Full Text of SB1469 100th General Assembly
SB1469ham001 100TH GENERAL ASSEMBLY | Rep. Gregory Harris Filed: 11/28/2018
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| 1 | | AMENDMENT TO SENATE BILL 1469
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1469 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Illinois Administrative Procedure Act is | 5 | | amended by changing Section 5-45 as follows: | 6 | | (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45) | 7 | | Sec. 5-45. Emergency rulemaking. | 8 | | (a) "Emergency" means the existence of any situation that | 9 | | any agency
finds reasonably constitutes a threat to the public | 10 | | interest, safety, or
welfare. | 11 | | (b) If any agency finds that an
emergency exists that | 12 | | requires adoption of a rule upon fewer days than
is required by | 13 | | Section 5-40 and states in writing its reasons for that
| 14 | | finding, the agency may adopt an emergency rule without prior | 15 | | notice or
hearing upon filing a notice of emergency rulemaking | 16 | | with the Secretary of
State under Section 5-70. The notice |
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| 1 | | shall include the text of the
emergency rule and shall be | 2 | | published in the Illinois Register. Consent
orders or other | 3 | | court orders adopting settlements negotiated by an agency
may | 4 | | be adopted under this Section. Subject to applicable | 5 | | constitutional or
statutory provisions, an emergency rule | 6 | | becomes effective immediately upon
filing under Section 5-65 or | 7 | | at a stated date less than 10 days
thereafter. The agency's | 8 | | finding and a statement of the specific reasons
for the finding | 9 | | shall be filed with the rule. The agency shall take
reasonable | 10 | | and appropriate measures to make emergency rules known to the
| 11 | | persons who may be affected by them. | 12 | | (c) An emergency rule may be effective for a period of not | 13 | | longer than
150 days, but the agency's authority to adopt an | 14 | | identical rule under Section
5-40 is not precluded. No | 15 | | emergency rule may be adopted more
than once in any 24-month | 16 | | period, except that this limitation on the number
of emergency | 17 | | rules that may be adopted in a 24-month period does not apply
| 18 | | to (i) emergency rules that make additions to and deletions | 19 | | from the Drug
Manual under Section 5-5.16 of the Illinois | 20 | | Public Aid Code or the
generic drug formulary under Section | 21 | | 3.14 of the Illinois Food, Drug
and Cosmetic Act, (ii) | 22 | | emergency rules adopted by the Pollution Control
Board before | 23 | | July 1, 1997 to implement portions of the Livestock Management
| 24 | | Facilities Act, (iii) emergency rules adopted by the Illinois | 25 | | Department of Public Health under subsections (a) through (i) | 26 | | of Section 2 of the Department of Public Health Act when |
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| 1 | | necessary to protect the public's health, (iv) emergency rules | 2 | | adopted pursuant to subsection (n) of this Section, (v) | 3 | | emergency rules adopted pursuant to subsection (o) of this | 4 | | Section, or (vi) emergency rules adopted pursuant to subsection | 5 | | (c-5) of this Section. Two or more emergency rules having | 6 | | substantially the same
purpose and effect shall be deemed to be | 7 | | a single rule for purposes of this
Section. | 8 | | (c-5) To facilitate the maintenance of the program of group | 9 | | health benefits provided to annuitants, survivors, and retired | 10 | | employees under the State Employees Group Insurance Act of | 11 | | 1971, rules to alter the contributions to be paid by the State, | 12 | | annuitants, survivors, retired employees, or any combination | 13 | | of those entities, for that program of group health benefits, | 14 | | shall be adopted as emergency rules. The adoption of those | 15 | | rules shall be considered an emergency and necessary for the | 16 | | public interest, safety, and welfare. | 17 | | (d) In order to provide for the expeditious and timely | 18 | | implementation
of the State's fiscal year 1999 budget, | 19 | | emergency rules to implement any
provision of Public Act 90-587 | 20 | | or 90-588
or any other budget initiative for fiscal year 1999 | 21 | | may be adopted in
accordance with this Section by the agency | 22 | | charged with administering that
provision or initiative, | 23 | | except that the 24-month limitation on the adoption
of | 24 | | emergency rules and the provisions of Sections 5-115 and 5-125 | 25 | | do not apply
to rules adopted under this subsection (d). The | 26 | | adoption of emergency rules
authorized by this subsection (d) |
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| 1 | | shall be deemed to be necessary for the
public interest, | 2 | | safety, and welfare. | 3 | | (e) In order to provide for the expeditious and timely | 4 | | implementation
of the State's fiscal year 2000 budget, | 5 | | emergency rules to implement any
provision of Public Act 91-24
| 6 | | or any other budget initiative for fiscal year 2000 may be | 7 | | adopted in
accordance with this Section by the agency charged | 8 | | with administering that
provision or initiative, except that | 9 | | the 24-month limitation on the adoption
of emergency rules and | 10 | | the provisions of Sections 5-115 and 5-125 do not apply
to | 11 | | rules adopted under this subsection (e). The adoption of | 12 | | emergency rules
authorized by this subsection (e) shall be | 13 | | deemed to be necessary for the
public interest, safety, and | 14 | | welfare. | 15 | | (f) In order to provide for the expeditious and timely | 16 | | implementation
of the State's fiscal year 2001 budget, | 17 | | emergency rules to implement any
provision of Public Act 91-712
| 18 | | or any other budget initiative for fiscal year 2001 may be | 19 | | adopted in
accordance with this Section by the agency charged | 20 | | with administering that
provision or initiative, except that | 21 | | the 24-month limitation on the adoption
of emergency rules and | 22 | | the provisions of Sections 5-115 and 5-125 do not apply
to | 23 | | rules adopted under this subsection (f). The adoption of | 24 | | emergency rules
authorized by this subsection (f) shall be | 25 | | deemed to be necessary for the
public interest, safety, and | 26 | | welfare. |
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| 1 | | (g) In order to provide for the expeditious and timely | 2 | | implementation
of the State's fiscal year 2002 budget, | 3 | | emergency rules to implement any
provision of Public Act 92-10
| 4 | | or any other budget initiative for fiscal year 2002 may be | 5 | | adopted in
accordance with this Section by the agency charged | 6 | | with administering that
provision or initiative, except that | 7 | | the 24-month limitation on the adoption
of emergency rules and | 8 | | the provisions of Sections 5-115 and 5-125 do not apply
to | 9 | | rules adopted under this subsection (g). The adoption of | 10 | | emergency rules
authorized by this subsection (g) shall be | 11 | | deemed to be necessary for the
public interest, safety, and | 12 | | welfare. | 13 | | (h) In order to provide for the expeditious and timely | 14 | | implementation
of the State's fiscal year 2003 budget, | 15 | | emergency rules to implement any
provision of Public Act 92-597
| 16 | | or any other budget initiative for fiscal year 2003 may be | 17 | | adopted in
accordance with this Section by the agency charged | 18 | | with administering that
provision or initiative, except that | 19 | | the 24-month limitation on the adoption
of emergency rules and | 20 | | the provisions of Sections 5-115 and 5-125 do not apply
to | 21 | | rules adopted under this subsection (h). The adoption of | 22 | | emergency rules
authorized by this subsection (h) shall be | 23 | | deemed to be necessary for the
public interest, safety, and | 24 | | welfare. | 25 | | (i) In order to provide for the expeditious and timely | 26 | | implementation
of the State's fiscal year 2004 budget, |
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| 1 | | emergency rules to implement any
provision of Public Act 93-20
| 2 | | or any other budget initiative for fiscal year 2004 may be | 3 | | adopted in
accordance with this Section by the agency charged | 4 | | with administering that
provision or initiative, except that | 5 | | the 24-month limitation on the adoption
of emergency rules and | 6 | | the provisions of Sections 5-115 and 5-125 do not apply
to | 7 | | rules adopted under this subsection (i). The adoption of | 8 | | emergency rules
authorized by this subsection (i) shall be | 9 | | deemed to be necessary for the
public interest, safety, and | 10 | | welfare. | 11 | | (j) In order to provide for the expeditious and timely | 12 | | implementation of the provisions of the State's fiscal year | 13 | | 2005 budget as provided under the Fiscal Year 2005 Budget | 14 | | Implementation (Human Services) Act, emergency rules to | 15 | | implement any provision of the Fiscal Year 2005 Budget | 16 | | Implementation (Human Services) Act may be adopted in | 17 | | accordance with this Section by the agency charged with | 18 | | administering that provision, except that the 24-month | 19 | | limitation on the adoption of emergency rules and the | 20 | | provisions of Sections 5-115 and 5-125 do not apply to rules | 21 | | adopted under this subsection (j). The Department of Public Aid | 22 | | may also adopt rules under this subsection (j) necessary to | 23 | | administer the Illinois Public Aid Code and the Children's | 24 | | Health Insurance Program Act. The adoption of emergency rules | 25 | | authorized by this subsection (j) shall be deemed to be | 26 | | necessary for the public interest, safety, and welfare.
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| 1 | | (k) In order to provide for the expeditious and timely | 2 | | implementation of the provisions of the State's fiscal year | 3 | | 2006 budget, emergency rules to implement any provision of | 4 | | Public Act 94-48 or any other budget initiative for fiscal year | 5 | | 2006 may be adopted in accordance with this Section by the | 6 | | agency charged with administering that provision or | 7 | | initiative, except that the 24-month limitation on the adoption | 8 | | of emergency rules and the provisions of Sections 5-115 and | 9 | | 5-125 do not apply to rules adopted under this subsection (k). | 10 | | The Department of Healthcare and Family Services may also adopt | 11 | | rules under this subsection (k) necessary to administer the | 12 | | Illinois Public Aid Code, the Senior Citizens and Persons with | 13 | | Disabilities Property Tax Relief Act, the Senior Citizens and | 14 | | Disabled Persons Prescription Drug Discount Program Act (now | 15 | | the Illinois Prescription Drug Discount Program Act), and the | 16 | | Children's Health Insurance Program Act. The adoption of | 17 | | emergency rules authorized by this subsection (k) shall be | 18 | | deemed to be necessary for the public interest, safety, and | 19 | | welfare.
| 20 | | (l) In order to provide for the expeditious and timely | 21 | | implementation of the provisions of the
State's fiscal year | 22 | | 2007 budget, the Department of Healthcare and Family Services | 23 | | may adopt emergency rules during fiscal year 2007, including | 24 | | rules effective July 1, 2007, in
accordance with this | 25 | | subsection to the extent necessary to administer the | 26 | | Department's responsibilities with respect to amendments to |
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| 1 | | the State plans and Illinois waivers approved by the federal | 2 | | Centers for Medicare and Medicaid Services necessitated by the | 3 | | requirements of Title XIX and Title XXI of the federal Social | 4 | | Security Act. The adoption of emergency rules
authorized by | 5 | | this subsection (l) shall be deemed to be necessary for the | 6 | | public interest,
safety, and welfare.
| 7 | | (m) In order to provide for the expeditious and timely | 8 | | implementation of the provisions of the
State's fiscal year | 9 | | 2008 budget, the Department of Healthcare and Family Services | 10 | | may adopt emergency rules during fiscal year 2008, including | 11 | | rules effective July 1, 2008, in
accordance with this | 12 | | subsection to the extent necessary to administer the | 13 | | Department's responsibilities with respect to amendments to | 14 | | the State plans and Illinois waivers approved by the federal | 15 | | Centers for Medicare and Medicaid Services necessitated by the | 16 | | requirements of Title XIX and Title XXI of the federal Social | 17 | | Security Act. The adoption of emergency rules
authorized by | 18 | | this subsection (m) shall be deemed to be necessary for the | 19 | | public interest,
safety, and welfare.
