Full Text of HB0356 101st General Assembly
HB0356sam003 101ST GENERAL ASSEMBLY | Sen. Heather A. Steans Filed: 1/12/2021
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| 1 | | AMENDMENT TO HOUSE BILL 356
| 2 | | AMENDMENT NO. ______. Amend House Bill 356 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Nursing Home Care Act is amended by | 5 | | changing Section 3-206 as follows:
| 6 | | (210 ILCS 45/3-206) (from Ch. 111 1/2, par. 4153-206)
| 7 | | Sec. 3-206.
The Department shall prescribe a curriculum for | 8 | | training
nursing assistants, habilitation aides, and child | 9 | | care aides.
| 10 | | (a) No person, except a volunteer who receives no | 11 | | compensation from a
facility and is not included for the | 12 | | purpose of meeting any staffing
requirements set forth by the | 13 | | Department, shall act as a nursing assistant,
habilitation | 14 | | aide, or child care aide in a facility, nor shall any person, | 15 | | under any
other title, not licensed, certified, or registered | 16 | | to render medical care
by the Department of Financial and |
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| 1 | | Professional Regulation, assist with the
personal, medical, or | 2 | | nursing care of residents in a facility, unless such
person | 3 | | meets the following requirements:
| 4 | | (1) Be at least 16 years of age, of temperate habits | 5 | | and good moral
character, honest, reliable and | 6 | | trustworthy.
| 7 | | (2) Be able to speak and understand the English | 8 | | language or a language
understood by a substantial | 9 | | percentage of the facility's residents.
| 10 | | (3) Provide evidence of employment or occupation, if | 11 | | any, and residence
for 2 years prior to his present | 12 | | employment.
| 13 | | (4) Have completed at least 8 years of grade school or | 14 | | provide proof of
equivalent knowledge.
| 15 | | (5) Begin a current course of training for nursing | 16 | | assistants,
habilitation aides, or child care aides, | 17 | | approved by the Department, within 45 days of initial
| 18 | | employment in the capacity of a nursing assistant, | 19 | | habilitation aide, or
child care aide
at any facility. Such | 20 | | courses of training shall be successfully completed
within | 21 | | 120 days of initial employment in the capacity of nursing | 22 | | assistant,
habilitation aide, or child care aide at a | 23 | | facility. Nursing assistants, habilitation
aides, and | 24 | | child care aides who are enrolled in approved courses in | 25 | | community
colleges or other educational institutions on a | 26 | | term, semester or trimester
basis, shall be exempt from the |
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| 1 | | 120-day completion time limit. The
Department shall adopt | 2 | | rules for such courses of training.
These rules shall | 3 | | include procedures for facilities to
carry on an approved | 4 | | course of training within the facility. The Department | 5 | | shall allow an individual to satisfy the supervised | 6 | | clinical experience requirement for placement on the | 7 | | Health Care Worker Registry under 77 Ill. Adm. Code 300.663 | 8 | | through supervised clinical experience at an assisted | 9 | | living establishment licensed under the Assisted Living | 10 | | and Shared Housing Act. The Department shall adopt rules | 11 | | requiring that the Health Care Worker Registry include | 12 | | information identifying where an individual on the Health | 13 | | Care Worker Registry received his or her clinical training.
| 14 | | The Department may accept comparable training in lieu | 15 | | of the 120-hour
course for student nurses, foreign nurses, | 16 | | military personnel, or employees of
the Department of Human | 17 | | Services.
