Full Text of SB1680 97th General Assembly
SB1680ham001 97TH GENERAL ASSEMBLY | Rep. Frank J. Mautino Filed: 4/28/2011
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| 1 | | AMENDMENT TO SENATE BILL 1680
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1680 as follows:
| 3 | | on page 1, line 5, by replacing "5A-2 and 5A-14" with "5A-2, | 4 | | 5A-3, 5A-5, 5A-8, 5A-10, and 5A-14"; and | 5 | | on page 4, by inserting immediately below line 23 the | 6 | | following: | 7 | | "(305 ILCS 5/5A-3) (from Ch. 23, par. 5A-3)
| 8 | | Sec. 5A-3. Exemptions.
| 9 | | (a) (Blank).
| 10 | | (b) A hospital provider that is a State agency, a State | 11 | | university, or
a county
with a population of 3,000,000 or more | 12 | | is exempt from the assessment imposed
by Section 5A-2.
| 13 | | (b-2) A hospital provider
that is a county with a | 14 | | population of less than 3,000,000 or a
township,
municipality,
| 15 | | hospital district, or any other local governmental unit is |
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| 1 | | exempt from the
assessment
imposed by Section 5A-2.
| 2 | | (b-5) (Blank).
| 3 | | (b-10) For State fiscal years 2004 through 2016 2014 , a | 4 | | hospital provider, described in Section 1903(w)(3)(F) of the | 5 | | Social Security Act, whose hospital does not
charge for its | 6 | | services is exempt from the assessment imposed
by Section 5A-2, | 7 | | unless the exemption is adjudged to be unconstitutional or
| 8 | | otherwise invalid, in which case the hospital provider shall | 9 | | pay the assessment
imposed by Section 5A-2.
| 10 | | (b-15) For State fiscal years 2004 and 2005, a hospital | 11 | | provider whose hospital is licensed by
the Department of Public | 12 | | Health as a psychiatric hospital is
exempt from the assessment | 13 | | imposed by Section 5A-2, unless the exemption is
adjudged to be | 14 | | unconstitutional or
otherwise invalid, in which case the | 15 | | hospital provider shall pay the assessment
imposed by Section | 16 | | 5A-2.
| 17 | | (b-20) For State fiscal years 2004 and 2005, a hospital | 18 | | provider whose hospital is licensed by the Department of
Public | 19 | | Health as a rehabilitation hospital is exempt from the | 20 | | assessment
imposed by
Section 5A-2, unless the exemption is
| 21 | | adjudged to be unconstitutional or
otherwise invalid, in which | 22 | | case the hospital provider shall pay the assessment
imposed by | 23 | | Section 5A-2.
| 24 | | (b-25) For State fiscal years 2004 and 2005, a hospital | 25 | | provider whose hospital (i) is not a psychiatric hospital,
| 26 | | rehabilitation hospital, or children's hospital and (ii) has an |
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| 1 | | average length
of inpatient
stay greater than 25 days is exempt | 2 | | from the assessment imposed by Section
5A-2, unless the | 3 | | exemption is
adjudged to be unconstitutional or
otherwise | 4 | | invalid, in which case the hospital provider shall pay the | 5 | | assessment
imposed by Section 5A-2.
| 6 | | (c) (Blank).
| 7 | | (Source: P.A. 95-859, eff. 8-19-08; 96-1530, eff. 2-16-11.)
| 8 | | (305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5) | 9 | | Sec. 5A-5. Notice; penalty; maintenance of records.
| 10 | | (a)
The Department of Healthcare and Family Services shall | 11 | | send a
notice of assessment to every hospital provider subject
| 12 | | to assessment under this Article. The notice of assessment | 13 | | shall notify the hospital of its assessment and shall be sent | 14 | | after receipt by the Department of notification from the | 15 | | Centers for Medicare and Medicaid Services of the U.S. | 16 | | Department of Health and Human Services that the payment | 17 | | methodologies required under Section 5A-12, Section 5A-12.1, | 18 | | or Section 5A-12.2, whichever is applicable for that fiscal | 19 | | year, and, if necessary, the waiver granted under 42 CFR 433.68 | 20 | | have been approved. The notice
shall be on a form
prepared by | 21 | | the Illinois Department and shall state the following:
| 22 | | (1) The name of the hospital provider.