| 20 | | (n) In order to provide for the expeditious and timely | 21 | | implementation of the provisions of the State's fiscal year | 22 | | 2010 budget, emergency rules to implement any provision of | 23 | | Public Act 96-45 or any other budget initiative authorized by | 24 | | the 96th General Assembly for fiscal year 2010 may be adopted | 25 | | in accordance with this Section by the agency charged with | 26 | | administering that provision or initiative. The adoption of |
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| 1 | | emergency rules authorized by this subsection (n) shall be | 2 | | deemed to be necessary for the public interest, safety, and | 3 | | welfare. The rulemaking authority granted in this subsection | 4 | | (n) shall apply only to rules promulgated during Fiscal Year | 5 | | 2010. | 6 | | (o) In order to provide for the expeditious and timely | 7 | | implementation of the provisions of the State's fiscal year | 8 | | 2011 budget, emergency rules to implement any provision of | 9 | | Public Act 96-958 or any other budget initiative authorized by | 10 | | the 96th General Assembly for fiscal year 2011 may be adopted | 11 | | in accordance with this Section by the agency charged with | 12 | | administering that provision or initiative. The adoption of | 13 | | emergency rules authorized by this subsection (o) is deemed to | 14 | | be necessary for the public interest, safety, and welfare. The | 15 | | rulemaking authority granted in this subsection (o) applies | 16 | | only to rules promulgated on or after July 1, 2010 (the | 17 | | effective date of Public Act 96-958) through June 30, 2011. | 18 | | (p) In order to provide for the expeditious and timely | 19 | | implementation of the provisions of Public Act 97-689, | 20 | | emergency rules to implement any provision of Public Act 97-689 | 21 | | may be adopted in accordance with this subsection (p) by the | 22 | | agency charged with administering that provision or | 23 | | initiative. The 150-day limitation of the effective period of | 24 | | emergency rules does not apply to rules adopted under this | 25 | | subsection (p), and the effective period may continue through | 26 | | June 30, 2013. The 24-month limitation on the adoption of |
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| 1 | | emergency rules does not apply to rules adopted under this | 2 | | subsection (p). The adoption of emergency rules authorized by | 3 | | this subsection (p) is deemed to be necessary for the public | 4 | | interest, safety, and welfare. | 5 | | (q) In order to provide for the expeditious and timely | 6 | | implementation of the provisions of Articles 7, 8, 9, 11, and | 7 | | 12 of Public Act 98-104, emergency rules to implement any | 8 | | provision of Articles 7, 8, 9, 11, and 12 of Public Act 98-104 | 9 | | may be adopted in accordance with this subsection (q) by the | 10 | | agency charged with administering that provision or | 11 | | initiative. The 24-month limitation on the adoption of | 12 | | emergency rules does not apply to rules adopted under this | 13 | | subsection (q). The adoption of emergency rules authorized by | 14 | | this subsection (q) is deemed to be necessary for the public | 15 | | interest, safety, and welfare. | 16 | | (r) In order to provide for the expeditious and timely | 17 | | implementation of the provisions of Public Act 98-651, | 18 | | emergency rules to implement Public Act 98-651 may be adopted | 19 | | in accordance with this subsection (r) by the Department of | 20 | | Healthcare and Family Services. The 24-month limitation on the | 21 | | adoption of emergency rules does not apply to rules adopted | 22 | | under this subsection (r). The adoption of emergency rules | 23 | | authorized by this subsection (r) is deemed to be necessary for | 24 | | the public interest, safety, and welfare. | 25 | | (s) In order to provide for the expeditious and timely | 26 | | implementation of the provisions of Sections 5-5b.1 and 5A-2 of |
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| 1 | | the Illinois Public Aid Code, emergency rules to implement any | 2 | | provision of Section 5-5b.1 or Section 5A-2 of the Illinois | 3 | | Public Aid Code may be adopted in accordance with this | 4 | | subsection (s) by the Department of Healthcare and Family | 5 | | Services. The rulemaking authority granted in this subsection | 6 | | (s) shall apply only to those rules adopted prior to July 1, | 7 | | 2015. Notwithstanding any other provision of this Section, any | 8 | | emergency rule adopted under this subsection (s) shall only | 9 | | apply to payments made for State fiscal year 2015. The adoption | 10 | | of emergency rules authorized by this subsection (s) is deemed | 11 | | to be necessary for the public interest, safety, and welfare. | 12 | | (t) In order to provide for the expeditious and timely | 13 | | implementation of the provisions of Article II of Public Act | 14 | | 99-6, emergency rules to implement the changes made by Article | 15 | | II of Public Act 99-6 to the Emergency Telephone System Act may | 16 | | be adopted in accordance with this subsection (t) by the | 17 | | Department of State Police. The rulemaking authority granted in | 18 | | this subsection (t) shall apply only to those rules adopted | 19 | | prior to July 1, 2016. The 24-month limitation on the adoption | 20 | | of emergency rules does not apply to rules adopted under this | 21 | | subsection (t). The adoption of emergency rules authorized by | 22 | | this subsection (t) is deemed to be necessary for the public | 23 | | interest, safety, and welfare. | 24 | | (u) In order to provide for the expeditious and timely | 25 | | implementation of the provisions of the Burn Victims Relief | 26 | | Act, emergency rules to implement any provision of the Act may |
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| 1 | | be adopted in accordance with this subsection (u) by the | 2 | | Department of Insurance. The rulemaking authority granted in | 3 | | this subsection (u) shall apply only to those rules adopted | 4 | | prior to December 31, 2015. The adoption of emergency rules | 5 | | authorized by this subsection (u) is deemed to be necessary for | 6 | | the public interest, safety, and welfare. | 7 | | (v) In order to provide for the expeditious and timely | 8 | | implementation of the provisions of Public Act 99-516, | 9 | | emergency rules to implement Public Act 99-516 may be adopted | 10 | | in accordance with this subsection (v) by the Department of | 11 | | Healthcare and Family Services. The 24-month limitation on the | 12 | | adoption of emergency rules does not apply to rules adopted | 13 | | under this subsection (v). The adoption of emergency rules | 14 | | authorized by this subsection (v) is deemed to be necessary for | 15 | | the public interest, safety, and welfare. | 16 | | (w) In order to provide for the expeditious and timely | 17 | | implementation of the provisions of Public Act 99-796, | 18 | | emergency rules to implement the changes made by Public Act | 19 | | 99-796 may be adopted in accordance with this subsection (w) by | 20 | | the Adjutant General. The adoption of emergency rules | 21 | | authorized by this subsection (w) is deemed to be necessary for | 22 | | the public interest, safety, and welfare. | 23 | | (x) In order to provide for the expeditious and timely | 24 | | implementation of the provisions of Public Act 99-906, | 25 | | emergency rules to implement subsection (i) of Section 16-115D, | 26 | | subsection (g) of Section 16-128A, and subsection (a) of |
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| 1 | | Section 16-128B of the Public Utilities Act may be adopted in | 2 | | accordance with this subsection (x) by the Illinois Commerce | 3 | | Commission. The rulemaking authority granted in this | 4 | | subsection (x) shall apply only to those rules adopted within | 5 | | 180 days after June 1, 2017 (the effective date of Public Act | 6 | | 99-906). The adoption of emergency rules authorized by this | 7 | | subsection (x) is deemed to be necessary for the public | 8 | | interest, safety, and welfare. | 9 | | (y) In order to provide for the expeditious and timely | 10 | | implementation of the provisions of Public Act 100-23 this | 11 | | amendatory Act of the 100th General Assembly , emergency rules | 12 | | to implement the changes made by Public Act 100-23 this | 13 | | amendatory Act of the 100th General Assembly to Section 4.02 of | 14 | | the Illinois Act on the Aging, Sections 5.5.4 and 5-5.4i of the | 15 | | Illinois Public Aid Code, Section 55-30 of the Alcoholism and | 16 | | Other Drug Abuse and Dependency Act, and Sections 74 and 75 of | 17 | | the Mental Health and Developmental Disabilities | 18 | | Administrative Act may be adopted in accordance with this | 19 | | subsection (y) by the respective Department. The adoption of | 20 | | emergency rules authorized by this subsection (y) is deemed to | 21 | | be necessary for the public interest, safety, and welfare. | 22 | | (z) In order to provide for the expeditious and timely | 23 | | implementation of the provisions of Public Act 100-554 this | 24 | | amendatory Act of the 100th General Assembly , emergency rules | 25 | | to implement the changes made by Public Act 100-554 this | 26 | | amendatory Act of the 100th General Assembly to Section 4.7 of |
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| 1 | | the Lobbyist Registration Act may be adopted in accordance with | 2 | | this subsection (z) by the Secretary of State. The adoption of | 3 | | emergency rules authorized by this subsection (z) is deemed to | 4 | | be necessary for the public interest, safety, and welfare. | 5 | | (aa) In order to provide for the expeditious and timely | 6 | | initial implementation of the changes made to Articles 5, 5A, | 7 | | 12, and 14 of the Illinois Public Aid Code under the provisions | 8 | | of Public Act 100-581 this amendatory Act of the 100th General | 9 | | Assembly , the Department of Healthcare and Family Services may | 10 | | adopt emergency rules in accordance with this subsection (aa). | 11 | | The 24-month limitation on the adoption of emergency rules does | 12 | | not apply to rules to initially implement the changes made to | 13 | | Articles 5, 5A, 12, and 14 of the Illinois Public Aid Code | 14 | | adopted under this subsection (aa). The adoption of emergency | 15 | | rules authorized by this subsection (aa) is deemed to be | 16 | | necessary for the public interest, safety, and welfare. | 17 | | (bb) In order to provide for the expeditious and timely | 18 | | implementation of the provisions of Public Act 100-587 this | 19 | | amendatory Act of the 100th General Assembly , emergency rules | 20 | | to implement the changes made by Public Act 100-587 this | 21 | | amendatory Act of the 100th General Assembly to Section 4.02 of | 22 | | the Illinois Act on the Aging, Sections 5.5.4 and 5-5.4i of the | 23 | | Illinois Public Aid Code, subsection (b) of Section 55-30 of | 24 | | the Alcoholism and Other Drug Abuse and Dependency Act, Section | 25 | | 5-104 of the Specialized Mental Health Rehabilitation Act of | 26 | | 2013, and Section 75 and subsection (b) of Section 74 of the |
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| 1 | | Mental Health and Developmental Disabilities Administrative | 2 | | Act may be adopted in accordance with this subsection (bb) by | 3 | | the respective Department. The adoption of emergency rules | 4 | | authorized by this subsection (bb) is deemed to be necessary | 5 | | for the public interest, safety, and welfare. | 6 | | (cc) (bb) In order to provide for the expeditious and | 7 | | timely implementation of the provisions of Public Act 100-587 | 8 | | this amendatory Act of the 100th General Assembly , emergency | 9 | | rules may be adopted in accordance with this subsection (cc) | 10 | | (bb) to implement the changes made by Public Act 100-587 this | 11 | | amendatory Act of the 100th General Assembly to: Sections | 12 | | 14-147.5 and 14-147.6 of the Illinois Pension Code by the Board | 13 | | created under Article 14 of the Code; Sections 15-185.5 and | 14 | | 15-185.6 of the Illinois Pension Code by the Board created | 15 | | under Article 15 of the Code; and Sections 16-190.5 and | 16 | | 16-190.6 of the Illinois Pension Code by the Board created | 17 | | under Article 16 of the Code. The adoption of emergency rules | 18 | | authorized by this subsection (cc) (bb) is deemed to be | 19 | | necessary for the public interest, safety, and welfare. | 20 | | (dd) (aa) In order to provide for the expeditious and | 21 | | timely implementation of the provisions of Public Act 100-864 | 22 | | this amendatory Act of the 100th General Assembly , emergency | 23 | | rules to implement the changes made by Public Act 100-864 this | 24 | | amendatory Act of the 100th General Assembly to Section 3.35 of | 25 | | the Newborn Metabolic Screening Act may be adopted in | 26 | | accordance with this subsection (dd) (aa) by the Secretary of |
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| 1 | | State. The adoption of emergency rules authorized by this | 2 | | subsection (dd) (aa) is deemed to be necessary for the public | 3 | | interest, safety, and welfare. | 4 | | (ee) In order to provide for the expeditious and timely | 5 | | initial implementation of the changes made to Articles 5A and | 6 | | 14 of the Illinois Public Aid Code under the provisions of this | 7 | | amendatory Act of the 100th General Assembly, the Department of | 8 | | Healthcare and Family Services may on a one-time-only basis | 9 | | adopt emergency rules in accordance with this subsection (ee). | 10 | | The 24-month limitation on the adoption of emergency rules does | 11 | | not apply to rules to initially implement the changes made to | 12 | | Articles 5A and 14 of the Illinois Public Aid Code adopted | 13 | | under this subsection (ee). The adoption of emergency rules | 14 | | authorized by this subsection (ee) is deemed to be necessary | 15 | | for the public interest, safety, and welfare. | 16 | | (Source: P.A. 99-2, eff. 3-26-15; 99-6, eff. 1-1-16; 99-143, | 17 | | eff. 7-27-15; 99-455, eff. 1-1-16; 99-516, eff. 6-30-16; | 18 | | 99-642, eff. 7-28-16; 99-796, eff. 1-1-17; 99-906, eff. 6-1-17; | 19 | | 100-23, eff. 7-6-17; 100-554, eff. 11-16-17; 100-581, eff. | 20 | | 3-12-18; 100-587, Article 95, Section 95-5, eff. 6-4-18; | 21 | | 100-587, Article 110, Section 110-5, eff. 6-4-18; 100-864, eff. | 22 | | 8-14-18; revised 10-18-18.) | 23 | | Section 15. The Use Tax Act is amended by changing Section | 24 | | 3-8 as follows: |
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| 1 | | (35 ILCS 105/3-8) | 2 | | Sec. 3-8. Hospital exemption. | 3 | | (a) Until July 1, 2022, tangible Tangible personal property | 4 | | sold to or used by a hospital owner that owns one or more | 5 | | hospitals licensed under the Hospital Licensing Act or operated | 6 | | under the University of Illinois Hospital Act, or a hospital | 7 | | affiliate that is not already exempt under another provision of | 8 | | this Act and meets the criteria for an exemption under this | 9 | | Section, is exempt from taxation under this Act. | 10 | | (b) A hospital owner or hospital affiliate satisfies the | 11 | | conditions for an exemption under this Section if the value of | 12 | | qualified services or activities listed in subsection (c) of | 13 | | this Section for the hospital year equals or exceeds the | 14 | | relevant hospital entity's estimated property tax liability, | 15 | | without regard to any property tax exemption granted under | 16 | | Section 15-86 of the Property Tax Code, for the calendar year | 17 | | in which exemption or renewal of exemption is sought. For | 18 | | purposes of making the calculations required by this subsection | 19 | | (b), if the relevant hospital entity is a hospital owner that | 20 | | owns more than one hospital, the value of the services or | 21 | | activities listed in subsection (c) shall be calculated on the | 22 | | basis of only those services and activities relating to the | 23 | | hospital that includes the subject property, and the relevant | 24 | | hospital entity's estimated property tax liability shall be | 25 | | calculated only with respect to the properties comprising that | 26 | | hospital. In the case of a multi-state hospital system or |
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| 1 | | hospital affiliate, the value of the services or activities | 2 | | listed in subsection (c) shall be calculated on the basis of | 3 | | only those services and activities that occur in Illinois and | 4 | | the relevant hospital entity's estimated property tax | 5 | | liability shall be calculated only with respect to its property | 6 | | located in Illinois. | 7 | | (c) The following services and activities shall be | 8 | | considered for purposes of making the calculations required by | 9 | | subsection (b): | 10 | | (1) Charity care. Free or discounted services provided | 11 | | pursuant to the relevant hospital entity's financial | 12 | | assistance policy, measured at cost, including discounts | 13 | | provided under the Hospital Uninsured Patient Discount | 14 | | Act. | 15 | | (2) Health services to low-income and underserved | 16 | | individuals. Other unreimbursed costs of the relevant | 17 | | hospital entity for providing without charge, paying for, | 18 | | or subsidizing goods, activities, or services for the | 19 | | purpose of addressing the health of low-income or | 20 | | underserved individuals. Those activities or services may | 21 | | include, but are not limited to: financial or in-kind | 22 | | support to affiliated or unaffiliated hospitals, hospital | 23 | | affiliates, community clinics, or programs that treat | 24 | | low-income or underserved individuals; paying for or | 25 | | subsidizing health care professionals who care for | 26 | | low-income or underserved individuals; providing or |
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| 1 | | subsidizing outreach or educational services to low-income | 2 | | or underserved individuals for disease management and | 3 | | prevention; free or subsidized goods, supplies, or | 4 | | services needed by low-income or underserved individuals | 5 | | because of their medical condition; and prenatal or | 6 | | childbirth outreach to low-income or underserved persons. | 7 | | (3) Subsidy of State or local governments. Direct or | 8 | | indirect financial or in-kind subsidies of State or local | 9 | | governments by the relevant hospital entity that pay for or | 10 | | subsidize activities or programs related to health care for | 11 | | low-income or underserved individuals. | 12 | | (4) Support for State health care programs for | 13 | | low-income individuals. At the election of the hospital | 14 | | applicant for each applicable year, either (A) 10% of | 15 | | payments to the relevant hospital entity and any hospital | 16 | | affiliate designated by the relevant hospital entity | 17 | | (provided that such hospital affiliate's operations | 18 | | provide financial or operational support for or receive | 19 | | financial or operational support from the relevant | 20 | | hospital entity) under Medicaid or other means-tested | 21 | | programs, including, but not limited to, General | 22 | | Assistance, the Covering ALL KIDS Health Insurance Act, and | 23 | | the State Children's Health Insurance Program or (B) the | 24 | | amount of subsidy provided by the relevant hospital entity | 25 | | and any hospital affiliate designated by the relevant | 26 | | hospital entity (provided that such hospital affiliate's |
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| 1 | | operations provide financial or operational support for or | 2 | | receive financial or operational support from the relevant | 3 | | hospital entity) to State or local government in treating | 4 | | Medicaid recipients and recipients of means-tested | 5 | | programs, including but not limited to General Assistance, | 6 | | the Covering ALL KIDS Health Insurance Act, and the State | 7 | | Children's Health Insurance Program. The amount of subsidy | 8 | | for purpose of this item (4) is calculated in the same | 9 | | manner as unreimbursed costs are calculated for Medicaid | 10 | | and other means-tested government programs in the Schedule | 11 | | H of IRS Form 990 in effect on the effective date of this | 12 | | amendatory Act of the 97th General Assembly. | 13 | | (5) Dual-eligible subsidy. The amount of subsidy | 14 | | provided to government by treating dual-eligible | 15 | | Medicare/Medicaid patients. The amount of subsidy for | 16 | | purposes of this item (5) is calculated by multiplying the | 17 | | relevant hospital entity's unreimbursed costs for | 18 | | Medicare, calculated in the same manner as determined in | 19 | | the Schedule H of IRS Form 990 in effect on the effective | 20 | | date of this amendatory Act of the 97th General Assembly, | 21 | | by the relevant hospital entity's ratio of dual-eligible | 22 | | patients to total Medicare patients. | 23 | | (6) Relief of the burden of government related to | 24 | | health care. Except to the extent otherwise taken into | 25 | | account in this subsection, the portion of unreimbursed | 26 | | costs of the relevant hospital entity attributable to |
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| 1 | | providing, paying for, or subsidizing goods, activities, | 2 | | or services that relieve the burden of government related | 3 | | to health care for low-income individuals. Such activities | 4 | | or services shall include, but are not limited to, | 5 | | providing emergency, trauma, burn, neonatal, psychiatric, | 6 | | rehabilitation, or other special services; providing | 7 | | medical education; and conducting medical research or | 8 | | training of health care professionals. The portion of those | 9 | | unreimbursed costs attributable to benefiting low-income | 10 | | individuals shall be determined using the ratio calculated | 11 | | by adding the relevant hospital entity's costs | 12 | | attributable to charity care, Medicaid, other means-tested | 13 | | government programs, Medicare patients with disabilities | 14 | | under age 65, and dual-eligible Medicare/Medicaid patients | 15 | | and dividing that total by the relevant hospital entity's | 16 | | total costs. Such costs for the numerator and denominator | 17 | | shall be determined by multiplying gross charges by the | 18 | | cost to charge ratio taken from the hospital's most | 19 | | recently filed Medicare cost report (CMS 2252-10 | 20 | | Worksheet, Part I). In the case of emergency services, the | 21 | | ratio shall be calculated using costs (gross charges | 22 | | multiplied by the cost to charge ratio taken from the | 23 | | hospital's most recently filed Medicare cost report (CMS | 24 | | 2252-10 Worksheet, Part I)) of patients treated in the | 25 | | relevant hospital entity's emergency department. | 26 | | (7) Any other activity by the relevant hospital entity |