| 18 | | The Department shall accept on-the-job experience in | 19 | | lieu of clinical training from any individual who | 20 | | participated in the temporary nursing assistant program | 21 | | during the COVID-19 pandemic before the end date of the | 22 | | temporary nursing assistant program and left the program in | 23 | | good standing, and the Department shall notify all approved | 24 | | certified nurse assistant training programs in the State of | 25 | | this requirement. The individual shall receive one hour of | 26 | | credit for every hour employed as a temporary nursing |
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| 1 | | assistant, up to 40 total hours, and shall be permitted 90 | 2 | | days after the end date of the temporary nursing assistant | 3 | | program to enroll in an approved certified nursing | 4 | | assistant training program and 240 days to successfully | 5 | | complete the certified nursing assistant training program. | 6 | | Temporary nursing assistants who enroll in a certified | 7 | | nursing assistant training program within 90 days of the | 8 | | end of the temporary nursing assistant program may continue | 9 | | to work as a nursing assistant for up to 240 days after | 10 | | enrollment in the certified nursing assistant training | 11 | | program. As used in this Section, "temporary nursing | 12 | | assistant program" means the program implemented by the | 13 | | Department of Public Health by emergency rule, as listed in | 14 | | 44 Ill. Reg. 7936, effective April 21, 2020. | 15 | | The facility shall develop and implement procedures, | 16 | | which shall be
approved by the Department, for an ongoing | 17 | | review process, which shall take
place within the facility, | 18 | | for nursing assistants, habilitation aides, and
child care | 19 | | aides.
| 20 | | At the time of each regularly scheduled licensure | 21 | | survey, or at the time
of a complaint investigation, the | 22 | | Department may require any nursing
assistant, habilitation | 23 | | aide, or child care aide to demonstrate, either through | 24 | | written
examination or action, or both, sufficient | 25 | | knowledge in all areas of
required training. If such | 26 | | knowledge is inadequate the Department shall
require the |
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| 1 | | nursing assistant, habilitation aide, or child care aide to | 2 | | complete inservice
training and review in the facility | 3 | | until the nursing assistant, habilitation
aide, or child | 4 | | care aide demonstrates to the Department, either through | 5 | | written
examination or action, or both, sufficient | 6 | | knowledge in all areas of
required training.
| 7 | | (6) Be familiar with and have general skills related to | 8 | | resident care.
| 9 | | (a-0.5) An educational entity, other than a secondary | 10 | | school, conducting a
nursing assistant, habilitation aide, or | 11 | | child care aide
training program
shall initiate a criminal | 12 | | history record check in accordance with the Health Care Worker | 13 | | Background Check Act prior to entry of an
individual into the | 14 | | training program.
A secondary school may initiate a criminal | 15 | | history record check in accordance with the Health Care Worker | 16 | | Background Check Act at any time during or after a training | 17 | | program.
| 18 | | (a-1) Nursing assistants, habilitation aides, or child | 19 | | care aides seeking to be included on the Health Care Worker | 20 | | Registry under the Health Care Worker Background Check Act on | 21 | | or
after January 1, 1996 must authorize the Department of | 22 | | Public Health or its
designee
to request a criminal history | 23 | | record check in accordance with the Health Care Worker | 24 | | Background Check Act and submit all necessary
information. An | 25 | | individual may not newly be included on the Health Care Worker | 26 | | Registry unless a criminal history record check has been |
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| 1 | | conducted with respect to the individual.
| 2 | | (b) Persons subject to this Section shall perform their | 3 | | duties under the
supervision of a licensed nurse.
| 4 | | (c) It is unlawful for any facility to employ any person in | 5 | | the capacity
of nursing assistant, habilitation aide, or child | 6 | | care aide, or under any other title, not
licensed by the State | 7 | | of Illinois to assist in the personal, medical, or
nursing care | 8 | | of residents in such facility unless such person has complied
| 9 | | with this Section.
| 10 | | (d) Proof of compliance by each employee with the | 11 | | requirements set out
in this Section shall be maintained for | 12 | | each such employee by each facility
in the individual personnel | 13 | | folder of the employee. Proof of training shall be obtained | 14 | | only from the Health Care Worker Registry.
| 15 | | (e) Each facility shall obtain access to the Health Care | 16 | | Worker Registry's web application, maintain the employment and | 17 | | demographic information relating to each employee, and verify | 18 | | by the category and type of employment that
each employee | 19 | | subject to this Section meets all the requirements of this
| 20 | | Section.
| 21 | | (f) Any facility that is operated under Section 3-803 shall | 22 | | be
exempt
from the requirements of this Section.
