Full Text of SB3743 96th General Assembly
SB3743sam002 96TH GENERAL ASSEMBLY
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Sen. Christine Radogno
Filed: 3/12/2010
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| AMENDMENT TO SENATE BILL 3743
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| AMENDMENT NO. ______. Amend Senate Bill 3743, AS AMENDED, | 3 |
| with reference to Senate Amendment 1 as follows:
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| on page 3, line 12, by adding before the period the following: | 5 |
| ", or a hospital that begins operations after January 1, 2010 | 6 |
| and is designated by Medicare as a long term acute care | 7 |
| hospital."; and | 8 |
| on page 4, line 4, by deleting "on the effective date of this | 9 |
| Act" and replacing it with "October 1, 2010"; and | 10 |
| on page 5, line 1, by inserting "to the Department" before "the | 11 |
| CARE tool"; and | 12 |
| on page 5, line 11, by inserting after "hospital" the | 13 |
| following: | 14 |
| "with the exception of STAC hospitals identified in paragraphs |
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| (1) and (2) under subsection (a) of Section 25 of this Act"; | 2 |
| and | 3 |
| on page 6, line 12, by deleting "The quotient of:"; and | 4 |
| on page 6, by deleting lines 13 through 16; and | 5 |
| on page 6, line 19, by deleting "The quotient of:"; and | 6 |
| on page 6, by deleting lines 20 through 22; and | 7 |
| on page 6, line 25, by deleting "The"; and | 8 |
| on page 6, by deleting line 26; and | 9 |
| on page 7, by deleting lines 1 through 17; and | 10 |
| on page 7, line 22, by deleting "The quotient of:"; and | 11 |
| on page 7, by deleting lines 23 through 26; and | 12 |
| by deleting page 8; and | 13 |
| on page 9, line 1, by deleting "The"; and | 14 |
| on page 9, by deleting lines 2 through 20; and |
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| on page 9, by deleting line 26; and | 2 |
| by deleting page 10; and | 3 |
| on page 11, by deleting lines 1 through 4; and | 4 |
| on page 12, line 7, by replacing "with a notice to the | 5 |
| Department" with "with 30 calendar days' notice to the | 6 |
| Department."; and | 7 |
| on page 12, by deleting lines 8 through 10; and | 8 |
| on page 12, by replacing lines 11 through 13 with the | 9 |
| following: | 10 |
| "(c) The LTAC hospital must develop patient and family | 11 |
| education materials concerning the Program and submit those | 12 |
| materials to the Department for review and approval."; and | 13 |
| on page 12, line 21, by replacing "who" with ":"; and | 14 |
| on page 12, by replacing lines 22 and 23 with the following: | 15 |
| "(1) who upon admission to the LTAC hospital meet LTAC | 16 |
| hospital criteria; and | 17 |
| (2) whose care is primarily paid for by the Department | 18 |
| under Title XIX of the Social Security Act or whose care is |
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| primarily paid for by the Department after the patient has | 2 |
| exhausted his or her benefits under Medicare."; and | 3 |
| on page 13, line 1, by replacing "the LTAC hospital no" with | 4 |
| "any of the following conditions are met:"; and | 5 |
| on page 13, by replacing lines 2 through 6 with the following: | 6 |
| "(1) the LTAC hospital no longer meets the requirements | 7 |
| under Section 15 of this Act or terminates the agreement | 8 |
| specified under Section 15 of this Act; | 9 |
| (2) the patient does not meet the LTAC hospital | 10 |
| criteria upon admission; or | 11 |
| (3) the patient's care is primarily paid for by | 12 |
| Medicare and the patient has not exhausted his or her | 13 |
| Medicare benefits, resulting in the Department becoming | 14 |
| the primary payer."; and | 15 |
| on page 13, by replacing lines 7 through 14 with the following: | 16 |
| "(c) The Department may adjust the LTAC supplemental per | 17 |
| diem rate calculated under this Section based only on the | 18 |
| conditions and requirements described under Section 40 and | 19 |
| Section 45 of this Act."; and | 20 |
| on page 14, by inserting immediately below line 12 the | 21 |
| following: |
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| "Section 40. Rate adjustments for quality measures. | 2 |
| (a) The Department may adjust the LTAC supplemental per | 3 |
| diem rate calculated under Section 35 of this Act based on the | 4 |
| requirements of this Section. | 5 |
| (b) After the first year of operation of the Program | 6 |
| established by this Act, the Department may reduce the LTAC | 7 |
| supplemental per diem rate calculated under Section 35 of this | 8 |
| Act by no more than 5% for an LTAC hospital that does not meet | 9 |
| benchmarks or targets set by the Department under paragraph (2) | 10 |
| of subsection (b) of Section 50. | 11 |
| (c) After the first year of operation of the Program | 12 |
| established by this Act, the Department may increase the LTAC | 13 |
| supplemental per diem rate calculated under Section 35 of this | 14 |
| Act by no more than 5% for an LTAC hospital that exceeds the | 15 |
| benchmarks or targets set by the Department under paragraph (2) | 16 |
| of subsection (a) of Section 50. | 17 |
| (d) If an LTAC hospital misses a majority of the benchmarks | 18 |
| for quality measures for 3 consecutive years, the Department | 19 |
| may reduce the LTAC supplemental per diem rate calculated under | 20 |