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| 1 | | that the Department determines relieves the burden of | 2 | | government or addresses the health of low-income or | 3 | | underserved individuals. | 4 | | (d) The hospital applicant shall include information in its | 5 | | exemption application establishing that it satisfies the | 6 | | requirements of subsection (b). For purposes of making the | 7 | | calculations required by subsection (b), the hospital | 8 | | applicant may for each year elect to use either (1) the value | 9 | | of the services or activities listed in subsection (e) for the | 10 | | hospital year or (2) the average value of those services or | 11 | | activities for the 3 fiscal years ending with the hospital | 12 | | year. If the relevant hospital entity has been in operation for | 13 | | less than 3 completed fiscal years, then the latter | 14 | | calculation, if elected, shall be performed on a pro rata | 15 | | basis. | 16 | | (e) For purposes of making the calculations required by | 17 | | this Section: | 18 | | (1) particular services or activities eligible for | 19 | | consideration under any of the paragraphs (1) through (7) | 20 | | of subsection (c) may not be counted under more than one of | 21 | | those paragraphs; and | 22 | | (2) the amount of unreimbursed costs and the amount of | 23 | | subsidy shall not be reduced by restricted or unrestricted | 24 | | payments received by the relevant hospital entity as | 25 | | contributions deductible under Section 170(a) of the | 26 | | Internal Revenue Code. |
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| 1 | | (f) (Blank). | 2 | | (g) Estimation of Exempt Property Tax Liability. The | 3 | | estimated property tax liability used for the determination in | 4 | | subsection (b) shall be calculated as follows: | 5 | | (1) "Estimated property tax liability" means the | 6 | | estimated dollar amount of property tax that would be owed, | 7 | | with respect to the exempt portion of each of the relevant | 8 | | hospital entity's properties that are already fully or | 9 | | partially exempt, or for which an exemption in whole or in | 10 | | part is currently being sought, and then aggregated as | 11 | | applicable, as if the exempt portion of those properties | 12 | | were subject to tax, calculated with respect to each such | 13 | | property by multiplying: | 14 | | (A) the lesser of (i) the actual assessed value, if | 15 | | any, of the portion of the property for which an | 16 | | exemption is sought or (ii) an estimated assessed value | 17 | | of the exempt portion of such property as determined in | 18 | | item (2) of this subsection (g), by | 19 | | (B) the applicable State equalization rate | 20 | | (yielding the equalized assessed value), by | 21 | | (C) the applicable tax rate. | 22 | | (2) The estimated assessed value of the exempt portion | 23 | | of the property equals the sum of (i) the estimated fair | 24 | | market value of buildings on the property, as determined in | 25 | | accordance with subparagraphs (A) and (B) of this item (2), | 26 | | multiplied by the applicable assessment factor, and (ii) |
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| 1 | | the estimated assessed value of the land portion of the | 2 | | property, as determined in accordance with subparagraph | 3 | | (C). | 4 | | (A) The "estimated fair market value of buildings | 5 | | on the property" means the replacement value of any | 6 | | exempt portion of buildings on the property, minus | 7 | | depreciation, determined utilizing the cost | 8 | | replacement method whereby the exempt square footage | 9 | | of all such buildings is multiplied by the replacement | 10 | | cost per square foot for Class A Average building found | 11 | | in the most recent edition of the Marshall & Swift | 12 | | Valuation Services Manual, adjusted by any appropriate | 13 | | current cost and local multipliers. | 14 | | (B) Depreciation, for purposes of calculating the | 15 | | estimated fair market value of buildings on the | 16 | | property, is applied by utilizing a weighted mean life | 17 | | for the buildings based on original construction and | 18 | | assuming a 40-year life for hospital buildings and the | 19 | | applicable life for other types of buildings as | 20 | | specified in the American Hospital Association | 21 | | publication "Estimated Useful Lives of Depreciable | 22 | | Hospital Assets". In the case of hospital buildings, | 23 | | the remaining life is divided by 40 and this ratio is | 24 | | multiplied by the replacement cost of the buildings to | 25 | | obtain an estimated fair market value of buildings. If | 26 | | a hospital building is older than 35 years, a remaining |
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| 1 | | life of 5 years for residual value is assumed; and if a | 2 | | building is less than 8 years old, a remaining life of | 3 | | 32 years is assumed. | 4 | | (C) The estimated assessed value of the land | 5 | | portion of the property shall be determined by | 6 | | multiplying (i) the per square foot average of the | 7 | | assessed values of three parcels of land (not including | 8 | | farm land, and excluding the assessed value of the | 9 | | improvements thereon) reasonably comparable to the | 10 | | property, by (ii) the number of square feet comprising | 11 | | the exempt portion of the property's land square | 12 | | footage. | 13 | | (3) The assessment factor, State equalization rate, | 14 | | and tax rate (including any special factors such as | 15 | | Enterprise Zones) used in calculating the estimated | 16 | | property tax liability shall be for the most recent year | 17 | | that is publicly available from the applicable chief county | 18 | | assessment officer or officers at least 90 days before the | 19 | | end of the hospital year. | 20 | | (4) The method utilized to calculate estimated | 21 | | property tax liability for purposes of this Section 15-86 | 22 | | shall not be utilized for the actual valuation, assessment, | 23 | | or taxation of property pursuant to the Property Tax Code. | 24 | | (h) For the purpose of this Section, the following terms | 25 | | shall have the meanings set forth below: | 26 | | (1) "Hospital" means any institution, place, building, |
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| 1 | | buildings on a campus, or other health care facility | 2 | | located in Illinois that is licensed under the Hospital | 3 | | Licensing Act and has a hospital owner. | 4 | | (2) "Hospital owner" means a not-for-profit | 5 | | corporation that is the titleholder of a hospital, or the | 6 | | owner of the beneficial interest in an Illinois land trust | 7 | | that is the titleholder of a hospital. | 8 | | (3) "Hospital affiliate" means any corporation, | 9 | | partnership, limited partnership, joint venture, limited | 10 | | liability company, association or other organization, | 11 | | other than a hospital owner, that directly or indirectly | 12 | | controls, is controlled by, or is under common control with | 13 | | one or more hospital owners and that supports, is supported | 14 | | by, or acts in furtherance of the exempt health care | 15 | | purposes of at least one of those hospital owners' | 16 | | hospitals. | 17 | | (4) "Hospital system" means a hospital and one or more | 18 | | other hospitals or hospital affiliates related by common | 19 | | control or ownership. | 20 | | (5) "Control" relating to hospital owners, hospital | 21 | | affiliates, or hospital systems means possession, direct | 22 | | or indirect, of the power to direct or cause the direction | 23 | | of the management and policies of the entity, whether | 24 | | through ownership of assets, membership interest, other | 25 | | voting or governance rights, by contract or otherwise. | 26 | | (6) "Hospital applicant" means a hospital owner or |
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| 1 | | hospital affiliate that files an application for an | 2 | | exemption or renewal of exemption under this Section. | 3 | | (7) "Relevant hospital entity" means (A) the hospital | 4 | | owner, in the case of a hospital applicant that is a | 5 | | hospital owner, and (B) at the election of a hospital | 6 | | applicant that is a hospital affiliate, either (i) the | 7 | | hospital affiliate or (ii) the hospital system to which the | 8 | | hospital applicant belongs, including any hospitals or | 9 | | hospital affiliates that are related by common control or | 10 | | ownership. | 11 | | (8) "Subject property" means property used for the | 12 | | calculation under subsection (b) of this Section. | 13 | | (9) "Hospital year" means the fiscal year of the | 14 | | relevant hospital entity, or the fiscal year of one of the | 15 | | hospital owners in the hospital system if the relevant | 16 | | hospital entity is a hospital system with members with | 17 | | different fiscal years, that ends in the year for which the | 18 | | exemption is sought.
| 19 | | (i) It is the intent of the General Assembly that any | 20 | | exemptions taken, granted, or renewed under this Section prior | 21 | | to the effective date of this amendatory Act of the 100th | 22 | | General Assembly are hereby validated. | 23 | | (Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.) | 24 | | Section 20. The Service Use Tax Act is amended by changing | 25 | | Section 3-8 as follows: |
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| 1 | | (35 ILCS 110/3-8) | 2 | | Sec. 3-8. Hospital exemption. | 3 | | (a) Until July 1, 2022, tangible Tangible personal property | 4 | | sold to or used by a hospital owner that owns one or more | 5 | | hospitals licensed under the Hospital Licensing Act or operated | 6 | | under the University of Illinois Hospital Act, or a hospital | 7 | | affiliate that is not already exempt under another provision of | 8 | | this Act and meets the criteria for an exemption under this | 9 | | Section, is exempt from taxation under this Act. | 10 | | (b) A hospital owner or hospital affiliate satisfies the | 11 | | conditions for an exemption under this Section if the value of | 12 | | qualified services or activities listed in subsection (c) of | 13 | | this Section for the hospital year equals or exceeds the | 14 | | relevant hospital entity's estimated property tax liability, | 15 | | without regard to any property tax exemption granted under | 16 | | Section 15-86 of the Property Tax Code, for the calendar year | 17 | | in which exemption or renewal of exemption is sought. For | 18 | | purposes of making the calculations required by this subsection | 19 | | (b), if the relevant hospital entity is a hospital owner that | 20 | | owns more than one hospital, the value of the services or | 21 | | activities listed in subsection (c) shall be calculated on the | 22 | | basis of only those services and activities relating to the | 23 | | hospital that includes the subject property, and the relevant | 24 | | hospital entity's estimated property tax liability shall be | 25 | | calculated only with respect to the properties comprising that |
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| 1 | | hospital. In the case of a multi-state hospital system or | 2 | | hospital affiliate, the value of the services or activities | 3 | | listed in subsection (c) shall be calculated on the basis of | 4 | | only those services and activities that occur in Illinois and | 5 | | the relevant hospital entity's estimated property tax | 6 | | liability shall be calculated only with respect to its property | 7 | | located in Illinois. | 8 | | (c) The following services and activities shall be | 9 | | considered for purposes of making the calculations required by | 10 | | subsection (b): | 11 | | (1) Charity care. Free or discounted services provided | 12 | | pursuant to the relevant hospital entity's financial | 13 | | assistance policy, measured at cost, including discounts | 14 | | provided under the Hospital Uninsured Patient Discount | 15 | | Act. | 16 | | (2) Health services to low-income and underserved | 17 | | individuals. Other unreimbursed costs of the relevant | 18 | | hospital entity for providing without charge, paying for, | 19 | | or subsidizing goods, activities, or services for the | 20 | | purpose of addressing the health of low-income or | 21 | | underserved individuals. Those activities or services may | 22 | | include, but are not limited to: financial or in-kind | 23 | | support to affiliated or unaffiliated hospitals, hospital | 24 | | affiliates, community clinics, or programs that treat | 25 | | low-income or underserved individuals; paying for or | 26 | | subsidizing health care professionals who care for |
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| 1 | | low-income or underserved individuals; providing or | 2 | | subsidizing outreach or educational services to low-income | 3 | | or underserved individuals for disease management and | 4 | | prevention; free or subsidized goods, supplies, or | 5 | | services needed by low-income or underserved individuals | 6 | | because of their medical condition; and prenatal or | 7 | | childbirth outreach to low-income or underserved persons. | 8 | | (3) Subsidy of State or local governments. Direct or | 9 | | indirect financial or in-kind subsidies of State or local | 10 | | governments by the relevant hospital entity that pay for or | 11 | | subsidize activities or programs related to health care for | 12 | | low-income or underserved individuals. | 13 | | (4) Support for State health care programs for | 14 | | low-income individuals. At the election of the hospital | 15 | | applicant for each applicable year, either (A) 10% of | 16 | | payments to the relevant hospital entity and any hospital | 17 | | affiliate designated by the relevant hospital entity | 18 | | (provided that such hospital affiliate's operations | 19 | | provide financial or operational support for or receive | 20 | | financial or operational support from the relevant | 21 | | hospital entity) under Medicaid or other means-tested | 22 | | programs, including, but not limited to, General | 23 | | Assistance, the Covering ALL KIDS Health Insurance Act, and | 24 | | the State Children's Health Insurance Program or (B) the | 25 | | amount of subsidy provided by the relevant hospital entity | 26 | | and any hospital affiliate designated by the relevant |
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| 1 | | hospital entity (provided that such hospital affiliate's | 2 | | operations provide financial or operational support for or | 3 | | receive financial or operational support from the relevant | 4 | | hospital entity) to State or local government in treating | 5 | | Medicaid recipients and recipients of means-tested | 6 | | programs, including but not limited to General Assistance, | 7 | | the Covering ALL KIDS Health Insurance Act, and the State | 8 | | Children's Health Insurance Program. The amount of subsidy | 9 | | for purposes of this item (4) is calculated in the same | 10 | | manner as unreimbursed costs are calculated for Medicaid | 11 | | and other means-tested government programs in the Schedule | 12 | | H of IRS Form 990 in effect on the effective date of this | 13 | | amendatory Act of the 97th General Assembly. | 14 | | (5) Dual-eligible subsidy. The amount of subsidy | 15 | | provided to government by treating dual-eligible | 16 | | Medicare/Medicaid patients. The amount of subsidy for | 17 | | purposes of this item (5) is calculated by multiplying the | 18 | | relevant hospital entity's unreimbursed costs for | 19 | | Medicare, calculated in the same manner as determined in | 20 | | the Schedule H of IRS Form 990 in effect on the effective | 21 | | date of this amendatory Act of the 97th General Assembly, | 22 | | by the relevant hospital entity's ratio of dual-eligible | 23 | | patients to total Medicare patients. | 24 | | (6) Relief of the burden of government related to | 25 | | health care. Except to the extent otherwise taken into | 26 | | account in this subsection, the portion of unreimbursed |
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| 1 | | costs of the relevant hospital entity attributable to | 2 | | providing, paying for, or subsidizing goods, activities, | 3 | | or services that relieve the burden of government related | 4 | | to health care for low-income individuals. Such activities | 5 | | or services shall include, but are not limited to, | 6 | | providing emergency, trauma, burn, neonatal, psychiatric, | 7 | | rehabilitation, or other special services; providing | 8 | | medical education; and conducting medical research or | 9 | | training of health care professionals. The portion of those | 10 | | unreimbursed costs attributable to benefiting low-income | 11 | | individuals shall be determined using the ratio calculated | 12 | | by adding the relevant hospital entity's costs | 13 | | attributable to charity care, Medicaid, other means-tested | 14 | | government programs, Medicare patients with disabilities | 15 | | under age 65, and dual-eligible Medicare/Medicaid patients | 16 | | and dividing that total by the relevant hospital entity's | 17 | | total costs. Such costs for the numerator and denominator | 18 | | shall be determined by multiplying gross charges by the | 19 | | cost to charge ratio taken from the hospital's most | 20 | | recently filed Medicare cost report (CMS 2252-10 | 21 | | Worksheet, Part I). In the case of emergency services, the | 22 | | ratio shall be calculated using costs (gross charges | 23 | | multiplied by the cost to charge ratio taken from the | 24 | | hospital's most recently filed Medicare cost report (CMS | 25 | | 2252-10 Worksheet, Part I)) of patients treated in the | 26 | | relevant hospital entity's emergency department. |
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| 1 | | (7) Any other activity by the relevant hospital entity | 2 | | that the Department determines relieves the burden of | 3 | | government or addresses the health of low-income or | 4 | | underserved individuals. | 5 | | (d) The hospital applicant shall include information in its | 6 | | exemption application establishing that it satisfies the | 7 | | requirements of subsection (b). For purposes of making the | 8 | | calculations required by subsection (b), the hospital | 9 | | applicant may for each year elect to use either (1) the value | 10 | | of the services or activities listed in subsection (e) for the | 11 | | hospital year or (2) the average value of those services or | 12 | | activities for the 3 fiscal years ending with the hospital | 13 | | year. If the relevant hospital entity has been in operation for | 14 | | less than 3 completed fiscal years, then the latter | 15 | | calculation, if elected, shall be performed on a pro rata | 16 | | basis. | 17 | | (e) For purposes of making the calculations required by | 18 | | this Section: | 19 | | (1) particular services or activities eligible for | 20 | | consideration under any of the paragraphs (1) through (7) | 21 | | of subsection (c) may not be counted under more than one of | 22 | | those paragraphs; and | 23 | | (2) the amount of unreimbursed costs and the amount of | 24 | | subsidy shall not be reduced by restricted or unrestricted | 25 | | payments received by the relevant hospital entity as | 26 | | contributions deductible under Section 170(a) of the |
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| 1 | | Internal Revenue Code. | 2 | | (f) (Blank). | 3 | | (g) Estimation of Exempt Property Tax Liability. The | 4 | | estimated property tax liability used for the determination in | 5 | | subsection (b) shall be calculated as follows: | 6 | | (1) "Estimated property tax liability" means the | 7 | | estimated dollar amount of property tax that would be owed, | 8 | | with respect to the exempt portion of each of the relevant | 9 | | hospital entity's properties that are already fully or | 10 | | partially exempt, or for which an exemption in whole or in | 11 | | part is currently being sought, and then aggregated as | 12 | | applicable, as if the exempt portion of those properties | 13 | | were subject to tax, calculated with respect to each such | 14 | | property by multiplying: | 15 | | (A) the lesser of (i) the actual assessed value, if | 16 | | any, of the portion of the property for which an | 17 | | exemption is sought or (ii) an estimated assessed value | 18 | | of the exempt portion of such property as determined in | 19 | | item (2) of this subsection (g), by | 20 | | (B) the applicable State equalization rate | 21 | | (yielding the equalized assessed value), by | 22 | | (C) the applicable tax rate. | 23 | | (2) The estimated assessed value of the exempt portion | 24 | | of the property equals the sum of (i) the estimated fair | 25 | | market value of buildings on the property, as determined in | 26 | | accordance with subparagraphs (A) and (B) of this item (2), |
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| 1 | | multiplied by the applicable assessment factor, and (ii) | 2 | | the estimated assessed value of the land portion of the | 3 | | property, as determined in accordance with subparagraph | 4 | | (C). | 5 | | (A) The "estimated fair market value of buildings | 6 | | on the property" means the replacement value of any | 7 | | exempt portion of buildings on the property, minus | 8 | | depreciation, determined utilizing the cost | 9 | | replacement method whereby the exempt square footage | 10 | | of all such buildings is multiplied by the replacement | 11 | | cost per square foot for Class A Average building found | 12 | | in the most recent edition of the Marshall & Swift | 13 | | Valuation Services Manual, adjusted by any appropriate | 14 | | current cost and local multipliers. | 15 | | (B) Depreciation, for purposes of calculating the | 16 | | estimated fair market value of buildings on the | 17 | | property, is applied by utilizing a weighted mean life | 18 | | for the buildings based on original construction and | 19 | | assuming a 40-year life for hospital buildings and the | 20 | | applicable life for other types of buildings as | 21 | | specified in the American Hospital Association | 22 | | publication "Estimated Useful Lives of Depreciable | 23 | | Hospital Assets". In the case of hospital buildings, | 24 | | the remaining life is divided by 40 and this ratio is | 25 | | multiplied by the replacement cost of the buildings to | 26 | | obtain an estimated fair market value of buildings. If |
