Full Text of SB3171 98th General Assembly
SB3171ham001 98TH GENERAL ASSEMBLY | Rep. Greg Harris Filed: 11/6/2014
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| 1 | | AMENDMENT TO SENATE BILL 3171
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 3171 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5e as follows: | 6 | | (305 ILCS 5/5-5e) | 7 | | Sec. 5-5e. Adjusted rates of reimbursement. | 8 | | (a) Rates or payments for services in effect on June 30, | 9 | | 2012 shall be adjusted and
services shall be affected as | 10 | | required by any other provision of this amendatory Act of
the | 11 | | 97th General Assembly. In addition, the Department shall do the | 12 | | following: | 13 | | (1) Delink the per diem rate paid for supportive living | 14 | | facility services from the per diem rate paid for nursing | 15 | | facility services, effective for services provided on or | 16 | | after May 1, 2011. |
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| 1 | | (2) Cease payment for bed reserves in nursing | 2 | | facilities and specialized mental health rehabilitation | 3 | | facilities ; for purposes of therapeutic home visits for | 4 | | individuals scoring as TBI on the MDS 3.0, beginning June | 5 | | 1, 2015, the Department shall approve payments for bed | 6 | | reserves in nursing facilities and specialized mental | 7 | | health rehabilitation facilities that have at least a 90% | 8 | | occupancy level and at least 90% of their residents are | 9 | | Medicaid eligible. Payment shall be at a daily rate of 75% | 10 | | of an individual's current Medicaid per diem and shall not | 11 | | exceed 10 days in a calendar month . | 12 | | (2.5) Cease payment for bed reserves for purposes of | 13 | | inpatient hospitalizations to intermediate care facilities | 14 | | for persons with development disabilities, except in the | 15 | | instance of residents who are under 21 years of age. | 16 | | (3) Cease payment of the $10 per day add-on payment to | 17 | | nursing facilities for certain residents with | 18 | | developmental disabilities. | 19 | | (b) After the application of subsection (a), | 20 | | notwithstanding any other provision of this
Code to the | 21 | | contrary and to the extent permitted by federal law, on and | 22 | | after July 1,
2012, the rates of reimbursement for services and | 23 | | other payments provided under this
Code shall further be | 24 | | reduced as follows: | 25 | | (1) Rates or payments for physician services, dental | 26 | | services, or community health center services reimbursed |
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| 1 | | through an encounter rate, and services provided under the | 2 | | Medicaid Rehabilitation Option of the Illinois Title XIX | 3 | | State Plan shall not be further reduced. | 4 | | (2) Rates or payments, or the portion thereof, paid to | 5 | | a provider that is operated by a unit of local government | 6 | | or State University that provides the non-federal share of | 7 | | such services shall not be further reduced. | 8 | | (3) Rates or payments for hospital services delivered | 9 | | by a hospital defined as a Safety-Net Hospital under | 10 | | Section 5-5e.1 of this Code shall not be further reduced. | 11 | | (4) Rates or payments for hospital services delivered | 12 | | by a Critical Access Hospital, which is an Illinois | 13 | | hospital designated as a critical care hospital by the | 14 | | Department of Public Health in accordance with 42 CFR 485, | 15 | | Subpart F, shall not be further reduced. | 16 | | (5) Rates or payments for Nursing Facility Services | 17 | | shall only be further adjusted pursuant to Section 5-5.2 of | 18 | | this Code. | 19 | | (6) Rates or payments for services delivered by long | 20 | | term care facilities licensed under the ID/DD Community | 21 | | Care Act and developmental training services shall not be | 22 | | further reduced. | 23 | | (7) Rates or payments for services provided under | 24 | | capitation rates shall be adjusted taking into | 25 | | consideration the rates reduction and covered services | 26 | | required by this amendatory Act of the 97th General |
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| 1 | | Assembly. | 2 | | (8) For hospitals not previously described in this | 3 | | subsection, the rates or payments for hospital services | 4 | | shall be further reduced by 3.5%, except for payments | 5 | | authorized under Section 5A-12.4 of this Code. | 6 | | (9) For all other rates or payments for services | 7 | | delivered by providers not specifically referenced in | 8 | | paragraphs (1) through (8), rates or payments shall be | 9 | | further reduced by 2.7%. | 10 | | (c) Any assessment imposed by this Code shall continue and | 11 | | nothing in this Section shall be construed to cause it to | 12 | | cease.
| 13 | | (d) Notwithstanding any other provision of this Code to the | 14 | | contrary, subject to federal approval under Title XIX of the | 15 | | Social Security Act, for dates of service on and after July 1, | 16 | | 2014, rates or payments for services provided for the purpose | 17 | | of transitioning children from a hospital to home placement or | 18 | | other appropriate setting by a children's community-based | 19 | | health care center authorized under the Alternative Health Care | 20 | | Delivery Act shall be $683 per day. | 21 | | (e) Notwithstanding any other provision of this Code to the | 22 | | contrary, subject to federal approval under Title XIX of the | 23 | | Social Security Act, for dates of service on and after July 1, | 24 | | 2014, rates or payments for home health visits shall be $72. | 25 | | (f) Notwithstanding any other provision of this Code to the | 26 | | contrary, subject to federal approval under Title XIX of the |
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| 1 | | Social Security Act, for dates of service on and after July 1, | 2 | | 2014, rates or payments for the certified nursing assistant | 3 | | component of the home health agency rate shall be $20. | 4 | | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13; | 5 | | 98-651, eff. 6-16-14.)
| 6 | | Section 99. Effective date. This Act takes effect June 1, | 7 | | 2015.".
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