| 23 | | (g) Each skilled nursing and intermediate care facility | 24 | | that
admits
persons who are diagnosed as having Alzheimer's | 25 | | disease or related
dementias shall require all nursing | 26 | | assistants, habilitation aides, or child
care aides, who did |
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| 1 | | not receive 12 hours of training in the care and
treatment of | 2 | | such residents during the training required under paragraph
(5) | 3 | | of subsection (a), to obtain 12 hours of in-house training in | 4 | | the care
and treatment of such residents. If the facility does | 5 | | not provide the
training in-house, the training shall be | 6 | | obtained from other facilities,
community colleges or other | 7 | | educational institutions that have a
recognized course for such | 8 | | training. The Department shall, by rule,
establish a recognized | 9 | | course for such training. The Department's rules shall provide | 10 | | that such
training may be conducted in-house at each facility | 11 | | subject to the
requirements of this subsection, in which case | 12 | | such training shall be
monitored by the Department.
| 13 | | The Department's rules shall also provide for | 14 | | circumstances and procedures
whereby any person who has | 15 | | received training that meets
the
requirements of this | 16 | | subsection shall not be required to undergo additional
training | 17 | | if he or she is transferred to or obtains employment at a
| 18 | | different facility or a facility other than a long-term care | 19 | | facility but remains continuously employed for pay as a nursing | 20 | | assistant,
habilitation aide, or child care aide. Individuals
| 21 | | who have performed no nursing or nursing-related services
for a | 22 | | period of 24 consecutive months shall be listed as "inactive"
| 23 | | and as such do not meet the requirements of this Section. | 24 | | Licensed sheltered care facilities
shall be
exempt from the | 25 | | requirements of this Section.
| 26 | | An individual employed during the COVID-19 pandemic as a |
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| 1 | | nursing assistant in accordance with any Executive Orders, | 2 | | emergency rules, or policy memoranda related to COVID-19 shall | 3 | | be assumed to meet competency standards and may continue to be | 4 | | employed as a certified nurse assistant when the pandemic ends | 5 | | and the Executive Orders or emergency rules lapse. Such | 6 | | individuals shall be listed on the Department's Health Care | 7 | | Worker Registry website as "active". | 8 | | (Source: P.A. 100-297, eff. 8-24-17; 100-432, eff. 8-25-17; | 9 | | 100-863, eff. 8-14-18.)
| 10 | | Section 10. The Illinois Public Aid Code is amended by | 11 | | adding Section 5A-2.1 as follows: | 12 | | (305 ILCS 5/5A-2.1 new) | 13 | | Sec. 5A-2.1. Continuation of Section 5A-2 of this Code; | 14 | | validation. | 15 | | (a) The General Assembly finds and declares that: | 16 | | (1) Public Act 101-650, which took effect on July 7, | 17 | | 2020, contained provisions that would have changed the | 18 | | repeal date for Section 5A-2 of this Act from July 1, 2020 | 19 | | to December 31, 2022. | 20 | | (2) The Statute on Statutes sets forth general rules on | 21 | | the repeal of statutes and the construction of multiple | 22 | | amendments, but Section 1 of that Act also states that | 23 | | these rules will not be observed when the result would be | 24 | | "inconsistent with the manifest intent of the General |
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| 1 | | Assembly or repugnant to the context of the statute". | 2 | | (3) This amendatory Act of the 101st General Assembly | 3 | | manifests the intention of the General Assembly to extend | 4 | | the repeal date for Section 5A-2 of this Code and have | 5 | | Section 5A-2 of this Code, as amended by Public Act | 6 | | 101-650, continue in effect until December 31, 2022. | 7 | | (b) Any construction of this Code that results in the | 8 | | repeal of Section 5A-2 of this Code on July 1, 2020 would be | 9 | | inconsistent with the manifest intent of the General Assembly | 10 | | and repugnant to the context of this Code. | 11 | | (c) It is hereby declared to have been the intent of the | 12 | | General Assembly that Section 5A-2 of this Code shall not be | 13 | | subject to repeal on July 1, 2020. | 14 | | (d) Section 5A-2 of this Code shall be deemed to have been | 15 | | in continuous effect since July 8, 1992 (the effective date of | 16 | | Public Act 87-861), and it shall continue to be in effect, as | 17 | | amended by Public Act 101-650, until it is otherwise lawfully | 18 | | amended or repealed. All previously enacted amendments to the | 19 | | Section taking effect on or after July 8, 1992, are hereby | 20 | | validated. | 21 | | (e) In order to ensure the continuing effectiveness of | 22 | | Section 5A-2 of this Code, that Section is set forth in
full | 23 | | and reenacted by this amendatory Act of the 101st General
| 24 | | Assembly. In this amendatory Act of the 101st General Assembly, | 25 | | the base text of the reenacted Section is set forth as amended | 26 | | by Public Act 101-650. |
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| 1 | | (f) All actions of the Illinois Department or any other | 2 | | person or entity taken in reliance on or pursuant to Section | 3 | | 5A-2 of this Code are hereby validated. | 4 | | Section 15. The Illinois Public Aid Code is amended by | 5 | | reenacting Section 5A-2 as follows: | 6 | | (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2) | 7 | | Sec. 5A-2. Assessment.