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| 1 | | a hospital building is older than 35 years, a remaining | 2 | | life of 5 years for residual value is assumed; and if a | 3 | | building is less than 8 years old, a remaining life of | 4 | | 32 years is assumed. | 5 | | (C) The estimated assessed value of the land | 6 | | portion of the property shall be determined by | 7 | | multiplying (i) the per square foot average of the | 8 | | assessed values of three parcels of land (not including | 9 | | farm land, and excluding the assessed value of the | 10 | | improvements thereon) reasonably comparable to the | 11 | | property, by (ii) the number of square feet comprising | 12 | | the exempt portion of the property's land square | 13 | | footage. | 14 | | (3) The assessment factor, State equalization rate, | 15 | | and tax rate (including any special factors such as | 16 | | Enterprise Zones) used in calculating the estimated | 17 | | property tax liability shall be for the most recent year | 18 | | that is publicly available from the applicable chief county | 19 | | assessment officer or officers at least 90 days before the | 20 | | end of the hospital year. | 21 | | (4) The method utilized to calculate estimated | 22 | | property tax liability for purposes of this Section 15-86 | 23 | | shall not be utilized for the actual valuation, assessment, | 24 | | or taxation of property pursuant to the Property Tax Code. | 25 | | (h) For the purpose of this Section, the following terms | 26 | | shall have the meanings set forth below: |
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| 1 | | (1) "Hospital" means any institution, place, building, | 2 | | buildings on a campus, or other health care facility | 3 | | located in Illinois that is licensed under the Hospital | 4 | | Licensing Act and has a hospital owner. | 5 | | (2) "Hospital owner" means a not-for-profit | 6 | | corporation that is the titleholder of a hospital, or the | 7 | | owner of the beneficial interest in an Illinois land trust | 8 | | that is the titleholder of a hospital. | 9 | | (3) "Hospital affiliate" means any corporation, | 10 | | partnership, limited partnership, joint venture, limited | 11 | | liability company, association or other organization, | 12 | | other than a hospital owner, that directly or indirectly | 13 | | controls, is controlled by, or is under common control with | 14 | | one or more hospital owners and that supports, is supported | 15 | | by, or acts in furtherance of the exempt health care | 16 | | purposes of at least one of those hospital owners' | 17 | | hospitals. | 18 | | (4) "Hospital system" means a hospital and one or more | 19 | | other hospitals or hospital affiliates related by common | 20 | | control or ownership. | 21 | | (5) "Control" relating to hospital owners, hospital | 22 | | affiliates, or hospital systems means possession, direct | 23 | | or indirect, of the power to direct or cause the direction | 24 | | of the management and policies of the entity, whether | 25 | | through ownership of assets, membership interest, other | 26 | | voting or governance rights, by contract or otherwise. |
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| 1 | | (6) "Hospital applicant" means a hospital owner or | 2 | | hospital affiliate that files an application for an | 3 | | exemption or renewal of exemption under this Section. | 4 | | (7) "Relevant hospital entity" means (A) the hospital | 5 | | owner, in the case of a hospital applicant that is a | 6 | | hospital owner, and (B) at the election of a hospital | 7 | | applicant that is a hospital affiliate, either (i) the | 8 | | hospital affiliate or (ii) the hospital system to which the | 9 | | hospital applicant belongs, including any hospitals or | 10 | | hospital affiliates that are related by common control or | 11 | | ownership. | 12 | | (8) "Subject property" means property used for the | 13 | | calculation under subsection (b) of this Section. | 14 | | (9) "Hospital year" means the fiscal year of the | 15 | | relevant hospital entity, or the fiscal year of one of the | 16 | | hospital owners in the hospital system if the relevant | 17 | | hospital entity is a hospital system with members with | 18 | | different fiscal years, that ends in the year for which the | 19 | | exemption is sought.
| 20 | | (i) It is the intent of the General Assembly that any | 21 | | exemptions taken, granted, or renewed under this Section prior | 22 | | to the effective date of this amendatory Act of the 100th | 23 | | General Assembly are hereby validated. | 24 | | (Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.) | 25 | | Section 25. The Service Occupation Tax Act is amended by |
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| 1 | | changing Section 3-8 as follows: | 2 | | (35 ILCS 115/3-8) | 3 | | Sec. 3-8. Hospital exemption. | 4 | | (a) Until July 1, 2022, tangible Tangible personal property | 5 | | sold to or used by a hospital owner that owns one or more | 6 | | hospitals licensed under the Hospital Licensing Act or operated | 7 | | under the University of Illinois Hospital Act, or a hospital | 8 | | affiliate that is not already exempt under another provision of | 9 | | this Act and meets the criteria for an exemption under this | 10 | | Section, is exempt from taxation under this Act. | 11 | | (b) A hospital owner or hospital affiliate satisfies the | 12 | | conditions for an exemption under this Section if the value of | 13 | | qualified services or activities listed in subsection (c) of | 14 | | this Section for the hospital year equals or exceeds the | 15 | | relevant hospital entity's estimated property tax liability, | 16 | | without regard to any property tax exemption granted under | 17 | | Section 15-86 of the Property Tax Code, for the calendar year | 18 | | in which exemption or renewal of exemption is sought. For | 19 | | purposes of making the calculations required by this subsection | 20 | | (b), if the relevant hospital entity is a hospital owner that | 21 | | owns more than one hospital, the value of the services or | 22 | | activities listed in subsection (c) shall be calculated on the | 23 | | basis of only those services and activities relating to the | 24 | | hospital that includes the subject property, and the relevant | 25 | | hospital entity's estimated property tax liability shall be |
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| 1 | | calculated only with respect to the properties comprising that | 2 | | hospital. In the case of a multi-state hospital system or | 3 | | hospital affiliate, the value of the services or activities | 4 | | listed in subsection (c) shall be calculated on the basis of | 5 | | only those services and activities that occur in Illinois and | 6 | | the relevant hospital entity's estimated property tax | 7 | | liability shall be calculated only with respect to its property | 8 | | located in Illinois. | 9 | | (c) The following services and activities shall be | 10 | | considered for purposes of making the calculations required by | 11 | | subsection (b): | 12 | | (1) Charity care. Free or discounted services provided | 13 | | pursuant to the relevant hospital entity's financial | 14 | | assistance policy, measured at cost, including discounts | 15 | | provided under the Hospital Uninsured Patient Discount | 16 | | Act. | 17 | | (2) Health services to low-income and underserved | 18 | | individuals. Other unreimbursed costs of the relevant | 19 | | hospital entity for providing without charge, paying for, | 20 | | or subsidizing goods, activities, or services for the | 21 | | purpose of addressing the health of low-income or | 22 | | underserved individuals. Those activities or services may | 23 | | include, but are not limited to: financial or in-kind | 24 | | support to affiliated or unaffiliated hospitals, hospital | 25 | | affiliates, community clinics, or programs that treat | 26 | | low-income or underserved individuals; paying for or |
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| 1 | | subsidizing health care professionals who care for | 2 | | low-income or underserved individuals; providing or | 3 | | subsidizing outreach or educational services to low-income | 4 | | or underserved individuals for disease management and | 5 | | prevention; free or subsidized goods, supplies, or | 6 | | services needed by low-income or underserved individuals | 7 | | because of their medical condition; and prenatal or | 8 | | childbirth outreach to low-income or underserved persons. | 9 | | (3) Subsidy of State or local governments. Direct or | 10 | | indirect financial or in-kind subsidies of State or local | 11 | | governments by the relevant hospital entity that pay for or | 12 | | subsidize activities or programs related to health care for | 13 | | low-income or underserved individuals. | 14 | | (4) Support for State health care programs for | 15 | | low-income individuals. At the election of the hospital | 16 | | applicant for each applicable year, either (A) 10% of | 17 | | payments to the relevant hospital entity and any hospital | 18 | | affiliate designated by the relevant hospital entity | 19 | | (provided that such hospital affiliate's operations | 20 | | provide financial or operational support for or receive | 21 | | financial or operational support from the relevant | 22 | | hospital entity) under Medicaid or other means-tested | 23 | | programs, including, but not limited to, General | 24 | | Assistance, the Covering ALL KIDS Health Insurance Act, and | 25 | | the State Children's Health Insurance Program or (B) the | 26 | | amount of subsidy provided by the relevant hospital entity |
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| 1 | | and any hospital affiliate designated by the relevant | 2 | | hospital entity (provided that such hospital affiliate's | 3 | | operations provide financial or operational support for or | 4 | | receive financial or operational support from the relevant | 5 | | hospital entity) to State or local government in treating | 6 | | Medicaid recipients and recipients of means-tested | 7 | | programs, including but not limited to General Assistance, | 8 | | the Covering ALL KIDS Health Insurance Act, and the State | 9 | | Children's Health Insurance Program. The amount of subsidy | 10 | | for purposes of this item (4) is calculated in the same | 11 | | manner as unreimbursed costs are calculated for Medicaid | 12 | | and other means-tested government programs in the Schedule | 13 | | H of IRS Form 990 in effect on the effective date of this | 14 | | amendatory Act of the 97th General Assembly. | 15 | | (5) Dual-eligible subsidy. The amount of subsidy | 16 | | provided to government by treating dual-eligible | 17 | | Medicare/Medicaid patients. The amount of subsidy for | 18 | | purposes of this item (5) is calculated by multiplying the | 19 | | relevant hospital entity's unreimbursed costs for | 20 | | Medicare, calculated in the same manner as determined in | 21 | | the Schedule H of IRS Form 990 in effect on the effective | 22 | | date of this amendatory Act of the 97th General Assembly, | 23 | | by the relevant hospital entity's ratio of dual-eligible | 24 | | patients to total Medicare patients. | 25 | | (6) Relief of the burden of government related to | 26 | | health care. Except to the extent otherwise taken into |
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| 1 | | account in this subsection, the portion of unreimbursed | 2 | | costs of the relevant hospital entity attributable to | 3 | | providing, paying for, or subsidizing goods, activities, | 4 | | or services that relieve the burden of government related | 5 | | to health care for low-income individuals. Such activities | 6 | | or services shall include, but are not limited to, | 7 | | providing emergency, trauma, burn, neonatal, psychiatric, | 8 | | rehabilitation, or other special services; providing | 9 | | medical education; and conducting medical research or | 10 | | training of health care professionals. The portion of those | 11 | | unreimbursed costs attributable to benefiting low-income | 12 | | individuals shall be determined using the ratio calculated | 13 | | by adding the relevant hospital entity's costs | 14 | | attributable to charity care, Medicaid, other means-tested | 15 | | government programs, Medicare patients with disabilities | 16 | | under age 65, and dual-eligible Medicare/Medicaid patients | 17 | | and dividing that total by the relevant hospital entity's | 18 | | total costs. Such costs for the numerator and denominator | 19 | | shall be determined by multiplying gross charges by the | 20 | | cost to charge ratio taken from the hospital's most | 21 | | recently filed Medicare cost report (CMS 2252-10 | 22 | | Worksheet, Part I). In the case of emergency services, the | 23 | | ratio shall be calculated using costs (gross charges | 24 | | multiplied by the cost to charge ratio taken from the | 25 | | hospital's most recently filed Medicare cost report (CMS | 26 | | 2252-10 Worksheet, Part I)) of patients treated in the |
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| 1 | | relevant hospital entity's emergency department. | 2 | | (7) Any other activity by the relevant hospital entity | 3 | | that the Department determines relieves the burden of | 4 | | government or addresses the health of low-income or | 5 | | underserved individuals. | 6 | | (d) The hospital applicant shall include information in its | 7 | | exemption application establishing that it satisfies the | 8 | | requirements of subsection (b). For purposes of making the | 9 | | calculations required by subsection (b), the hospital | 10 | | applicant may for each year elect to use either (1) the value | 11 | | of the services or activities listed in subsection (e) for the | 12 | | hospital year or (2) the average value of those services or | 13 | | activities for the 3 fiscal years ending with the hospital | 14 | | year. If the relevant hospital entity has been in operation for | 15 | | less than 3 completed fiscal years, then the latter | 16 | | calculation, if elected, shall be performed on a pro rata | 17 | | basis. | 18 | | (e) For purposes of making the calculations required by | 19 | | this Section: | 20 | | (1) particular services or activities eligible for | 21 | | consideration under any of the paragraphs (1) through (7) | 22 | | of subsection (c) may not be counted under more than one of | 23 | | those paragraphs; and | 24 | | (2) the amount of unreimbursed costs and the amount of | 25 | | subsidy shall not be reduced by restricted or unrestricted | 26 | | payments received by the relevant hospital entity as |
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| 1 | | contributions deductible under Section 170(a) of the | 2 | | Internal Revenue Code. | 3 | | (f) (Blank). | 4 | | (g) Estimation of Exempt Property Tax Liability. The | 5 | | estimated property tax liability used for the determination in | 6 | | subsection (b) shall be calculated as follows: | 7 | | (1) "Estimated property tax liability" means the | 8 | | estimated dollar amount of property tax that would be owed, | 9 | | with respect to the exempt portion of each of the relevant | 10 | | hospital entity's properties that are already fully or | 11 | | partially exempt, or for which an exemption in whole or in | 12 | | part is currently being sought, and then aggregated as | 13 | | applicable, as if the exempt portion of those properties | 14 | | were subject to tax, calculated with respect to each such | 15 | | property by multiplying: | 16 | | (A) the lesser of (i) the actual assessed value, if | 17 | | any, of the portion of the property for which an | 18 | | exemption is sought or (ii) an estimated assessed value | 19 | | of the exempt portion of such property as determined in | 20 | | item (2) of this subsection (g), by | 21 | | (B) the applicable State equalization rate | 22 | | (yielding the equalized assessed value), by | 23 | | (C) the applicable tax rate. | 24 | | (2) The estimated assessed value of the exempt portion | 25 | | of the property equals the sum of (i) the estimated fair | 26 | | market value of buildings on the property, as determined in |
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| 1 | | accordance with subparagraphs (A) and (B) of this item (2), | 2 | | multiplied by the applicable assessment factor, and (ii) | 3 | | the estimated assessed value of the land portion of the | 4 | | property, as determined in accordance with subparagraph | 5 | | (C). | 6 | | (A) The "estimated fair market value of buildings | 7 | | on the property" means the replacement value of any | 8 | | exempt portion of buildings on the property, minus | 9 | | depreciation, determined utilizing the cost | 10 | | replacement method whereby the exempt square footage | 11 | | of all such buildings is multiplied by the replacement | 12 | | cost per square foot for Class A Average building found | 13 | | in the most recent edition of the Marshall & Swift | 14 | | Valuation Services Manual, adjusted by any appropriate | 15 | | current cost and local multipliers. | 16 | | (B) Depreciation, for purposes of calculating the | 17 | | estimated fair market value of buildings on the | 18 | | property, is applied by utilizing a weighted mean life | 19 | | for the buildings based on original construction and | 20 | | assuming a 40-year life for hospital buildings and the | 21 | | applicable life for other types of buildings as | 22 | | specified in the American Hospital Association | 23 | | publication "Estimated Useful Lives of Depreciable | 24 | | Hospital Assets". In the case of hospital buildings, | 25 | | the remaining life is divided by 40 and this ratio is | 26 | | multiplied by the replacement cost of the buildings to |
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| 1 | | obtain an estimated fair market value of buildings. If | 2 | | a hospital building is older than 35 years, a remaining | 3 | | life of 5 years for residual value is assumed; and if a | 4 | | building is less than 8 years old, a remaining life of | 5 | | 32 years is assumed. | 6 | | (C) The estimated assessed value of the land | 7 | | portion of the property shall be determined by | 8 | | multiplying (i) the per square foot average of the | 9 | | assessed values of three parcels of land (not including | 10 | | farm land, and excluding the assessed value of the | 11 | | improvements thereon) reasonably comparable to the | 12 | | property, by (ii) the number of square feet comprising | 13 | | the exempt portion of the property's land square | 14 | | footage. | 15 | | (3) The assessment factor, State equalization rate, | 16 | | and tax rate (including any special factors such as | 17 | | Enterprise Zones) used in calculating the estimated | 18 | | property tax liability shall be for the most recent year | 19 | | that is publicly available from the applicable chief county | 20 | | assessment officer or officers at least 90 days before the | 21 | | end of the hospital year. | 22 | | (4) The method utilized to calculate estimated | 23 | | property tax liability for purposes of this Section 15-86 | 24 | | shall not be utilized for the actual valuation, assessment, | 25 | | or taxation of property pursuant to the Property Tax Code. | 26 | | (h) For the purpose of this Section, the following terms |
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| 1 | | shall have the meanings set forth below: | 2 | | (1) "Hospital" means any institution, place, building, | 3 | | buildings on a campus, or other health care facility | 4 | | located in Illinois that is licensed under the Hospital | 5 | | Licensing Act and has a hospital owner. | 6 | | (2) "Hospital owner" means a not-for-profit | 7 | | corporation that is the titleholder of a hospital, or the | 8 | | owner of the beneficial interest in an Illinois land trust | 9 | | that is the titleholder of a hospital. | 10 | | (3) "Hospital affiliate" means any corporation, | 11 | | partnership, limited partnership, joint venture, limited | 12 | | liability company, association or other organization, | 13 | | other than a hospital owner, that directly or indirectly | 14 | | controls, is controlled by, or is under common control with | 15 | | one or more hospital owners and that supports, is supported | 16 | | by, or acts in furtherance of the exempt health care | 17 | | purposes of at least one of those hospital owners' | 18 | | hospitals. | 19 | | (4) "Hospital system" means a hospital and one or more | 20 | | other hospitals or hospital affiliates related by common | 21 | | control or ownership. | 22 | | (5) "Control" relating to hospital owners, hospital | 23 | | affiliates, or hospital systems means possession, direct | 24 | | or indirect, of the power to direct or cause the direction | 25 | | of the management and policies of the entity, whether | 26 | | through ownership of assets, membership interest, other |
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| 1 | | voting or governance rights, by contract or otherwise. | 2 | | (6) "Hospital applicant" means a hospital owner or | 3 | | hospital affiliate that files an application for an | 4 | | exemption or renewal of exemption under this Section. | 5 | | (7) "Relevant hospital entity" means (A) the hospital | 6 | | owner, in the case of a hospital applicant that is a | 7 | | hospital owner, and (B) at the election of a hospital | 8 | | applicant that is a hospital affiliate, either (i) the | 9 | | hospital affiliate or (ii) the hospital system to which the | 10 | | hospital applicant belongs, including any hospitals or | 11 | | hospital affiliates that are related by common control or | 12 | | ownership. | 13 | | (8) "Subject property" means property used for the | 14 | | calculation under subsection (b) of this Section. | 15 | | (9) "Hospital year" means the fiscal year of the | 16 | | relevant hospital entity, or the fiscal year of one of the | 17 | | hospital owners in the hospital system if the relevant | 18 | | hospital entity is a hospital system with members with | 19 | | different fiscal years, that ends in the year for which the | 20 | | exemption is sought.