| 23 | | (2) The address of the hospital provider's principal | 24 | | place
of business from which the provider engages in the | 25 | | occupation of hospital
provider in this State, and the name |
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| 1 | | and address of each hospital
operated, conducted, or | 2 | | maintained by the provider in this State.
| 3 | | (3) The occupied bed days, occupied bed days less | 4 | | Medicare days, or adjusted gross hospital revenue of the
| 5 | | hospital
provider (whichever is applicable), the amount of
| 6 | | assessment imposed under Section 5A-2 for the State fiscal | 7 | | year
for which the notice is sent, and the amount of
each
| 8 | | installment to be paid during the State fiscal year.
| 9 | | (4) (Blank).
| 10 | | (5) Other reasonable information as determined by the | 11 | | Illinois
Department.
| 12 | | (b) If a hospital provider conducts, operates, or
maintains | 13 | | more than one hospital licensed by the Illinois
Department of | 14 | | Public Health, the provider shall pay the
assessment for each | 15 | | hospital separately.
| 16 | | (c) Notwithstanding any other provision in this Article, in
| 17 | | the case of a person who ceases to conduct, operate, or | 18 | | maintain a
hospital in respect of which the person is subject | 19 | | to assessment
under this Article as a hospital provider, the | 20 | | assessment for the State
fiscal year in which the cessation | 21 | | occurs shall be adjusted by
multiplying the assessment computed | 22 | | under Section 5A-2 by a
fraction, the numerator of which is the | 23 | | number of days in the
year during which the provider conducts, | 24 | | operates, or maintains
the hospital and the denominator of | 25 | | which is 365. Immediately
upon ceasing to conduct, operate, or | 26 | | maintain a hospital, the person
shall pay the assessment
for |
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| 1 | | the year as so adjusted (to the extent not previously paid).
| 2 | | (d) Notwithstanding any other provision in this Article, a
| 3 | | provider who commences conducting, operating, or maintaining a
| 4 | | hospital, upon notice by the Illinois Department,
shall pay the | 5 | | assessment computed under Section 5A-2 and
subsection (e) in | 6 | | installments on the due dates stated in the
notice and on the | 7 | | regular installment due dates for the State
fiscal year | 8 | | occurring after the due dates of the initial
notice.
| 9 | | (e) Notwithstanding any other provision in this Article, | 10 | | for State fiscal years 2004 and 2005, in
the case of a hospital | 11 | | provider that did not conduct, operate, or
maintain a hospital | 12 | | throughout calendar year 2001, the assessment for that State | 13 | | fiscal year
shall be computed on the basis of hypothetical | 14 | | occupied bed days for the full calendar year as determined by | 15 | | the Illinois Department.
Notwithstanding any other provision | 16 | | in this Article, for State fiscal years 2006 through 2008, in | 17 | | the case of a hospital provider that did not conduct, operate, | 18 | | or maintain a hospital in 2003, the assessment for that State | 19 | | fiscal year shall be computed on the basis of hypothetical | 20 | | adjusted gross hospital revenue for the hospital's first full | 21 | | fiscal year as determined by the Illinois Department (which may | 22 | | be based on annualization of the provider's actual revenues for | 23 | | a portion of the year, or revenues of a comparable hospital for | 24 | | the year, including revenues realized by a prior provider of | 25 | | the same hospital during the year).
Notwithstanding any other | 26 | | provision in this Article, for State fiscal years 2009 through |
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| 1 | | 2016 2014 , in the case of a hospital provider that did not | 2 | | conduct, operate, or maintain a hospital in 2005, the | 3 | | assessment for that State fiscal year shall be computed on the | 4 | | basis of hypothetical occupied bed days for the full calendar | 5 | | year as determined by the Illinois Department.
| 6 | | (f) Every hospital provider subject to assessment under | 7 | | this Article shall keep sufficient records to permit the | 8 | | determination of adjusted gross hospital revenue for the | 9 | | hospital's fiscal year. All such records shall be kept in the | 10 | | English language and shall, at all times during regular | 11 | | business hours of the day, be subject to inspection by the | 12 | | Illinois Department or its duly authorized agents and | 13 | | employees.
