Full Text of SB1386 100th General Assembly
SB1386sam002 100TH GENERAL ASSEMBLY | Sen. Kimberly A. Lightford Filed: 3/10/2017
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| 1 | | AMENDMENT TO SENATE BILL 1386
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1386 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| changing Section 5A-2 as follows: | 6 | | (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2) | 7 | | (Section scheduled to be repealed on July 1, 2018) | 8 | | Sec. 5A-2. Assessment.
| 9 | | (a)(1)
Subject to Sections 5A-3 and
and 5A-10, for State | 10 | | fiscal years 2009 through 2018, an annual assessment on | 11 | | inpatient services is imposed on each hospital provider in an | 12 | | amount equal to $218.38 multiplied by the difference of the | 13 | | hospital's occupied bed days less the hospital's Medicare bed | 14 | | days, provided, however, that the amount of $218.38 shall be | 15 | | increased by a uniform percentage to generate an amount equal | 16 | | to 75% of the State share of the payments authorized under |
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| 1 | | Section 5A-12.5, with such increase only taking effect upon the | 2 | | date that a State share for such payments is required under | 3 | | federal law. For the period of April through June 2015, the | 4 | | amount of $218.38 used to calculate the assessment under this | 5 | | paragraph shall, by emergency rule under subsection (s) of | 6 | | Section 5-45 of the Illinois Administrative Procedure Act, be | 7 | | increased by a uniform percentage to generate $20,250,000 in | 8 | | the aggregate for that period from all hospitals subject to the | 9 | | annual assessment under this paragraph. | 10 | | (2) In addition to any other assessments imposed under this | 11 | | Article, effective July 1, 2016 and semi-annually thereafter | 12 | | through June 2018, in addition to any federally required State | 13 | | share as authorized under paragraph (1), the amount of $218.38 | 14 | | shall be increased by a uniform percentage to generate an | 15 | | amount equal to 75% of the ACA Assessment Adjustment, as | 16 | | defined in subsection (b-6) of this Section. | 17 | | For State fiscal years 2009 through 2014 and after, a | 18 | | hospital's occupied bed days and Medicare bed days shall be | 19 | | determined using the most recent data available from each | 20 | | hospital's 2005 Medicare cost report as contained in the | 21 | | Healthcare Cost Report Information System file, for the quarter | 22 | | ending on December 31, 2006, without regard to any subsequent | 23 | | adjustments or changes to such data. If a hospital's 2005 | 24 | | Medicare cost report is not contained in the Healthcare Cost | 25 | | Report Information System, then the Illinois Department may | 26 | | obtain the hospital provider's occupied bed days and Medicare |
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| 1 | | bed days from any source available, including, but not limited | 2 | | to, records maintained by the hospital provider, which may be | 3 | | inspected at all times during business hours of the day by the | 4 | | Illinois Department or its duly authorized agents and | 5 | | employees. | 6 | | (b) (Blank).
| 7 | | (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the | 8 | | portion of State fiscal year 2012, beginning June 10, 2012 | 9 | | through June 30, 2012, and for State fiscal years 2013 through | 10 | | 2018, an annual assessment on outpatient services is imposed on | 11 | | each hospital provider in an amount equal to .008766 multiplied | 12 | | by the hospital's outpatient gross revenue, provided, however, | 13 | | that the amount of .008766 shall be increased by a uniform | 14 | | percentage to generate an amount equal to 25% of the State | 15 | | share of the payments authorized under Section 5A-12.5, with | 16 | | such increase only taking effect upon the date that a State | 17 | | share for such payments is required under federal law. For the | 18 | | period beginning June 10, 2012 through June 30, 2012, the | 19 | | annual assessment on outpatient services shall be prorated by | 20 | | multiplying the assessment amount by a fraction, the numerator | 21 | | of which is 21 days and the denominator of which is 365 days. | 22 | | For the period of April through June 2015, the amount of | 23 | | .008766 used to calculate the assessment under this paragraph | 24 | | shall, by emergency rule under subsection (s) of Section 5-45 | 25 | | of the Illinois Administrative Procedure Act, be increased by a | 26 | | uniform percentage to generate $6,750,000 in the aggregate for |