| 21 | | (i) It is the intent of the General Assembly that any | 22 | | exemptions taken, granted, or renewed under this Section prior | 23 | | to the effective date of this amendatory Act of the 100th | 24 | | General Assembly are hereby validated. | 25 | | (Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.) |
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| 1 | | Section 30. The Retailers' Occupation Tax Act is amended by | 2 | | changing Section 2-9 as follows: | 3 | | (35 ILCS 120/2-9) | 4 | | Sec. 2-9. Hospital exemption. | 5 | | (a) Until July 1, 2022, tangible Tangible personal property | 6 | | sold to or used by a hospital owner that owns one or more | 7 | | hospitals licensed under the Hospital Licensing Act or operated | 8 | | under the University of Illinois Hospital Act, or a hospital | 9 | | affiliate that is not already exempt under another provision of | 10 | | this Act and meets the criteria for an exemption under this | 11 | | Section, is exempt from taxation under this Act. | 12 | | (b) A hospital owner or hospital affiliate satisfies the | 13 | | conditions for an exemption under this Section if the value of | 14 | | qualified services or activities listed in subsection (c) of | 15 | | this Section for the hospital year equals or exceeds the | 16 | | relevant hospital entity's estimated property tax liability, | 17 | | without regard to any property tax exemption granted under | 18 | | Section 15-86 of the Property Tax Code, for the calendar year | 19 | | in which exemption or renewal of exemption is sought. For | 20 | | purposes of making the calculations required by this subsection | 21 | | (b), if the relevant hospital entity is a hospital owner that | 22 | | owns more than one hospital, the value of the services or | 23 | | activities listed in subsection (c) shall be calculated on the | 24 | | basis of only those services and activities relating to the | 25 | | hospital that includes the subject property, and the relevant |
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| 1 | | hospital entity's estimated property tax liability shall be | 2 | | calculated only with respect to the properties comprising that | 3 | | hospital. In the case of a multi-state hospital system or | 4 | | hospital affiliate, the value of the services or activities | 5 | | listed in subsection (c) shall be calculated on the basis of | 6 | | only those services and activities that occur in Illinois and | 7 | | the relevant hospital entity's estimated property tax | 8 | | liability shall be calculated only with respect to its property | 9 | | located in Illinois. | 10 | | (c) The following services and activities shall be | 11 | | considered for purposes of making the calculations required by | 12 | | subsection (b): | 13 | | (1) Charity care. Free or discounted services provided | 14 | | pursuant to the relevant hospital entity's financial | 15 | | assistance policy, measured at cost, including discounts | 16 | | provided under the Hospital Uninsured Patient Discount | 17 | | Act. | 18 | | (2) Health services to low-income and underserved | 19 | | individuals. Other unreimbursed costs of the relevant | 20 | | hospital entity for providing without charge, paying for, | 21 | | or subsidizing goods, activities, or services for the | 22 | | purpose of addressing the health of low-income or | 23 | | underserved individuals. Those activities or services may | 24 | | include, but are not limited to: financial or in-kind | 25 | | support to affiliated or unaffiliated hospitals, hospital | 26 | | affiliates, community clinics, or programs that treat |
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| 1 | | low-income or underserved individuals; paying for or | 2 | | subsidizing health care professionals who care for | 3 | | low-income or underserved individuals; providing or | 4 | | subsidizing outreach or educational services to low-income | 5 | | or underserved individuals for disease management and | 6 | | prevention; free or subsidized goods, supplies, or | 7 | | services needed by low-income or underserved individuals | 8 | | because of their medical condition; and prenatal or | 9 | | childbirth outreach to low-income or underserved persons. | 10 | | (3) Subsidy of State or local governments. Direct or | 11 | | indirect financial or in-kind subsidies of State or local | 12 | | governments by the relevant hospital entity that pay for or | 13 | | subsidize activities or programs related to health care for | 14 | | low-income or underserved individuals. | 15 | | (4) Support for State health care programs for | 16 | | low-income individuals. At the election of the hospital | 17 | | applicant for each applicable year, either (A) 10% of | 18 | | payments to the relevant hospital entity and any hospital | 19 | | affiliate designated by the relevant hospital entity | 20 | | (provided that such hospital affiliate's operations | 21 | | provide financial or operational support for or receive | 22 | | financial or operational support from the relevant | 23 | | hospital entity) under Medicaid or other means-tested | 24 | | programs, including, but not limited to, General | 25 | | Assistance, the Covering ALL KIDS Health Insurance Act, and | 26 | | the State Children's Health Insurance Program or (B) the |
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| 1 | | amount of subsidy provided by the relevant hospital entity | 2 | | and any hospital affiliate designated by the relevant | 3 | | hospital entity (provided that such hospital affiliate's | 4 | | operations provide financial or operational support for or | 5 | | receive financial or operational support from the relevant | 6 | | hospital entity) to State or local government in treating | 7 | | Medicaid recipients and recipients of means-tested | 8 | | programs, including but not limited to General Assistance, | 9 | | the Covering ALL KIDS Health Insurance Act, and the State | 10 | | Children's Health Insurance Program. The amount of subsidy | 11 | | for purposes of this item (4) is calculated in the same | 12 | | manner as unreimbursed costs are calculated for Medicaid | 13 | | and other means-tested government programs in the Schedule | 14 | | H of IRS Form 990 in effect on the effective date of this | 15 | | amendatory Act of the 97th General Assembly. | 16 | | (5) Dual-eligible subsidy. The amount of subsidy | 17 | | provided to government by treating dual-eligible | 18 | | Medicare/Medicaid patients. The amount of subsidy for | 19 | | purposes of this item (5) is calculated by multiplying the | 20 | | relevant hospital entity's unreimbursed costs for | 21 | | Medicare, calculated in the same manner as determined in | 22 | | the Schedule H of IRS Form 990 in effect on the effective | 23 | | date of this amendatory Act of the 97th General Assembly, | 24 | | by the relevant hospital entity's ratio of dual-eligible | 25 | | patients to total Medicare patients. | 26 | | (6) Relief of the burden of government related to |
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| 1 | | health care. Except to the extent otherwise taken into | 2 | | account in this subsection, the portion of unreimbursed | 3 | | costs of the relevant hospital entity attributable to | 4 | | providing, paying for, or subsidizing goods, activities, | 5 | | or services that relieve the burden of government related | 6 | | to health care for low-income individuals. Such activities | 7 | | or services shall include, but are not limited to, | 8 | | providing emergency, trauma, burn, neonatal, psychiatric, | 9 | | rehabilitation, or other special services; providing | 10 | | medical education; and conducting medical research or | 11 | | training of health care professionals. The portion of those | 12 | | unreimbursed costs attributable to benefiting low-income | 13 | | individuals shall be determined using the ratio calculated | 14 | | by adding the relevant hospital entity's costs | 15 | | attributable to charity care, Medicaid, other means-tested | 16 | | government programs, Medicare patients with disabilities | 17 | | under age 65, and dual-eligible Medicare/Medicaid patients | 18 | | and dividing that total by the relevant hospital entity's | 19 | | total costs. Such costs for the numerator and denominator | 20 | | shall be determined by multiplying gross charges by the | 21 | | cost to charge ratio taken from the hospital's most | 22 | | recently filed Medicare cost report (CMS 2252-10 | 23 | | Worksheet, Part I). In the case of emergency services, the | 24 | | ratio shall be calculated using costs (gross charges | 25 | | multiplied by the cost to charge ratio taken from the | 26 | | hospital's most recently filed Medicare cost report (CMS |
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| 1 | | 2252-10 Worksheet, Part I)) of patients treated in the | 2 | | relevant hospital entity's emergency department. | 3 | | (7) Any other activity by the relevant hospital entity | 4 | | that the Department determines relieves the burden of | 5 | | government or addresses the health of low-income or | 6 | | underserved individuals. | 7 | | (d) The hospital applicant shall include information in its | 8 | | exemption application establishing that it satisfies the | 9 | | requirements of subsection (b). For purposes of making the | 10 | | calculations required by subsection (b), the hospital | 11 | | applicant may for each year elect to use either (1) the value | 12 | | of the services or activities listed in subsection (e) for the | 13 | | hospital year or (2) the average value of those services or | 14 | | activities for the 3 fiscal years ending with the hospital | 15 | | year. If the relevant hospital entity has been in operation for | 16 | | less than 3 completed fiscal years, then the latter | 17 | | calculation, if elected, shall be performed on a pro rata | 18 | | basis. | 19 | | (e) For purposes of making the calculations required by | 20 | | this Section: | 21 | | (1) particular services or activities eligible for | 22 | | consideration under any of the paragraphs (1) through (7) | 23 | | of subsection (c) may not be counted under more than one of | 24 | | those paragraphs; and | 25 | | (2) the amount of unreimbursed costs and the amount of | 26 | | subsidy shall not be reduced by restricted or unrestricted |
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| 1 | | payments received by the relevant hospital entity as | 2 | | contributions deductible under Section 170(a) of the | 3 | | Internal Revenue Code. | 4 | | (f) (Blank). | 5 | | (g) Estimation of Exempt Property Tax Liability. The | 6 | | estimated property tax liability used for the determination in | 7 | | subsection (b) shall be calculated as follows: | 8 | | (1) "Estimated property tax liability" means the | 9 | | estimated dollar amount of property tax that would be owed, | 10 | | with respect to the exempt portion of each of the relevant | 11 | | hospital entity's properties that are already fully or | 12 | | partially exempt, or for which an exemption in whole or in | 13 | | part is currently being sought, and then aggregated as | 14 | | applicable, as if the exempt portion of those properties | 15 | | were subject to tax, calculated with respect to each such | 16 | | property by multiplying: | 17 | | (A) the lesser of (i) the actual assessed value, if | 18 | | any, of the portion of the property for which an | 19 | | exemption is sought or (ii) an estimated assessed value | 20 | | of the exempt portion of such property as determined in | 21 | | item (2) of this subsection (g), by | 22 | | (B) the applicable State equalization rate | 23 | | (yielding the equalized assessed value), by | 24 | | (C) the applicable tax rate. | 25 | | (2) The estimated assessed value of the exempt portion | 26 | | of the property equals the sum of (i) the estimated fair |
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| 1 | | market value of buildings on the property, as determined in | 2 | | accordance with subparagraphs (A) and (B) of this item (2), | 3 | | multiplied by the applicable assessment factor, and (ii) | 4 | | the estimated assessed value of the land portion of the | 5 | | property, as determined in accordance with subparagraph | 6 | | (C). | 7 | | (A) The "estimated fair market value of buildings | 8 | | on the property" means the replacement value of any | 9 | | exempt portion of buildings on the property, minus | 10 | | depreciation, determined utilizing the cost | 11 | | replacement method whereby the exempt square footage | 12 | | of all such buildings is multiplied by the replacement | 13 | | cost per square foot for Class A Average building found | 14 | | in the most recent edition of the Marshall & Swift | 15 | | Valuation Services Manual, adjusted by any appropriate | 16 | | current cost and local multipliers. | 17 | | (B) Depreciation, for purposes of calculating the | 18 | | estimated fair market value of buildings on the | 19 | | property, is applied by utilizing a weighted mean life | 20 | | for the buildings based on original construction and | 21 | | assuming a 40-year life for hospital buildings and the | 22 | | applicable life for other types of buildings as | 23 | | specified in the American Hospital Association | 24 | | publication "Estimated Useful Lives of Depreciable | 25 | | Hospital Assets". In the case of hospital buildings, | 26 | | the remaining life is divided by 40 and this ratio is |
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| 1 | | multiplied by the replacement cost of the buildings to | 2 | | obtain an estimated fair market value of buildings. If | 3 | | a hospital building is older than 35 years, a remaining | 4 | | life of 5 years for residual value is assumed; and if a | 5 | | building is less than 8 years old, a remaining life of | 6 | | 32 years is assumed. | 7 | | (C) The estimated assessed value of the land | 8 | | portion of the property shall be determined by | 9 | | multiplying (i) the per square foot average of the | 10 | | assessed values of three parcels of land (not including | 11 | | farm land, and excluding the assessed value of the | 12 | | improvements thereon) reasonably comparable to the | 13 | | property, by (ii) the number of square feet comprising | 14 | | the exempt portion of the property's land square | 15 | | footage. | 16 | | (3) The assessment factor, State equalization rate, | 17 | | and tax rate (including any special factors such as | 18 | | Enterprise Zones) used in calculating the estimated | 19 | | property tax liability shall be for the most recent year | 20 | | that is publicly available from the applicable chief county | 21 | | assessment officer or officers at least 90 days before the | 22 | | end of the hospital year. | 23 | | (4) The method utilized to calculate estimated | 24 | | property tax liability for purposes of this Section 15-86 | 25 | | shall not be utilized for the actual valuation, assessment, | 26 | | or taxation of property pursuant to the Property Tax Code. |
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| 1 | | (h) For the purpose of this Section, the following terms | 2 | | shall have the meanings set forth below: | 3 | | (1) "Hospital" means any institution, place, building, | 4 | | buildings on a campus, or other health care facility | 5 | | located in Illinois that is licensed under the Hospital | 6 | | Licensing Act and has a hospital owner. | 7 | | (2) "Hospital owner" means a not-for-profit | 8 | | corporation that is the titleholder of a hospital, or the | 9 | | owner of the beneficial interest in an Illinois land trust | 10 | | that is the titleholder of a hospital. | 11 | | (3) "Hospital affiliate" means any corporation, | 12 | | partnership, limited partnership, joint venture, limited | 13 | | liability company, association or other organization, | 14 | | other than a hospital owner, that directly or indirectly | 15 | | controls, is controlled by, or is under common control with | 16 | | one or more hospital owners and that supports, is supported | 17 | | by, or acts in furtherance of the exempt health care | 18 | | purposes of at least one of those hospital owners' | 19 | | hospitals. | 20 | | (4) "Hospital system" means a hospital and one or more | 21 | | other hospitals or hospital affiliates related by common | 22 | | control or ownership. | 23 | | (5) "Control" relating to hospital owners, hospital | 24 | | affiliates, or hospital systems means possession, direct | 25 | | or indirect, of the power to direct or cause the direction | 26 | | of the management and policies of the entity, whether |
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| 1 | | through ownership of assets, membership interest, other | 2 | | voting or governance rights, by contract or otherwise. | 3 | | (6) "Hospital applicant" means a hospital owner or | 4 | | hospital affiliate that files an application for an | 5 | | exemption or renewal of exemption under this Section. | 6 | | (7) "Relevant hospital entity" means (A) the hospital | 7 | | owner, in the case of a hospital applicant that is a | 8 | | hospital owner, and (B) at the election of a hospital | 9 | | applicant that is a hospital affiliate, either (i) the | 10 | | hospital affiliate or (ii) the hospital system to which the | 11 | | hospital applicant belongs, including any hospitals or | 12 | | hospital affiliates that are related by common control or | 13 | | ownership. | 14 | | (8) "Subject property" means property used for the | 15 | | calculation under subsection (b) of this Section. | 16 | | (9) "Hospital year" means the fiscal year of the | 17 | | relevant hospital entity, or the fiscal year of one of the | 18 | | hospital owners in the hospital system if the relevant | 19 | | hospital entity is a hospital system with members with | 20 | | different fiscal years, that ends in the year for which the | 21 | | exemption is sought.