| 14 | | (g) The Illinois Department may, by rule, provide a | 15 | | hospital provider a reasonable opportunity to request a | 16 | | clarification or correction of any clerical or computational | 17 | | errors contained in the calculation of its assessment, but such | 18 | | corrections shall not extend to updating the cost report | 19 | | information used to calculate the assessment.
| 20 | | (h) (Blank).
| 21 | | (Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08; | 22 | | 96-1530, eff. 2-16-11.)
| 23 | | (305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
| 24 | | Sec. 5A-8. Hospital Provider Fund.
| 25 | | (a) There is created in the State Treasury the Hospital |
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| 1 | | Provider Fund.
Interest earned by the Fund shall be credited to | 2 | | the Fund. The
Fund shall not be used to replace any moneys | 3 | | appropriated to the
Medicaid program by the General Assembly.
| 4 | | (b) The Fund is created for the purpose of receiving moneys
| 5 | | in accordance with Section 5A-6 and disbursing moneys only for | 6 | | the following
purposes, notwithstanding any other provision of | 7 | | law:
| 8 | | (1) For making payments to hospitals as required under | 9 | | Articles V, V-A, VI,
and XIV of this Code, under the | 10 | | Children's Health Insurance Program Act, under the | 11 | | Covering ALL KIDS Health Insurance Act, and under the | 12 | | Senior Citizens and Disabled Persons Property Tax Relief | 13 | | and Pharmaceutical Assistance Act.
| 14 | | (2) For the reimbursement of moneys collected by the
| 15 | | Illinois Department from hospitals or hospital providers | 16 | | through error or
mistake in performing the
activities | 17 | | authorized under this Article and Article V of this Code.
| 18 | | (3) For payment of administrative expenses incurred by | 19 | | the
Illinois Department or its agent in performing the | 20 | | activities
authorized by this Article.
| 21 | | (4) For payments of any amounts which are reimbursable | 22 | | to
the federal government for payments from this Fund which | 23 | | are
required to be paid by State warrant.
| 24 | | (5) For making transfers, as those transfers are | 25 | | authorized
in the proceedings authorizing debt under the | 26 | | Short Term Borrowing Act,
but transfers made under this |
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| 1 | | paragraph (5) shall not exceed the
principal amount of debt | 2 | | issued in anticipation of the receipt by
the State of | 3 | | moneys to be deposited into the Fund.
| 4 | | (6) For making transfers to any other fund in the State | 5 | | treasury, but
transfers made under this paragraph (6) shall | 6 | | not exceed the amount transferred
previously from that | 7 | | other fund into the Hospital Provider Fund.
| 8 | | (6.5) For making transfers to the Healthcare Provider | 9 | | Relief Fund, except that transfers made under this | 10 | | paragraph (6.5) shall not exceed $60,000,000 in the | 11 | | aggregate. | 12 | | (7) For State fiscal years 2004 and 2005 for making | 13 | | transfers to the Health and Human Services
Medicaid Trust | 14 | | Fund, including 20% of the moneys received from
hospital | 15 | | providers under Section 5A-4 and transferred into the | 16 | | Hospital
Provider
Fund under Section 5A-6. For State fiscal | 17 | | year 2006 for making transfers to the Health and Human | 18 | | Services Medicaid Trust Fund of up to $130,000,000 per year | 19 | | of the moneys received from hospital providers under | 20 | | Section 5A-4 and transferred into the Hospital Provider | 21 | | Fund under Section 5A-6. Transfers under this paragraph | 22 | | shall be made within 7
days after the payments have been | 23 | | received pursuant to the schedule of payments
provided in | 24 | | subsection (a) of Section 5A-4.
| 25 | | (7.5) For State fiscal year 2007 for making
transfers | 26 | | of the moneys received from hospital providers under |
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| 1 | | Section 5A-4 and transferred into the Hospital Provider | 2 | | Fund under Section 5A-6 to the designated funds not | 3 | | exceeding the following amounts
in that State fiscal year: | 4 | | Health and Human Services | 5 | | Medicaid Trust Fund .................
