Department shall annually report to the Governor and
28		the General Assembly by March 1st of each year on the
29		administration of pharmaceutical assistance under this Act. By
30		the effective date of this Act the Department shall determine
31		the reasonable costs of covered prescription drugs in
32		accordance with Section 3.16 of this Act.
33		(Source: P.A. 91-357, eff. 7-29-99; 92-651, eff. 7-11-02.)

1		Section 40. The Illinois Food, Drug and Cosmetic Act is
2		amended by changing Section 3.14 as follows:
3		(410 ILCS 620/3.14) (from Ch. 56 1/2, par. 503.14)
4		Sec. 3.14. Dispensing or causing to be dispensed a
5		different drug in place of the drug or brand of drug ordered or
6		prescribed without the express permission of the person
7		ordering or prescribing. However, this Section does not
8		prohibit the interchange of different brands of the same
9		generically equivalent drug product, when the drug products are
10		not required to bear the legend "Caution: Federal law prohibits
11		dispensing without prescription", provided that the same
12		dosage form is dispensed and there is no greater than 1%
13		variance in the stated amount of each active ingredient of the
14		drug products. Nothing in this Section shall prohibit the
15		selection of different brands of the same generic drug, based
16		upon a drug formulary listing which is developed, maintained,
17		and issued by the Department of Public Health under which drug
18		product selection is permitted, is not subject to review at a
19		meeting of the Technical Advisory Council, is not subject to a
20		hearing in accordance with this Section, or is not specifically
21		prohibited. A generic drug determined to be therapeutically
22		equivalent by the United States Food and Drug Administration
23		(FDA) shall be available for substitution in Illinois in
24		accordance with this Act and the Pharmacy Practice Act of 1987,
25		provided that each manufacturer submits to the Director of the
26		Department of Public Health a notification containing product
27		technical bioequivalence information as a prerequisite to
28		product substitution when they have completed all required
29		testing to support FDA product approval and, in any event, the
30		information shall be submitted no later than 60 days prior to
31		product substitution in the State. If the Technical Advisory
32		Council finds that a generic drug product may have issues
33		related to the practice of medicine or the practice of

1		pharmacy, the Technical Advisory Council shall review the
2		generic drug product at its next regularly scheduled Technical
3		Advisory Council meeting. Following the Technical Advisory
4		Council's review and initial recommendation that a generic drug
5		product not be included in the Illinois Formulary, a hearing
6		shall be conducted in accordance with the Department's Rules of
7		Practice and Procedure in Administrative Hearings (77 Ill.
8		Admin. Code 100) and Article 10 of the Illinois Administrative
9		Procedure Act if requested by the manufacturer. The Technical
10		Advisory Council shall make its recommendation to the
11		Department of Public Health within 20 business days after the
12		public hearing. If the Department of Public Health, on the
13		recommendation of the Technical Advisory Council, determines
14		that, based upon a preponderance of the evidence, the drug is
15		not bioequivalent, not therapeutically equivalent, or could
16		cause clinically significant harm to the health or safety of
17		patients receiving that generic drug, the Department of Public
18		Health may prohibit the generic drug from substitution in the
19		State. A decision by the Department to prohibit a drug product
20		from substitution shall constitute a final administrative
21		decision within the meaning of Section 22.2 of the Illinois
22		Food, Drug and Cosmetic Act and Section 3-101 of the Code of
23		Civil Procedure, and shall be subject to judicial review
24		pursuant to the provisions of Article III of the Administrative
25		Review Law. A decision to prohibit a generic drug from
26		substitution must be accompanied by a written detailed
27		explanation of the basis for the decision. Determination of
28		products which may be selected shall be recommended by a
29		Technical Advisory Council of the Department, selected by the
30		Director of Public Health, which council shall consist of 7
31		persons including 2 physicians, 2 pharmacists, 2
32		pharmacologists and one other prescriber who have special
33		knowledge of generic drugs and formulary. Technical Advisory
34		Council members shall serve without pay, and shall be appointed

1		for a 3 year term and until their successors are appointed and
2		qualified. The procedures for operation of the Drug Product
3		Selection Program shall be promulgated by the Director, however
4		the actual list of products prohibited or approved for drug
5		product selection need not be promulgated. The Technical
6		Advisory Council shall take cognizance of federal studies, the
7		U.S. Pharmacopoeia - National Formulary, or other recognized
8		authoritative sources, and shall advise the Director of any
9		necessary modifications. Drug products previously approved by
10		the Technical Advisory Council for generic interchange may be
11		substituted in the State of Illinois without further review
12		subject to the conditions of approval in the State of Illinois
13		prior to the effective date of this amendatory Act of the 91st
14		General Assembly.
15		Timely notice of revisions to the formulary shall be
16		furnished at no charge to all pharmacies by the Department.
17		Single copies of the drug formulary shall be made available at
18		no charge upon request to licensed prescribers, student
19		pharmacists, and pharmacists practicing pharmacy in this State
20		under a reciprocal license. The Department shall offer
21		subscriptions to the drug formulary and its revisions to other
22		interested parties at a reasonable charge to be established by
23		rule. Before the Department makes effective any additions to or
24		deletions from the procedures for operation of the Drug Product
25		Selection Program under this Section, the Department shall file
26		proposed rules to amend the procedures for operation of the
27		program under Section 5-40 of the Illinois Administrative
28		Procedure Act. The Department shall issue necessary rules and
29		regulations for the implementation of this Section.
30		(Source: P.A. 91-766, eff. 9-1-00; 92-112, eff. 7-20-01.)

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