| 22 | | (i) It is the intent of the General Assembly that any | 23 | | exemptions taken, granted, or renewed under this Section prior | 24 | | to the effective date of this amendatory Act of the 100th | 25 | | General Assembly are hereby validated. | 26 | | (Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.) |
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| 1 | | Section 35. The Specialized Mental Health Rehabilitation | 2 | | Act of 2013 is amended by changing Sections 2-101 and 4-102 as | 3 | | follows: | 4 | | (210 ILCS 49/2-101)
| 5 | | Sec. 2-101. Standards for facilities. | 6 | | (a) The Department shall, by rule, prescribe minimum | 7 | | standards for each level of care for facilities to be in place | 8 | | during the provisional licensure period and thereafter. These | 9 | | standards shall include, but are not limited to, the following:
| 10 | | (1) life safety standards that will ensure the health, | 11 | | safety and welfare of residents and their protection from | 12 | | hazards;
| 13 | | (2) number and qualifications of all personnel, | 14 | | including management and clinical personnel, having | 15 | | responsibility for any part of the care given to consumers; | 16 | | specifically, the Department shall establish staffing | 17 | | ratios for facilities which shall specify the number of | 18 | | staff hours per consumer of care that are needed for each | 19 | | level of care offered within the facility;
| 20 | | (3) all sanitary conditions within the facility and its | 21 | | surroundings, including water supply, sewage disposal, | 22 | | food handling, and general hygiene which shall ensure the | 23 | | health and comfort of consumers;
| 24 | | (4) a program for adequate maintenance of physical |
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| 1 | | plant and equipment;
| 2 | | (5) adequate accommodations, staff, and services for | 3 | | the number and types of services being offered to consumers | 4 | | for whom the facility is licensed to care; | 5 | | (6) development of evacuation and other appropriate | 6 | | safety plans for use during weather, health, fire, physical | 7 | | plant, environmental, and national defense emergencies; | 8 | | (7) maintenance of minimum financial or other | 9 | | resources necessary to meet the standards established | 10 | | under this Section, and to operate and conduct the facility | 11 | | in accordance with this Act; and | 12 | | (8) standards for coercive free environment, | 13 | | restraint, and therapeutic separation.
| 14 | | (b) Any requirement contained in administrative rule | 15 | | concerning a percentage of single occupancy rooms shall be | 16 | | calculated based on the total number of licensed or | 17 | | provisionally licensed beds under this Act on January 1, 2019 | 18 | | and shall not be calculated on a per-facility basis. | 19 | | (Source: P.A. 98-104, eff. 7-22-13.) | 20 | | (210 ILCS 49/4-102)
| 21 | | Sec. 4-102. Necessity of license. No person may establish, | 22 | | operate, maintain, offer, or advertise a facility within this | 23 | | State unless and until he or she obtains a valid license | 24 | | therefor as hereinafter provided, which license remains | 25 | | unsuspended, unrevoked, and unexpired. No public official or |
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| 1 | | employee may place any person in, or recommend that any person | 2 | | be in, or directly or indirectly cause any person to be placed | 3 | | in any facility that is being operated without a valid license. | 4 | | All licenses and licensing procedures established under | 5 | | Article III of the Nursing Home Care Act, except those | 6 | | contained in Section 3-202, shall be deemed valid under this | 7 | | Act until the Department establishes licensure. The Department | 8 | | is granted the authority under this Act to establish | 9 | | provisional licensure and licensing procedures under this Act | 10 | | by emergency rule and shall do so within 120 days of the | 11 | | effective date of this Act. The Department shall not grant a | 12 | | provisional license to any facility that does not possess a | 13 | | provisional license on November 30, 2018 and is licensed under | 14 | | the Nursing Home Care Act on or before November 30, 2018. The | 15 | | Department shall not grant a license to any facility that has | 16 | | not first received a provisional license. The changes made by | 17 | | this amendatory Act of the 100th General Assembly do not apply | 18 | | to the provisions of subsection (c) of Section 1-101.5 | 19 | | concerning facility closure and relocation.
| 20 | | (Source: P.A. 98-104, eff. 7-22-13.) | 21 | | Section 40. The Illinois Public Aid Code is amended by | 22 | | changing Sections 5-5.07, 5A-4, 5A-13, and 14-12 as follows: | 23 | | (305 ILCS 5/5-5.07) | 24 | | (Section scheduled to be repealed on January 27, 2019) |
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| 1 | | Sec. 5-5.07. Inpatient psychiatric stay; DCFS per diem | 2 | | rate. The Department of Children and Family Services shall pay | 3 | | the DCFS per diem rate for inpatient psychiatric stay at a | 4 | | free-standing psychiatric hospital effective the 11th day when | 5 | | a child is in the hospital beyond medical necessity, and the | 6 | | parent or caregiver has denied the child access to the home and | 7 | | has refused or failed to make provisions for another living | 8 | | arrangement for the child or the child's discharge is being | 9 | | delayed due to a pending inquiry or investigation by the | 10 | | Department of Children and Family Services. This Section is | 11 | | repealed on July 1, 2019 6 months after the effective date of | 12 | | this amendatory Act of the 100th General Assembly .
| 13 | | (Source: P.A. 100-646, eff. 7-27-18.) | 14 | | (305 ILCS 5/5A-4) (from Ch. 23, par. 5A-4) | 15 | | Sec. 5A-4. Payment of assessment; penalty.
| 16 | | (a) The assessment imposed by Section 5A-2 for State fiscal | 17 | | year 2009 through State fiscal year 2018 or as provided in | 18 | | Section 5A-16, shall be due and payable in monthly | 19 | | installments, each equaling one-twelfth of the assessment for | 20 | | the year, on the fourteenth State business day of each month.
| 21 | | No installment payment of an assessment imposed by Section 5A-2 | 22 | | shall be due
and
payable, however, until after the Comptroller | 23 | | has issued the payments required under this Article.
| 24 | | Except as provided in subsection (a-5) of this Section, the | 25 | | assessment imposed by subsection (b-5) of Section 5A-2 for the |
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| 1 | | portion of State fiscal year 2012 beginning June 10, 2012 | 2 | | through June 30, 2012, and for State fiscal year 2013 through | 3 | | State fiscal year 2018 or as provided in Section 5A-16, shall | 4 | | be due and payable in monthly installments, each equaling | 5 | | one-twelfth of the assessment for the year, on the 17th 14th | 6 | | State business day of each month. No installment payment of an | 7 | | assessment imposed by subsection (b-5) of Section 5A-2 shall be | 8 | | due and payable, however, until after: (i) the Department | 9 | | notifies the hospital provider, in writing, that the payment | 10 | | methodologies to hospitals required under Section 5A-12.4, | 11 | | have been approved by the Centers for Medicare and Medicaid | 12 | | Services of the U.S. Department of Health and Human Services, | 13 | | and the waiver under 42 CFR 433.68 for the assessment imposed | 14 | | by subsection (b-5) of Section 5A-2, if necessary, has been | 15 | | granted by the Centers for Medicare and Medicaid Services of | 16 | | the U.S. Department of Health and Human Services; and (ii) the | 17 | | Comptroller has issued the payments required under Section | 18 | | 5A-12.4. Upon notification to the Department of approval of the | 19 | | payment methodologies required under Section 5A-12.4 and the | 20 | | waiver granted under 42 CFR 433.68, if necessary, all | 21 | | installments otherwise due under subsection (b-5) of Section | 22 | | 5A-2 prior to the date of notification shall be due and payable | 23 | | to the Department upon written direction from the Department | 24 | | and issuance by the Comptroller of the payments required under | 25 | | Section 5A-12.4. | 26 | | Except as provided in subsection (a-5) of this Section, the |
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| 1 | | assessment imposed under Section 5A-2 for State fiscal year | 2 | | 2019 and each subsequent State fiscal year shall be due and | 3 | | payable in monthly installments, each equaling one-twelfth of | 4 | | the assessment for the year, on the 14th State business day of | 5 | | each month. No installment payment of an assessment imposed by | 6 | | Section 5A-2 shall be due and payable, however, until after: | 7 | | (i) the Department notifies the hospital provider, in writing, | 8 | | that the payment methodologies to hospitals required under | 9 | | Section 5A-12.6 have been approved by the Centers for Medicare | 10 | | and Medicaid Services of the U.S. Department of Health and | 11 | | Human Services, and the waiver under 42 CFR 433.68 for the | 12 | | assessment imposed by Section 5A-2, if necessary, has been | 13 | | granted by the Centers for Medicare and Medicaid Services of | 14 | | the U.S. Department of Health and Human Services; and (ii) the | 15 | | Comptroller has issued the payments required under Section | 16 | | 5A-12.6. Upon notification to the Department of approval of the | 17 | | payment methodologies required under Section 5A-12.6 and the | 18 | | waiver granted under 42 CFR 433.68, if necessary, all | 19 | | installments otherwise due under Section 5A-2 prior to the date | 20 | | of notification shall be due and payable to the Department upon | 21 | | written direction from the Department and issuance by the | 22 | | Comptroller of the payments required under Section 5A-12.6. | 23 | | (a-5) The Illinois Department may accelerate the schedule | 24 | | upon which assessment installments are due and payable by | 25 | | hospitals with a payment ratio greater than or equal to one. | 26 | | Such acceleration of due dates for payment of the assessment |
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| 1 | | may be made only in conjunction with a corresponding | 2 | | acceleration in access payments identified in Section 5A-12.2, | 3 | | Section 5A-12.4, or Section 5A-12.6 to the same hospitals. For | 4 | | the purposes of this subsection (a-5), a hospital's payment | 5 | | ratio is defined as the quotient obtained by dividing the total | 6 | | payments for the State fiscal year, as authorized under Section | 7 | | 5A-12.2, Section 5A-12.4, or Section 5A-12.6, by the total | 8 | | assessment for the State fiscal year imposed under Section 5A-2 | 9 | | or subsection (b-5) of Section 5A-2. | 10 | | (b) The Illinois Department is authorized to establish
| 11 | | delayed payment schedules for hospital providers that are | 12 | | unable
to make installment payments when due under this Section | 13 | | due to
financial difficulties, as determined by the Illinois | 14 | | Department.
| 15 | | (c) If a hospital provider fails to pay the full amount of
| 16 | | an installment when due (including any extensions granted under
| 17 | | subsection (b)), there shall, unless waived by the Illinois
| 18 | | Department for reasonable cause, be added to the assessment
| 19 | | imposed by Section 5A-2 a penalty
assessment equal to the | 20 | | lesser of (i) 5% of the amount of the
installment not paid on | 21 | | or before the due date plus 5% of the
portion thereof remaining | 22 | | unpaid on the last day of each 30-day period
thereafter or (ii) | 23 | | 100% of the installment amount not paid on or
before the due | 24 | | date. For purposes of this subsection, payments
will be | 25 | | credited first to unpaid installment amounts (rather than
to | 26 | | penalty or interest), beginning with the most delinquent
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| 1 | | installments.
| 2 | | (d) Any assessment amount that is due and payable to the | 3 | | Illinois Department more frequently than once per calendar | 4 | | quarter shall be remitted to the Illinois Department by the | 5 | | hospital provider by means of electronic funds transfer. The | 6 | | Illinois Department may provide for remittance by other means | 7 | | if (i) the amount due is less than $10,000 or (ii) electronic | 8 | | funds transfer is unavailable for this purpose. | 9 | | (Source: P.A. 100-581, eff. 3-12-18.) | 10 | | (305 ILCS 5/5A-13)
| 11 | | Sec. 5A-13. Emergency rulemaking. | 12 | | (a) The Department of Healthcare and Family Services | 13 | | (formerly Department of
Public Aid) may adopt rules necessary | 14 | | to implement
this amendatory Act of the 94th General Assembly
| 15 | | through the use of emergency rulemaking in accordance with
| 16 | | Section 5-45 of the Illinois Administrative Procedure Act.
For | 17 | | purposes of that Act, the General Assembly finds that the
| 18 | | adoption of rules to implement this
amendatory Act of the 94th | 19 | | General Assembly is deemed an
emergency and necessary for the | 20 | | public interest, safety, and welfare.
| 21 | | (b) The Department of Healthcare and Family Services may | 22 | | adopt rules necessary to implement
this amendatory Act of the | 23 | | 97th General Assembly
through the use of emergency rulemaking | 24 | | in accordance with
Section 5-45 of the Illinois Administrative | 25 | | Procedure Act.