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| 1 | | that period from all hospitals subject to the annual assessment | 2 | | under this paragraph. | 3 | | (2) In addition to any other assessments imposed under this | 4 | | Article, effective July 1, 2016 and semi-annually thereafter | 5 | | through June 2018, in addition to any federally required State | 6 | | share as authorized under paragraph (1), the amount of .008766 | 7 | | shall be increased by a uniform percentage to generate an | 8 | | amount equal to 25% of the ACA Assessment Adjustment, as | 9 | | defined in subsection (b-6) of this Section. | 10 | | For the portion of State fiscal year 2012, beginning June | 11 | | 10, 2012 through June 30, 2012, and State fiscal years 2013 | 12 | | through 2018, a hospital's outpatient gross revenue shall be | 13 | | determined using the most recent data available from each | 14 | | hospital's 2009 Medicare cost report as contained in the | 15 | | Healthcare Cost Report Information System file, for the quarter | 16 | | ending on June 30, 2011, without regard to any subsequent | 17 | | adjustments or changes to such data. If a hospital's 2009 | 18 | | Medicare cost report is not contained in the Healthcare Cost | 19 | | Report Information System, then the Department may obtain the | 20 | | hospital provider's outpatient gross revenue from any source | 21 | | available, including, but not limited to, records maintained by | 22 | | the hospital provider, which may be inspected at all times | 23 | | during business hours of the day by the Department or its duly | 24 | | authorized agents and employees. | 25 | | (b-6)(1) As used in this Section, "ACA Assessment | 26 | | Adjustment" means: |
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| 1 | | (A) For the period of July 1, 2016 through December 31, | 2 | | 2016, the product of .19125 multiplied by the sum of the | 3 | | fee-for-service payments to hospitals as authorized under | 4 | | Section 5A-12.5 and the adjustments authorized under | 5 | | subsection (t) of Section 5A-12.2 to managed care | 6 | | organizations for hospital services due and payable in the | 7 | | month of April 2016 multiplied by 6. | 8 | | (B) For the period of January 1, 2017 through June 30, | 9 | | 2017, the product of .19125 multiplied by the sum of the | 10 | | fee-for-service payments to hospitals as authorized under | 11 | | Section 5A-12.5 and the adjustments authorized under | 12 | | subsection (t) of Section 5A-12.2 to managed care | 13 | | organizations for hospital services due and payable in the | 14 | | month of October 2016 multiplied by 6, except that the | 15 | | amount calculated under this subparagraph (B) shall be | 16 | | adjusted, either positively or negatively, to account for | 17 | | the difference between the actual payments issued under | 18 | | Section 5A-12.5 for the period beginning July 1, 2016 | 19 | | through December 31, 2016 and the estimated payments due | 20 | | and payable in the month of April 2016 multiplied by 6 as | 21 | | described in subparagraph (A). | 22 | | (C) For the period of July 1, 2017 through December 31, | 23 | | 2017, the product of .19125 multiplied by the sum of the | 24 | | fee-for-service payments to hospitals as authorized under | 25 | | Section 5A-12.5 and the adjustments authorized under | 26 | | subsection (t) of Section 5A-12.2 to managed care |
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| 1 | | organizations for hospital services due and payable in the | 2 | | month of April 2017 multiplied by 6, except that the amount | 3 | | calculated under this subparagraph (C) shall be adjusted, | 4 | | either positively or negatively, to account for the | 5 | | difference between the actual payments issued under | 6 | | Section 5A-12.5 for the period beginning January 1, 2017 | 7 | | through June 30, 2017 and the estimated payments due and | 8 | | payable in the month of October 2016 multiplied by 6 as | 9 | | described in subparagraph (B). | 10 | | (D) For the period of January 1, 2018 through June 30, | 11 | | 2018, the product of .19125 multiplied by the sum of the | 12 | | fee-for-service payments to hospitals as authorized under | 13 | | Section 5A-12.5 and the adjustments authorized under | 14 | | subsection (t) of Section 5A-12.2 to managed care | 15 | | organizations for hospital services due and payable in the | 16 | | month of October 2017 multiplied by 6, except that: | 17 | | (i) the amount calculated under this subparagraph | 18 | | (D) shall be adjusted, either positively or | 19 | | negatively, to account for the difference between the | 20 | | actual payments issued under Section 5A-12.5 for the | 21 | | period of July 1, 2017 through December 31, 2017 and | 22 | | the estimated payments due and payable in the month of | 23 | | April 2017 multiplied by 6 as described in subparagraph | 24 | | (C); and | 25 | | (ii) the amount calculated under this subparagraph | 26 | | (D) shall be adjusted to include the product of .19125 |