$20,000,000 | 6 | | Long-Term Care Provider Fund ............
$30,000,000 | 7 | | General Revenue Fund ...................
$80,000,000. | 8 | | Transfers under this paragraph shall be made within 7 | 9 | | days after the payments have been received pursuant to the | 10 | | schedule of payments provided in subsection (a) of Section | 11 | | 5A-4.
| 12 | | (7.8) For State fiscal year 2008, for making transfers | 13 | | of the moneys received from hospital providers under | 14 | | Section 5A-4 and transferred into the Hospital Provider | 15 | | Fund under Section 5A-6 to the designated funds not | 16 | | exceeding the following amounts in that State fiscal year: | 17 | | Health and Human Services | 18 | | Medicaid Trust Fund ..................$40,000,000 | 19 | | Long-Term Care Provider Fund ..............$60,000,000 | 20 | | General Revenue Fund ...................$160,000,000. | 21 | | Transfers under this paragraph shall be made within 7 | 22 | | days after the payments have been received pursuant to the | 23 | | schedule of payments provided in subsection (a) of Section | 24 | | 5A-4. | 25 | | (7.9) For State fiscal years 2009 through 2016 2014 , | 26 | | for making transfers of the moneys received from hospital |
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| 1 | | providers under Section 5A-4 and transferred into the | 2 | | Hospital Provider Fund under Section 5A-6 to the designated | 3 | | funds not exceeding the following amounts in that State | 4 | | fiscal year: | 5 | | Health and Human Services | 6 | | Medicaid Trust Fund ...................$20,000,000 | 7 | | Long Term Care Provider Fund ..............$30,000,000 | 8 | | General Revenue Fund .....................$80,000,000. | 9 | | Except as provided under this paragraph, transfers | 10 | | under this paragraph shall be made within 7 business days | 11 | | after the payments have been received pursuant to the | 12 | | schedule of payments provided in subsection (a) of Section | 13 | | 5A-4. For State fiscal year 2009, transfers to the General | 14 | | Revenue Fund under this paragraph shall be made on or | 15 | | before June 30, 2009, as sufficient funds become available | 16 | | in the Hospital Provider Fund to both make the transfers | 17 | | and continue hospital payments. | 18 | | (8) For making refunds to hospital providers pursuant | 19 | | to Section 5A-10.
| 20 | | Disbursements from the Fund, other than transfers | 21 | | authorized under
paragraphs (5) and (6) of this subsection, | 22 | | shall be by
warrants drawn by the State Comptroller upon | 23 | | receipt of vouchers
duly executed and certified by the Illinois | 24 | | Department.
| 25 | | (c) The Fund shall consist of the following:
| 26 | | (1) All moneys collected or received by the Illinois
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| 1 | | Department from the hospital provider assessment imposed | 2 | | by this
Article.
| 3 | | (2) All federal matching funds received by the Illinois
| 4 | | Department as a result of expenditures made by the Illinois
| 5 | | Department that are attributable to moneys deposited in the | 6 | | Fund.
| 7 | | (3) Any interest or penalty levied in conjunction with | 8 | | the
administration of this Article.
| 9 | | (4) Moneys transferred from another fund in the State | 10 | | treasury.
| 11 | | (5) All other moneys received for the Fund from any | 12 | | other
source, including interest earned thereon.
| 13 | | (d) (Blank).
| 14 | | (Source: P.A. 95-707, eff. 1-11-08; 95-859, eff. 8-19-08; 96-3, | 15 | | eff. 2-27-09; 96-45, eff. 7-15-09; 96-821, eff. 11-20-09; | 16 | | 96-1530, eff. 2-16-11.)
| 17 | | (305 ILCS 5/5A-10) (from Ch. 23, par. 5A-10)
| 18 | | Sec. 5A-10. Applicability.