For purposes of that Act, the General Assembly |
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| 1 | | finds that the
adoption of rules to implement this
amendatory | 2 | | Act of the 97th General Assembly is deemed an
emergency and | 3 | | necessary for the public interest, safety, and welfare. | 4 | | (c) The Department of Healthcare and Family Services may | 5 | | adopt rules necessary to initially implement the changes to | 6 | | Articles 5, 5A, 12, and 14 of this Code under this amendatory | 7 | | Act of the 100th General Assembly through the use of emergency | 8 | | rulemaking in accordance with subsection (aa) of Section 5-45 | 9 | | of the Illinois Administrative Procedure Act. For purposes of | 10 | | that Act, the General Assembly finds that the adoption of rules | 11 | | to implement the changes to Articles 5, 5A, 12, and 14 of this | 12 | | Code under this amendatory Act of the 100th General Assembly is | 13 | | deemed an emergency and necessary for the public interest, | 14 | | safety, and welfare. The 24-month limitation on the adoption of | 15 | | emergency rules does not apply to rules adopted to initially | 16 | | implement the changes to Articles 5, 5A, 12, and 14 of this | 17 | | Code under this amendatory Act of the 100th General Assembly. | 18 | | For purposes of this subsection, "initially" means any | 19 | | emergency rules necessary to immediately implement the changes | 20 | | authorized to Articles 5, 5A, 12, and 14 of this Code under | 21 | | this amendatory Act of the 100th General Assembly; however, | 22 | | emergency rulemaking authority shall not be used to make | 23 | | changes that could otherwise be made following the process | 24 | | established in the Illinois Administrative Procedure Act. | 25 | | (d) The Department of Healthcare and Family Services may on | 26 | | a one-time-only basis adopt rules necessary to initially |
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| 1 | | implement the changes to Articles 5A and 14 of this Code under | 2 | | this amendatory Act of the 100th General Assembly through the | 3 | | use of emergency rulemaking in accordance with subsection (ee) | 4 | | of Section 5-45 of the Illinois Administrative Procedure Act. | 5 | | For purposes of that Act, the General Assembly finds that the | 6 | | adoption of rules on a one-time-only basis to implement the | 7 | | changes to Articles 5A and 14 of this Code under this | 8 | | amendatory Act of the 100th General Assembly is deemed an | 9 | | emergency and necessary for the public interest, safety, and | 10 | | welfare. The 24-month limitation on the adoption of emergency | 11 | | rules does not apply to rules adopted to initially implement | 12 | | the changes to Articles 5A and 14 of this Code under this | 13 | | amendatory Act of the 100th General Assembly. | 14 | | (Source: P.A. 100-581, eff. 3-12-18.) | 15 | | (305 ILCS 5/14-12) | 16 | | Sec. 14-12. Hospital rate reform payment system. The | 17 | | hospital payment system pursuant to Section 14-11 of this | 18 | | Article shall be as follows: | 19 | | (a) Inpatient hospital services. Effective for discharges | 20 | | on and after July 1, 2014, reimbursement for inpatient general | 21 | | acute care services shall utilize the All Patient Refined | 22 | | Diagnosis Related Grouping (APR-DRG) software, version 30, | 23 | | distributed by 3M TM Health Information System. | 24 | | (1) The Department shall establish Medicaid weighting | 25 | | factors to be used in the reimbursement system established |
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| 1 | | under this subsection. Initial weighting factors shall be | 2 | | the weighting factors as published by 3M Health Information | 3 | | System, associated with Version 30.0 adjusted for the | 4 | | Illinois experience. | 5 | | (2) The Department shall establish a | 6 | | statewide-standardized amount to be used in the inpatient | 7 | | reimbursement system. The Department shall publish these | 8 | | amounts on its website no later than 10 calendar days prior | 9 | | to their effective date. | 10 | | (3) In addition to the statewide-standardized amount, | 11 | | the Department shall develop adjusters to adjust the rate | 12 | | of reimbursement for critical Medicaid providers or | 13 | | services for trauma, transplantation services, perinatal | 14 | | care, and Graduate Medical Education (GME). | 15 | | (4) The Department shall develop add-on payments to | 16 | | account for exceptionally costly inpatient stays, | 17 | | consistent with Medicare outlier principles. Outlier fixed | 18 | | loss thresholds may be updated to control for excessive | 19 | | growth in outlier payments no more frequently than on an | 20 | | annual basis, but at least triennially. Upon updating the | 21 | | fixed loss thresholds, the Department shall be required to | 22 | | update base rates within 12 months. | 23 | | (5) The Department shall define those hospitals or | 24 | | distinct parts of hospitals that shall be exempt from the | 25 | | APR-DRG reimbursement system established under this | 26 | | Section. The Department shall publish these hospitals' |
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| 1 | | inpatient rates on its website no later than 10 calendar | 2 | | days prior to their effective date. | 3 | | (6) Beginning July 1, 2014 and ending on June 30, 2024, | 4 | | in addition to the statewide-standardized amount, the | 5 | | Department shall develop an adjustor to adjust the rate of | 6 | | reimbursement for safety-net hospitals defined in Section | 7 | | 5-5e.1 of this Code excluding pediatric hospitals. | 8 | | (7) Beginning July 1, 2014 and ending on June 30, 2020, | 9 | | or upon implementation of inpatient psychiatric rate | 10 | | increases as described in subsection (n) of Section | 11 | | 5A-12.6, in addition to the statewide-standardized amount, | 12 | | the Department shall develop an adjustor to adjust the rate | 13 | | of reimbursement for Illinois freestanding inpatient | 14 | | psychiatric hospitals that are not designated as | 15 | | children's hospitals by the Department but are primarily | 16 | | treating patients under the age of 21. | 17 | | (7.5) Beginning July 1, 2020, the reimbursement for | 18 | | inpatient psychiatric services shall be so that base claims | 19 | | projected reimbursement is increased by an amount equal to | 20 | | the funds allocated in paragraph (2) of subsection (b) of | 21 | | Section 5A-12.6, less the amount allocated under | 22 | | paragraphs (8) and (9) of this subsection and paragraphs | 23 | | (3) and (4) of subsection (b) multiplied by 13%. Beginning | 24 | | July 1, 2022, the reimbursement for inpatient psychiatric | 25 | | services shall be so that base claims projected | 26 | | reimbursement is increased by an amount equal to the funds |
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| 1 | | allocated in paragraph (3) of subsection (b) of Section | 2 | | 5A-12.6, less the amount allocated under paragraphs (8) and | 3 | | (9) of this subsection and paragraphs (3) and (4) of | 4 | | subsection (b) multiplied by 13%. Beginning July 1, 2024, | 5 | | the reimbursement for inpatient psychiatric services shall | 6 | | be so that base claims projected reimbursement is increased | 7 | | by an amount equal to the funds allocated in paragraph (4) | 8 | | of subsection (b) of Section 5A-12.6, less the amount | 9 | | allocated under paragraphs (8) and (9) of this subsection | 10 | | and paragraphs (3) and (4) of subsection (b) multiplied by | 11 | | 13%. | 12 | | (8) Beginning July 1, 2018, in addition to the | 13 | | statewide-standardized amount, the Department shall adjust | 14 | | the rate of reimbursement for hospitals designated by the | 15 | | Department of Public Health as a Perinatal Level II or II+ | 16 | | center by applying the same adjustor that is applied to | 17 | | Perinatal and Obstetrical care cases for Perinatal Level | 18 | | III centers, as of December 31, 2017. | 19 | | (9) Beginning July 1, 2018, in addition to the | 20 | | statewide-standardized amount, the Department shall apply | 21 | | the same adjustor that is applied to trauma cases as of | 22 | | December 31, 2017 to inpatient claims to treat patients | 23 | | with burns, including, but not limited to, APR-DRGs 841, | 24 | | 842, 843, and 844. | 25 | | (10) Beginning July 1, 2018, the | 26 | | statewide-standardized amount for inpatient general acute |
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| 1 | | care services shall be uniformly increased so that base | 2 | | claims projected reimbursement is increased by an amount | 3 | | equal to the funds allocated in paragraph (1) of subsection | 4 | | (b) of Section 5A-12.6, less the amount allocated under | 5 | | paragraphs (8) and (9) of this subsection and paragraphs | 6 | | (3) and (4) of subsection (b) multiplied by 40%. Beginning | 7 | | July 1, 2020, the statewide-standardized amount for | 8 | | inpatient general acute care services shall be uniformly | 9 | | increased so that base claims projected reimbursement is | 10 | | increased by an amount equal to the funds allocated in | 11 | | paragraph (2) of subsection (b) of Section 5A-12.6, less | 12 | | the amount allocated under paragraphs (8) and (9) of this | 13 | | subsection and paragraphs (3) and (4) of subsection (b) | 14 | | multiplied by 40%. Beginning July 1, 2022, the | 15 | | statewide-standardized amount for inpatient general acute | 16 | | care services shall be uniformly increased so that base | 17 | | claims projected reimbursement is increased by an amount | 18 | | equal to the funds allocated in paragraph (3) of subsection | 19 | | (b) of Section 5A-12.6, less the amount allocated under | 20 | | paragraphs (8) and (9) of this subsection and paragraphs | 21 | | (3) and (4) of subsection (b) multiplied by 40%. Beginning | 22 | | July 1, 2023 the statewide-standardized amount for | 23 | | inpatient general acute care services shall be uniformly | 24 | | increased so that base claims projected reimbursement is | 25 | | increased by an amount equal to the funds allocated in | 26 | | paragraph (4) of subsection (b) of Section 5A-12.6, less |
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| 1 | | the amount allocated under paragraphs (8) and (9) of this | 2 | | subsection and paragraphs (3) and (4) of subsection (b) | 3 | | multiplied by 40%. | 4 | | (11) Beginning July 1, 2018, the reimbursement for | 5 | | inpatient rehabilitation services shall be increased by | 6 | | the addition of a $96 per day add-on. | 7 | | Beginning July 1, 2020, the reimbursement for | 8 | | inpatient rehabilitation services shall be uniformly | 9 | | increased so that the $96 per day add-on is increased by an | 10 | | amount equal to the funds allocated in paragraph (2) of | 11 | | subsection (b) of Section 5A-12.6, less the amount | 12 | | allocated under paragraphs (8) and (9) of this subsection | 13 | | and paragraphs (3) and (4) of subsection (b) multiplied by | 14 | | 0.9%. | 15 | | Beginning July 1, 2022, the reimbursement for | 16 | | inpatient rehabilitation services shall be uniformly | 17 | | increased so that the $96 per day add-on as adjusted by the | 18 | | July 1, 2020 increase, is increased by an amount equal to | 19 | | the funds allocated in paragraph (3) of subsection (b) of | 20 | | Section 5A-12.6, less the amount allocated under | 21 | | paragraphs (8) and (9) of this subsection and paragraphs | 22 | | (3) and (4) of subsection (b) multiplied by 0.9%. | 23 | | Beginning July 1, 2023, the reimbursement for | 24 | | inpatient rehabilitation services shall be uniformly | 25 | | increased so that the $96 per day add-on as adjusted by the | 26 | | July 1, 2022 increase, is increased by an amount equal to |
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| 1 | | the funds allocated in paragraph (4) of subsection (b) of | 2 | | Section 5A-12.6, less the amount allocated under | 3 | | paragraphs (8) and (9) of this subsection and paragraphs | 4 | | (3) and (4) of subsection (b) multiplied by 0.9%. | 5 | | (b) Outpatient hospital services. Effective for dates of | 6 | | service on and after July 1, 2014, reimbursement for outpatient | 7 | | services shall utilize the Enhanced Ambulatory Procedure | 8 | | Grouping ( EAPG E-APG ) software, version 3.7 distributed by 3M TM | 9 | | Health Information System. | 10 | | (1) The Department shall establish Medicaid weighting | 11 | | factors to be used in the reimbursement system established | 12 | | under this subsection. The initial weighting factors shall | 13 | | be the weighting factors as published by 3M Health | 14 | | Information System, associated with Version 3.7. | 15 | | (2) The Department shall establish service specific | 16 | | statewide-standardized amounts to be used in the | 17 | | reimbursement system. | 18 | | (A) The initial statewide standardized amounts, | 19 | | with the labor portion adjusted by the Calendar Year | 20 | | 2013 Medicare Outpatient Prospective Payment System | 21 | | wage index with reclassifications, shall be published | 22 | | by the Department on its website no later than 10 | 23 | | calendar days prior to their effective date. | 24 | | (B) The Department shall establish adjustments to | 25 | | the statewide-standardized amounts for each Critical | 26 | | Access Hospital, as designated by the Department of |
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| 1 | | Public Health in accordance with 42 CFR 485, Subpart F. | 2 | | For outpatient services provided on or before June 30, | 3 | | 2018, the The EAPG standardized amounts are determined | 4 | | separately for each critical access hospital such that | 5 | | simulated EAPG payments using outpatient base period | 6 | | paid claim data plus payments under Section 5A-12.4 of | 7 | | this Code net of the associated tax costs are equal to | 8 | | the estimated costs of outpatient base period claims | 9 | | data with a rate year cost inflation factor applied. | 10 | | (3) In addition to the statewide-standardized amounts, | 11 | | the Department shall develop adjusters to adjust the rate | 12 | | of reimbursement for critical Medicaid hospital outpatient | 13 | | providers or services, including outpatient high volume or | 14 | | safety-net hospitals. Beginning July 1, 2018, the | 15 | | outpatient high volume adjustor shall be increased to | 16 | | increase annual expenditures associated with this adjustor | 17 | | by $79,200,000, based on the State Fiscal Year 2015 base | 18 | | year data and this adjustor shall apply to public | 19 | | hospitals, except for large public hospitals, as defined | 20 | | under 89 Ill. Adm. Code 148.25(a). | 21 | | (4) Beginning July 1, 2018, in addition to the | 22 | | statewide standardized amounts, the Department shall make | 23 | | an add-on payment for outpatient expensive devices and | 24 | | drugs. This add-on payment shall at least apply to claim | 25 | | lines that: (i) are assigned with one of the following | 26 | | EAPGs: 490, 1001 to 1020, and coded with one of the |
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| 1 | | following revenue codes: 0274 to 0276, 0278; or (ii) are | 2 | | assigned with one of the following EAPGs: 430 to 441, 443, | 3 | | 444, 460 to 465, 495, 496, 1090. The add-on payment shall | 4 | | be calculated as follows: the claim line's covered charges | 5 | | multiplied by the hospital's total acute cost to charge | 6 | | ratio, less the claim line's EAPG payment plus $1,000, | 7 | | multiplied by 0.8. | 8 | | (5) Beginning July 1, 2018, the statewide-standardized | 9 | | amounts for outpatient services shall be increased by a | 10 | | uniform percentage so that base claims projected | 11 | | reimbursement is increased by an amount equal to no less | 12 | | than the funds allocated in paragraph (1) of subsection (b) | 13 | | of Section 5A-12.6, less the amount allocated under | 14 | | paragraphs (8) and (9) of subsection (a) and paragraphs (3) | 15 | | and (4) of this subsection multiplied by 46%. Beginning | 16 | | July 1, 2020, the statewide-standardized amounts for | 17 | | outpatient services shall be increased by a uniform | 18 | | percentage so that base claims projected reimbursement is | 19 | | increased by an amount equal to no less than the funds | 20 | | allocated in paragraph (2) of subsection (b) of Section | 21 | | 5A-12.6, less the amount allocated under paragraphs (8) and | 22 | | (9) of subsection (a) and paragraphs (3) and (4) of this | 23 | | subsection multiplied by 46%. Beginning July 1, 2022, the | 24 | | statewide-standardized amounts for outpatient services | 25 | | shall be increased by a uniform percentage so that base | 26 | | claims projected reimbursement is increased by an amount |
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| 1 | | equal to the funds allocated in paragraph (3) of subsection | 2 | | (b) of Section 5A-12.6, less the amount allocated under | 3 | | paragraphs (8) and (9) of subsection (a) and paragraphs (3) | 4 | | and (4) of this subsection multiplied by 46%. Beginning | 5 | | July 1, 2023, the statewide-standardized amounts for | 6 | | outpatient services shall be increased by a uniform | 7 | | percentage so that base claims projected reimbursement is | 8 | | increased by an amount equal to no less than the funds | 9 | | allocated in paragraph (4) of subsection (b) of Section | 10 | | 5A-12.6, less the amount allocated under paragraphs (8) and | 11 | | (9) of subsection (a) and paragraphs (3) and (4) of this | 12 | | subsection multiplied by 46%. | 13 | | (6) Effective for dates of service on or after July 1, | 14 | | 2018, the Department shall establish adjustments to the | 15 | | statewide-standardized amounts for each Critical Access | 16 | | Hospital, as designated by the Department of Public Health | 17 | | in accordance with 42 CFR 485, Subpart F, such that each | 18 | | Critical Access Hospital's standardized amount for | 19 | | outpatient services shall be increased by the applicable | 20 | | uniform percentage determined pursuant to paragraph (5) of | 21 | | this subsection. It is the intent of the General Assembly | 22 | | that the adjustments required under this paragraph (6) by | 23 | | this amendatory Act of the 100th General Assembly shall be | 24 | | applied retroactively to claims for dates of service | 25 | | provided on or after July 1, 2018. | 26 | | (7) Effective for dates of service on or after the |
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| 1 | | effective date of this amendatory Act of the 100th General | 2 | | Assembly, the Department shall recalculate and implement | 3 | | an updated statewide-standardized amount for outpatient | 4 | | services provided by hospitals that are not Critical Access | 5 | | Hospitals to reflect the applicable uniform percentage | 6 | | determined pursuant to paragraph (5). | 7 | | (1) Any recalculation to the | 8 | | statewide-standardized amounts for outpatient services | 9 | | provided by hospitals that are not Critical Access | 10 | | Hospitals shall be the amount necessary to achieve the | 11 | | increase in the statewide-standardized amounts for | 12 | | outpatient services increased by a uniform percentage, | 13 | | so that base claims projected reimbursement is | 14 | | increased by an amount equal to no less than the funds | 15 | | allocated in paragraph (1) of subsection (b) of Section | 16 | | 5A-12.6, less the amount allocated under paragraphs | 17 | | (8) and (9) of subsection (a) and paragraphs (3) and | 18 | | (4) of this subsection, for all hospitals that are not | 19 | | Critical Access Hospitals, multiplied by 46%. | 20 | | (2) It is the intent of the General Assembly that | 21 | | the recalculations required under this paragraph (7) | 22 | | by this amendatory Act of the 100th General Assembly | 23 | | shall be applied prospectively to claims for dates of | 24 | | service provided on or after the effective date of this | 25 | | amendatory Act of the 100th General Assembly and that | 26 | | no recoupment or repayment by the Department or an MCO, |
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| 1 | | of payments attributable to recalculation under this | 2 | | paragraph (7), issued to the hospital for dates of | 3 | | service on or after July 1, 2018 and before the | 4 | | effective date of this amendatory Act of the 100th | 5 | | General Assembly shall be permitted. | 6 | | (8) The Department shall ensure that all necessary | 7 | | adjustments to the managed care organization capitation | 8 | | base rates necessitated by the adjustments under | 9 | | subparagraph (6) or (7) of this subsection are completed | 10 | | and applied retroactively in accordance with Section | 11 | | 5-30.8 of this Code within 90 days of the effective date of | 12 | | this amendatory Act of the 100th General Assembly. | 13 | | (c) In consultation with the hospital community, the | 14 | | Department is authorized to replace 89 Ill. Admin. Code 152.150 | 15 | | as published in 38 Ill. Reg. 4980 through 4986 within 12 months | 16 | | of June 16, 2014 ( the effective date of Public Act 98-651) this | 17 | | amendatory Act of the 98th General Assembly . If the Department | 18 | | does not replace these rules within 12 months of June 16, 2014 | 19 | | ( the effective date of Public Act 98-651) this amendatory Act | 20 | | of the 98th General Assembly , the rules in effect for 152.150 | 21 | | as published in 38 Ill. Reg. 4980 through 4986 shall remain in | 22 | | effect until modified by rule by the Department. Nothing in | 23 | | this subsection shall be construed to mandate that the | 24 | | Department file a replacement rule. | 25 | | (d) Transition period.