| Section 35 of this Act to zero. | 21 |
| (e) An LTAC hospital whose rate is reduced under subsection | 22 |
| (d) of this Section may have the LTAC supplemental per diem | 23 |
| rate calculated under Section 35 of this Act reinstated once | 24 |
| the LTAC hospital achieves the necessary benchmarks or targets. | 25 |
| (f) The Department may apply the reduction described in | 26 |
| subsection (d) of this Section after one year instead of 3 to |
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| an LTAC hospital that has had its rate previously reduced under | 2 |
| subsection (d) of this Section and later has had it reinstated | 3 |
| under subsection (e) of this Section. | 4 |
| (g) The rate adjustments described in this Section shall be | 5 |
| determined and applied only at the beginning of each rate year. | 6 |
| Section 45. Program evaluation. | 7 |
| (a) After the Program completes the 3rd full year of | 8 |
| operation on September 30, 2013, the Department must complete | 9 |
| an evaluation of the Program to determine the actual savings or | 10 |
| costs generated by the Program, both on an aggregate basis and | 11 |
| on an LTAC hospital-specific basis. The evaluation must be | 12 |
| conducted in each subsequent year. | 13 |
| (b) The Department and qualified LTAC hospitals must | 14 |
| determine the appropriate methodology to accurately calculate | 15 |
| the Program's savings and costs. | 16 |
| (c) The evaluation must also determine the effects the | 17 |
| Program has had in improving patient satisfaction and health | 18 |
| outcomes. | 19 |
| (d) If the evaluation indicates that the Program generates | 20 |
| a net cost to the Department, the Department may prospectively | 21 |
| adjust an individual hospital's LTAC supplemental per diem rate | 22 |
| under Section 35 of this Act to establish cost neutrality. The | 23 |
| rate adjustments applied under this subsection (d) do not need | 24 |
| to be applied uniformly to all qualified LTAC hospitals as long | 25 |
| as the adjustments are based on data from the evaluation on |
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| hospital-specific information. Cost neutrality under this | 2 |
| Section means that the cost to the Department resulting from | 3 |
| the LTAC supplemental per diem rate must not exceed the savings | 4 |
| generated from transferring the patient from a STAC hospital. | 5 |
| (e) The rate adjustment described in subsection (d) of this | 6 |
| Section, if necessary, shall be applied to the LTAC | 7 |
| supplemental per diem rate for the rate year beginning October | 8 |
| 1, 2014. The Department may apply this rate adjustment in | 9 |
| subsequent rate years if the conditions under subsection (d) of | 10 |
| this Section are met. The Department must apply the rate | 11 |
| adjustment to an individual LTAC hospital's LTAC supplemental | 12 |
| per diem rate only in years when the Program evaluation | 13 |
| indicates a net cost for the Department. | 14 |
| (f) The rate adjustments described in this Section shall be | 15 |
| determined and applied only at the beginning of each rate | 16 |
| year."; and | 17 |
| on page 14, line 13, by replacing "40" with "50"; and | 18 |
| on page 15, by replacing lines 2 through 14 with the following: | 19 |
| "(b) The Department shall include specific information on | 20 |
| the Program in its annual medical programs report."; and | 21 |
| on page 15, line 25, by replacing "execute an agreement as" | 22 |
| with "create and distribute to LTAC hospitals the agreement"; | 23 |
| and |
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| on page 15, line 26, by replacing "45 days after" with | 2 |
| "September 1, 2010."; and | 3 |
| on page 16, by deleting line 1; and | 4 |
| on page 16, line 16, by inserting after the period the | 5 |
| following: | 6 |
| "The Department must also notify LTAC hospitals that | 7 |
| accepting transfers from the STAC hospitals identified in | 8 |
| paragraphs (1) and (2) under subsection (a) of Section 25 of | 9 |
| this Act are not required under paragraph (5) of subsection (c) | 10 |
| of Section 15 of this Act. The Department must notify LTAC | 11 |
| hospitals that accepting transfers from the STAC hospitals | 12 |
| identified in paragraphs (1) and (2) under subsection (a) of | 13 |
| Section 25 of this Act shall negatively impact the savings | 14 |
| calculations under the Program evaluation required by Section | 15 |
| 40 of this Act and shall in turn require the Department to | 16 |
| initiate the penalty described in subsection (d) of Section 40 | 17 |
| of this Act."; and | 18 |
| on page 16, by replacing lines 17 through 20 with the | 19 |
| following: | 20 |
| "(j) The Department shall deem LTAC hospitals qualified | 21 |
| under Section 15 of this Act as qualifying for expedited | 22 |
| payments."; and |
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| on page 16, by inserting immediately below line 26 the | 2 |
| following: | 3 |
| "(l) The Department may promulgate rules as allowed by the | 4 |
| Illinois Administrative Procedure Act to implement this Act; | 5 |
| however, the requirements under this Act shall be implemented | 6 |
| by the Department even if the Department's proposed rules are | 7 |
| not yet adopted by the implementation date of October 1, | 8 |
| 2010.".
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