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| 1 | | multiplied by the sum of the fee-for-service payments, | 2 | | if any, estimated to be paid to hospitals under | 3 | | subsection (b) of Section 5A-12.5. | 4 | | (2) The Department shall complete and apply a final | 5 | | reconciliation of the ACA Assessment Adjustment prior to June | 6 | | 30, 2018 to account for: | 7 | | (A) any differences between the actual payments issued | 8 | | or scheduled to be issued prior to June 30, 2018 as | 9 | | authorized in Section 5A-12.5 for the period of January 1, | 10 | | 2018 through June 30, 2018 and the estimated payments due | 11 | | and payable in the month of October 2017 multiplied by 6 as | 12 | | described in subparagraph (D); and | 13 | | (B) any difference between the estimated | 14 | | fee-for-service payments under subsection (b) of Section | 15 | | 5A-12.5 and the amount of such payments that are actually | 16 | | scheduled to be paid. | 17 | | The Department shall notify hospitals of any additional | 18 | | amounts owed or reduction credits to be applied to the June | 19 | | 2018 ACA Assessment Adjustment. This is to be considered the | 20 | | final reconciliation for the ACA Assessment Adjustment. | 21 | | (3) Notwithstanding any other provision of this Section, if | 22 | | for any reason the scheduled payments under subsection (b) of | 23 | | Section 5A-12.5 are not issued in full by the final day of the | 24 | | period authorized under subsection (b) of Section 5A-12.5, | 25 | | funds collected from each hospital pursuant to subparagraph (D) | 26 | | of paragraph (1) and pursuant to paragraph (2), attributable to |
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| 1 | | the scheduled payments authorized under subsection (b) of | 2 | | Section 5A-12.5 that are not issued in full by the final day of | 3 | | the period attributable to each payment authorized under | 4 | | subsection (b) of Section 5A-12.5, shall be refunded. | 5 | | (4) The increases authorized under paragraph (2) of | 6 | | subsection (a) and paragraph (2) of subsection (b-5) shall be | 7 | | limited to the federally required State share of the total | 8 | | payments authorized under Section 5A-12.5 if the sum of such | 9 | | payments yields an annualized amount equal to or less than | 10 | | $450,000,000, or if the adjustments authorized under | 11 | | subsection (t) of Section 5A-12.2 are found not to be | 12 | | actuarially sound; however, this limitation shall not apply to | 13 | | the fee-for-service payments described in subsection (b) of | 14 | | Section 5A-12.5. | 15 | | (c) (Blank).
| 16 | | (d) Notwithstanding any of the other provisions of this | 17 | | Section, the Department is authorized to adopt rules to reduce | 18 | | the rate of any annual assessment imposed under this Section, | 19 | | as authorized by Section 5-46.2 of the Illinois Administrative | 20 | | Procedure Act.
| 21 | | (e) Notwithstanding any other provision of this Section, | 22 | | any plan providing for an assessment on a hospital provider as | 23 | | a permissible tax under Title XIX of the federal Social | 24 | | Security Act and Medicaid-eligible payments to hospital | 25 | | providers from the revenues derived from that assessment shall | 26 | | be reviewed by the Illinois Department of Healthcare and Family |
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| 1 | | Services, as the Single State Medicaid Agency required by | 2 | | federal law, to determine whether those assessments and | 3 | | hospital provider payments meet federal Medicaid standards. If | 4 | | the Department determines that the elements of the plan may | 5 | | meet federal Medicaid standards and a related State Medicaid | 6 | | Plan Amendment is prepared in a manner and form suitable for | 7 | | submission, that State Plan Amendment shall be submitted in a | 8 | | timely manner for review by the Centers for Medicare and | 9 | | Medicaid Services of the United States Department of Health and | 10 | | Human Services and subject to approval by the Centers for | 11 | | Medicare and Medicaid Services of the United States Department | 12 | | of Health and Human Services. No such plan shall become | 13 | | effective without approval by the Illinois General Assembly by | 14 | | the enactment into law of related legislation. Notwithstanding | 15 | | any other provision of this Section, the Department is | 16 | | authorized to adopt rules to reduce the rate of any annual | 17 | | assessment imposed under this Section. Any such rules may be | 18 | | adopted by the Department under Section 5-50 of the Illinois | 19 | | Administrative Procedure Act. | 20 | | (Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14; 99-2, | 21 | | eff. 3-26-15; 99-516, eff. 6-30-16.)".
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