There shall be a transition period | 26 | | to the reimbursement systems authorized under this Section that |
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| 1 | | shall begin on the effective date of these systems and continue | 2 | | until June 30, 2018, unless extended by rule by the Department. | 3 | | To help provide an orderly and predictable transition to the | 4 | | new reimbursement systems and to preserve and enhance access to | 5 | | the hospital services during this transition, the Department | 6 | | shall allocate a transitional hospital access pool of at least | 7 | | $290,000,000 annually so that transitional hospital access | 8 | | payments are made to hospitals. | 9 | | (1) After the transition period, the Department may | 10 | | begin incorporating the transitional hospital access pool | 11 | | into the base rate structure; however, the transitional | 12 | | hospital access payments in effect on June 30, 2018 shall | 13 | | continue to be paid, if continued under Section 5A-16. | 14 | | (2) After the transition period, if the Department | 15 | | reduces payments from the transitional hospital access | 16 | | pool, it shall increase base rates, develop new adjustors, | 17 | | adjust current adjustors, develop new hospital access | 18 | | payments based on updated information, or any combination | 19 | | thereof by an amount equal to the decreases proposed in the | 20 | | transitional hospital access pool payments, ensuring that | 21 | | the entire transitional hospital access pool amount shall | 22 | | continue to be used for hospital payments. | 23 | | (d-5) Hospital transformation program. The Department, in | 24 | | conjunction with the Hospital Transformation Review Committee | 25 | | created under subsection (d-5), shall develop a hospital | 26 | | transformation program to provide financial assistance to |
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| 1 | | hospitals in transforming their services and care models to | 2 | | better align with the needs of the communities they serve. The | 3 | | payments authorized in this Section shall be subject to | 4 | | approval by the federal government. | 5 | | (1) Phase 1. In State fiscal years 2019 through 2020, | 6 | | the Department shall allocate funds from the transitional | 7 | | access hospital pool to create a hospital transformation | 8 | | pool of at least $262,906,870 annually and make hospital | 9 | | transformation payments to hospitals. Subject to Section | 10 | | 5A-16, in State fiscal years 2019 and 2020, an Illinois | 11 | | hospital that received either a transitional hospital | 12 | | access payment under subsection (d) or a supplemental | 13 | | payment under subsection (f) of this Section in State | 14 | | fiscal year 2018, shall receive a hospital transformation | 15 | | payment as follows: | 16 | | (A) If the hospital's Rate Year 2017 Medicaid | 17 | | inpatient utilization rate is equal to or greater than | 18 | | 45%, the hospital transformation payment shall be | 19 | | equal to 100% of the sum of its transitional hospital | 20 | | access payment authorized under subsection (d) and any | 21 | | supplemental payment authorized under subsection (f). | 22 | | (B) If the hospital's Rate Year 2017 Medicaid | 23 | | inpatient utilization rate is equal to or greater than | 24 | | 25% but less than 45%, the hospital transformation | 25 | | payment shall be equal to 75% of the sum of its | 26 | | transitional hospital access payment authorized under |
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| 1 | | subsection (d) and any supplemental payment authorized | 2 | | under subsection (f). | 3 | | (C) If the hospital's Rate Year 2017 Medicaid | 4 | | inpatient utilization rate is less than 25%, the | 5 | | hospital transformation payment shall be equal to 50% | 6 | | of the sum of its transitional hospital access payment | 7 | | authorized under subsection (d) and any supplemental | 8 | | payment authorized under subsection (f). | 9 | | (2) Phase 2. During State fiscal years 2021 and 2022, | 10 | | the Department shall allocate funds from the transitional | 11 | | access hospital pool to create a hospital transformation | 12 | | pool annually and make hospital transformation payments to | 13 | | hospitals participating in the transformation program. Any | 14 | | hospital may seek transformation funding in Phase 2. Any | 15 | | hospital that seeks transformation funding in Phase 2 to | 16 | | update or repurpose the hospital's physical structure to | 17 | | transition to a new delivery model, must submit to the | 18 | | Department in writing a transformation plan, based on the | 19 | | Department's guidelines, that describes the desired | 20 | | delivery model with projections of patient volumes by | 21 | | service lines and projected revenues, expenses, and net | 22 | | income that correspond to the new delivery model. In Phase | 23 | | 2, subject to the approval of rules, the Department may use | 24 | | the hospital transformation pool to increase base rates, | 25 | | develop new adjustors, adjust current adjustors, or | 26 | | develop new access payments in order to support and |
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| 1 | | incentivize hospitals to pursue such transformation. In | 2 | | developing such methodologies, the Department shall ensure | 3 | | that the entire hospital transformation pool continues to | 4 | | be expended to ensure access to hospital services or to | 5 | | support organizations that had received hospital | 6 | | transformation payments under this Section. | 7 | | (A) Any hospital participating in the hospital | 8 | | transformation program shall provide an opportunity | 9 | | for public input by local community groups, hospital | 10 | | workers, and healthcare professionals and assist in | 11 | | facilitating discussions about any transformations or | 12 | | changes to the hospital. | 13 | | (B) As provided in paragraph (9) of Section 3 of | 14 | | the Illinois Health Facilities Planning Act, any | 15 | | hospital participating in the transformation program | 16 | | may be excluded from the requirements of the Illinois | 17 | | Health Facilities Planning Act for those projects | 18 | | related to the hospital's transformation. To be | 19 | | eligible, the hospital must submit to the Health | 20 | | Facilities and Services Review Board certification | 21 | | from the Department, approved by the Hospital | 22 | | Transformation Review Committee, that the project is a | 23 | | part of the hospital's transformation. | 24 | | (C) As provided in subsection (a-20) of Section | 25 | | 32.5 of the Emergency Medical Services (EMS) Systems | 26 | | Act, a hospital that received hospital transformation |
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| 1 | | payments under this Section may convert to a | 2 | | freestanding emergency center. To be eligible for such | 3 | | a conversion, the hospital must submit to the | 4 | | Department of Public Health certification from the | 5 | | Department, approved by the Hospital Transformation | 6 | | Review Committee, that the project is a part of the | 7 | | hospital's transformation. | 8 | | (3) By April 1, 2019 Within 6 months after the | 9 | | effective date of this amendatory Act of the 100th General | 10 | | Assembly, the Department, in conjunction with the Hospital | 11 | | Transformation Review Committee, shall develop and file as | 12 | | an administrative rule with the Secretary of State adopt, | 13 | | by rule, the goals, objectives, policies, standards, | 14 | | payment models, or criteria to be applied in Phase 2 of the | 15 | | program to allocate the hospital transformation funds. The | 16 | | goals, objectives, and policies to be considered may | 17 | | include, but are not limited to, achieving unmet needs of a | 18 | | community that a hospital serves such as behavioral health | 19 | | services, outpatient services, or drug rehabilitation | 20 | | services; attaining certain quality or patient safety | 21 | | benchmarks for health care services; or improving the | 22 | | coordination, effectiveness, and efficiency of care | 23 | | delivery. Notwithstanding any other provision of law, any | 24 | | rule adopted in accordance with this subsection (d-5) may | 25 | | be submitted to the Joint Committee on Administrative Rules | 26 | | for approval only if the rule has first been approved by 9 |
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| 1 | | of the 14 members of the Hospital Transformation Review | 2 | | Committee. | 3 | | (4) Hospital Transformation Review Committee. There is | 4 | | created the Hospital Transformation Review Committee. The | 5 | | Committee shall consist of 14 members. No later than 30 | 6 | | days after March 12, 2018 ( the effective date of Public Act | 7 | | 100-581) this amendatory Act of the 100th General Assembly , | 8 | | the 4 legislative leaders shall each appoint 3 members; the | 9 | | Governor shall appoint the Director of Healthcare and | 10 | | Family Services, or his or her designee, as a member; and | 11 | | the Director of Healthcare and Family Services shall | 12 | | appoint one member. Any vacancy shall be filled by the | 13 | | applicable appointing authority within 15 calendar days. | 14 | | The members of the Committee shall select a Chair and a | 15 | | Vice-Chair from among its members, provided that the Chair | 16 | | and Vice-Chair cannot be appointed by the same appointing | 17 | | authority and must be from different political parties. The | 18 | | Chair shall have the authority to establish a meeting | 19 | | schedule and convene meetings of the Committee, and the | 20 | | Vice-Chair shall have the authority to convene meetings in | 21 | | the absence of the Chair. The Committee may establish its | 22 | | own rules with respect to meeting schedule, notice of | 23 | | meetings, and the disclosure of documents; however, the | 24 | | Committee shall not have the power to subpoena individuals | 25 | | or documents and any rules must be approved by 9 of the 14 | 26 | | members. The Committee shall perform the functions |
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| 1 | | described in this Section and advise and consult with the | 2 | | Director in the administration of this Section. In addition | 3 | | to reviewing and approving the policies, procedures, and | 4 | | rules for the hospital transformation program, the | 5 | | Committee shall consider and make recommendations related | 6 | | to qualifying criteria and payment methodologies related | 7 | | to safety-net hospitals and children's hospitals. Members | 8 | | of the Committee appointed by the legislative leaders shall | 9 | | be subject to the jurisdiction of the Legislative Ethics | 10 | | Commission, not the Executive Ethics Commission, and all | 11 | | requests under the Freedom of Information Act shall be | 12 | | directed to the applicable Freedom of Information officer | 13 | | for the General Assembly. The Department shall provide | 14 | | operational support to the Committee as necessary. The | 15 | | Committee is dissolved on April 1, 2019. | 16 | | (e) Beginning 36 months after initial implementation, the | 17 | | Department shall update the reimbursement components in | 18 | | subsections (a) and (b), including standardized amounts and | 19 | | weighting factors, and at least triennially and no more | 20 | | frequently than annually thereafter. The Department shall | 21 | | publish these updates on its website no later than 30 calendar | 22 | | days prior to their effective date. | 23 | | (f) Continuation of supplemental payments. Any | 24 | | supplemental payments authorized under Illinois Administrative | 25 | | Code 148 effective January 1, 2014 and that continue during the | 26 | | period of July 1, 2014 through December 31, 2014 shall remain |
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| 1 | | in effect as long as the assessment imposed by Section 5A-2 | 2 | | that is in effect on December 31, 2017 remains in effect. | 3 | | (g) Notwithstanding subsections (a) through (f) of this | 4 | | Section and notwithstanding the changes authorized under | 5 | | Section 5-5b.1, any updates to the system shall not result in | 6 | | any diminishment of the overall effective rates of | 7 | | reimbursement as of the implementation date of the new system | 8 | | (July 1, 2014). These updates shall not preclude variations in | 9 | | any individual component of the system or hospital rate | 10 | | variations. Nothing in this Section shall prohibit the | 11 | | Department from increasing the rates of reimbursement or | 12 | | developing payments to ensure access to hospital services. | 13 | | Nothing in this Section shall be construed to guarantee a | 14 | | minimum amount of spending in the aggregate or per hospital as | 15 | | spending may be impacted by factors including but not limited | 16 | | to the number of individuals in the medical assistance program | 17 | | and the severity of illness of the individuals. | 18 | | (h) The Department shall have the authority to modify by | 19 | | rulemaking any changes to the rates or methodologies in this | 20 | | Section as required by the federal government to obtain federal | 21 | | financial participation for expenditures made under this | 22 | | Section. | 23 | | (i) Except for subsections (g) and (h) of this Section, the | 24 | | Department shall, pursuant to subsection (c) of Section 5-40 of | 25 | | the Illinois Administrative Procedure Act, provide for | 26 | | presentation at the June 2014 hearing of the Joint Committee on |
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| 1 | | Administrative Rules (JCAR) additional written notice to JCAR | 2 | | of the following rules in order to commence the second notice | 3 | | period for the following rules: rules published in the Illinois | 4 | | Register, rule dated February 21, 2014 at 38 Ill. Reg. 4559 | 5 | | (Medical Payment), 4628 (Specialized Health Care Delivery | 6 | | Systems), 4640 (Hospital Services), 4932 (Diagnostic Related | 7 | | Grouping (DRG) Prospective Payment System (PPS)), and 4977 | 8 | | (Hospital Reimbursement Changes), and published in the | 9 | | Illinois Register dated March 21, 2014 at 38 Ill. Reg. 6499 | 10 | | (Specialized Health Care Delivery Systems) and 6505 (Hospital | 11 | | Services).
| 12 | | (j) Out-of-state hospitals. Beginning July 1, 2018, for | 13 | | purposes of determining for State fiscal years 2019 and 2020 | 14 | | the hospitals eligible for the payments authorized under | 15 | | subsections (a) and (b) of this Section, the Department shall | 16 | | include out-of-state hospitals that are designated a Level I | 17 | | pediatric trauma center or a Level I trauma center by the | 18 | | Department of Public Health as of December 1, 2017. | 19 | | (k) The Department shall notify each hospital and managed | 20 | | care organization, in writing, of the impact of the updates | 21 | | under this Section at least 30 calendar days prior to their | 22 | | effective date. | 23 | | (Source: P.A. 99-2, eff. 3-26-15; 100-581, eff. 3-12-18; | 24 | | revised 10-3-18.) | 25 | | Section 97. Severability. The provisions of this Act are |
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| 1 | | severable under Section 1.31 of the Statute on Statutes.
| 2 | | Section 99. Effective date. This Act takes effect upon | 3 | | becoming law.".
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