| 19 | | (a) The assessment imposed by Section 5A-2 shall not take | 20 | | effect or shall
cease to be imposed, and
any moneys
remaining | 21 | | in the Fund shall be refunded to hospital providers
in | 22 | | proportion to the amounts paid by them, if:
| 23 | | (1) The sum of the appropriations for State fiscal | 24 | | years 2004 and 2005
from the
General Revenue Fund for | 25 | | hospital payments
under the medical assistance program is |
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| 1 | | less than $4,500,000,000 or the appropriation for each of | 2 | | State fiscal years 2006, 2007 and 2008 from the General | 3 | | Revenue Fund for hospital payments under the medical | 4 | | assistance program is less than $2,500,000,000 increased | 5 | | annually to reflect any increase in the number of | 6 | | recipients, or the annual appropriation for State fiscal | 7 | | years 2009 through 2016 2014 , from the General Revenue Fund | 8 | | combined with the Hospital Provider Fund as authorized in | 9 | | Section 5A-8 for hospital payments under the medical | 10 | | assistance program, is less than the amount appropriated | 11 | | for State fiscal year 2009, adjusted annually to reflect | 12 | | any change in the number of recipients, excluding State | 13 | | fiscal year 2009 supplemental appropriations made | 14 | | necessary by the enactment of the American Recovery and | 15 | | Reinvestment Act of 2009; or
| 16 | | (2) For State fiscal years prior to State fiscal year | 17 | | 2009, the Department of Healthcare and Family Services | 18 | | (formerly Department of Public Aid) makes changes in its | 19 | | rules
that
reduce the hospital inpatient or outpatient | 20 | | payment rates, including adjustment
payment rates, in | 21 | | effect on October 1, 2004, except for hospitals described | 22 | | in
subsection (b) of Section 5A-3 and except for changes in | 23 | | the methodology for calculating outlier payments to | 24 | | hospitals for exceptionally costly stays, so long as those | 25 | | changes do not reduce aggregate
expenditures below the | 26 | | amount expended in State fiscal year 2005 for such
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| 1 | | services; or
| 2 | | (2.1) For State fiscal years 2009 through 2016 2014 , | 3 | | the
Department of Healthcare and Family Services adopts any | 4 | | administrative rule change to reduce payment rates or | 5 | | alters any payment methodology that reduces any payment | 6 | | rates made to operating hospitals under the approved Title | 7 | | XIX or Title XXI State plan in effect January 1, 2008 | 8 | | except for: | 9 | | (A) any changes for hospitals described in | 10 | | subsection (b) of Section 5A-3; or | 11 | | (B) any rates for payments made under this Article | 12 | | V-A; or | 13 | | (C) any changes proposed in State plan amendment | 14 | | transmittal numbers 08-01, 08-02, 08-04, 08-06, and | 15 | | 08-07; or | 16 | | (D) in relation to any admissions on or after | 17 | | January 1, 2011, a modification in the methodology for | 18 | | calculating outlier payments to hospitals for | 19 | | exceptionally costly stays, for hospitals reimbursed | 20 | | under the diagnosis-related grouping methodology; | 21 | | provided that the Department shall be limited to one | 22 | | such modification during the 36-month period after the | 23 | | effective date of this amendatory Act of the 96th | 24 | | General Assembly; or | 25 | | (3) The payments to hospitals required under Section | 26 | | 5A-12 or Section 5A-12.2 are changed or
are
not eligible |
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| 1 | | for federal matching funds under Title XIX or XXI of the | 2 | | Social
Security Act.
| 3 | | (b) The assessment imposed by Section 5A-2 shall not take | 4 | | effect or
shall
cease to be imposed if the assessment is | 5 | | determined to be an impermissible
tax under Title XIX
of the | 6 | | Social Security Act. Moneys in the Hospital Provider Fund | 7 | | derived
from assessments imposed prior thereto shall be
| 8 | | disbursed in accordance with Section 5A-8 to the extent federal | 9 | | financial participation is
not reduced due to the | 10 | | impermissibility of the assessments, and any
remaining
moneys | 11 | | shall be
refunded to hospital providers in proportion to the | 12 | | amounts paid by them.
| 13 | | (Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08; 96-8, | 14 | | eff. 4-28-09; 96-1530, eff. 2-16-11.)"; and
| 15 | | on page 5, line 4, by replacing "2013" with " 2016 2013 ".
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