| 8 | | (a)(1)
Subject to Sections 5A-3 and 5A-10, for State fiscal | 9 | | years 2009 through 2018, or as long as continued under Section | 10 | | 5A-16, an annual assessment on inpatient services is imposed on | 11 | | each hospital provider in an amount equal to $218.38 multiplied | 12 | | by the difference of the hospital's occupied bed days less the | 13 | | hospital's Medicare bed days, provided, however, that the | 14 | | amount of $218.38 shall be increased by a uniform percentage to | 15 | | generate an amount equal to 75% of the State share of the | 16 | | payments authorized under Section 5A-12.5, with such increase | 17 | | only taking effect upon the date that a State share for such | 18 | | payments is required under federal law. For the period of April | 19 | | through June 2015, the amount of $218.38 used to calculate the | 20 | | assessment under this paragraph shall, by emergency rule under | 21 | | subsection (s) of Section 5-45 of the Illinois Administrative | 22 | | Procedure Act, be increased by a uniform percentage to generate | 23 | | $20,250,000 in the aggregate for that period from all hospitals | 24 | | subject to the annual assessment under this paragraph. |
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| 1 | | (2) In addition to any other assessments imposed under this | 2 | | Article, effective July 1, 2016 and semi-annually thereafter | 3 | | through June 2018, or as provided in Section 5A-16, in addition | 4 | | to any federally required State share as authorized under | 5 | | paragraph (1), the amount of $218.38 shall be increased by a | 6 | | uniform percentage to generate an amount equal to 75% of the | 7 | | ACA Assessment Adjustment, as defined in subsection (b-6) of | 8 | | this Section. | 9 | | For State fiscal years 2009 through 2018, or as provided in | 10 | | Section 5A-16, a hospital's occupied bed days and Medicare bed | 11 | | days shall be determined using the most recent data available | 12 | | from each hospital's 2005 Medicare cost report as contained in | 13 | | the Healthcare Cost Report Information System file, for the | 14 | | quarter ending on December 31, 2006, without regard to any | 15 | | subsequent adjustments or changes to such data. If a hospital's | 16 | | 2005 Medicare cost report is not contained in the Healthcare | 17 | | Cost Report Information System, then the Illinois Department | 18 | | may obtain the hospital provider's occupied bed days and | 19 | | Medicare bed days from any source available, including, but not | 20 | | limited to, records maintained by the hospital provider, which | 21 | | may be inspected at all times during business hours of the day | 22 | | by the Illinois Department or its duly authorized agents and | 23 | | employees. | 24 | | (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State | 25 | | fiscal years 2019 and 2020, an annual assessment on inpatient | 26 | | services is imposed on each hospital provider in an amount |
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| 1 | | equal to $197.19 multiplied by the difference of the hospital's | 2 | | occupied bed days less the hospital's Medicare bed days. For | 3 | | State fiscal years 2019 and 2020, a hospital's occupied bed | 4 | | days and Medicare bed days shall be determined using the most | 5 | | recent data available from each hospital's 2015 Medicare cost | 6 | | report as contained in the Healthcare Cost Report Information | 7 | | System file, for the quarter ending on March 31, 2017, without | 8 | | regard to any subsequent adjustments or changes to such data. | 9 | | If a hospital's 2015 Medicare cost report is not contained in | 10 | | the Healthcare Cost Report Information System, then the | 11 | | Illinois Department may obtain the hospital provider's | 12 | | occupied bed days and Medicare bed days from any source | 13 | | available, including, but not limited to, records maintained by | 14 | | the hospital provider, which may be inspected at all times | 15 | | during business hours of the day by the Illinois Department or | 16 | | its duly authorized agents and employees. Notwithstanding any | 17 | | other provision in this Article, for a hospital provider that | 18 | | did not have a 2015 Medicare cost report, but paid an | 19 | | assessment in State fiscal year 2018 on the basis of | 20 | | hypothetical data, that assessment amount shall be used for | 21 | | State fiscal years 2019 and 2020. | 22 | | (4) Subject to Sections 5A-3 and 5A-10, for the period of | 23 | | July 1, 2020 through December 31, 2020 and calendar years 2021 | 24 | | and 2022, an annual assessment on inpatient services is imposed | 25 | | on each hospital provider in an amount equal to $221.50 | 26 | | multiplied by the difference of the hospital's occupied bed |
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| 1 | | days less the hospital's Medicare bed days, provided however: | 2 | | for the period of July 1, 2020 through December 31, 2020, (i) | 3 | | the assessment shall be equal to 50% of the annual amount; and | 4 | | (ii) the amount of $221.50 shall be retroactively adjusted by a | 5 | | uniform percentage to generate an amount equal to 50% of the | 6 | | Assessment Adjustment, as defined in subsection (b-7). For the | 7 | | period of July 1, 2020 through December 31, 2020 and calendar | 8 | | years 2021 and 2022, a hospital's occupied bed days and | 9 | | Medicare bed days shall be determined using the most recent | 10 | | data available from each hospital's 2015 Medicare cost report | 11 | | as contained in the Healthcare Cost Report Information System | 12 | | file, for the quarter ending on March 31, 2017, without regard | 13 | | to any subsequent adjustments or changes to such data. If a | 14 | | hospital's 2015 Medicare cost report is not contained in the | 15 | | Healthcare Cost Report Information System, then the Illinois | 16 | | Department may obtain the hospital provider's occupied bed days | 17 | | and Medicare bed days from any source available, including, but | 18 | | not limited to, records maintained by the hospital provider, | 19 | | which may be inspected at all times during business hours of | 20 | | the day by the Illinois Department or its duly authorized | 21 | | agents and employees. Should the change in the assessment | 22 | | methodology for fiscal years 2021 through December 31, 2022 not | 23 | | be approved on or before June 30, 2020, the assessment and | 24 | | payments under this Article in effect for fiscal year 2020 | 25 | | shall remain in place until the new assessment is approved. If | 26 | | the assessment methodology for July 1, 2020 through December |
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| 1 | | 31, 2022, is approved on or after July 1, 2020, it shall be | 2 | | retroactive to July 1, 2020, subject to federal approval and | 3 | | provided that the payments authorized under Section 5A-12.7 | 4 | | have the same effective date as the new assessment methodology. | 5 | | In giving retroactive effect to the assessment approved after | 6 | | June 30, 2020, credit toward the new assessment shall be given | 7 | | for any payments of the previous assessment for periods after | 8 | | June 30, 2020. Notwithstanding any other provision of this | 9 | | Article, for a hospital provider that did not have a 2015 | 10 | | Medicare cost report, but paid an assessment in State Fiscal | 11 | | Year 2020 on the basis of hypothetical data, the data that was | 12 | | the basis for the 2020 assessment shall be used to calculate | 13 | | the assessment under this paragraph. | 14 | | (b) (Blank).
| 15 | | (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the | 16 | | portion of State fiscal year 2012, beginning June 10, 2012 | 17 | | through June 30, 2012, and for State fiscal years 2013 through | 18 | | 2018, or as provided in Section 5A-16, an annual assessment on | 19 | | outpatient services is imposed on each hospital provider in an | 20 | | amount equal to .008766 multiplied by the hospital's outpatient | 21 | | gross revenue, provided, however, that the amount of .008766 | 22 | | shall be increased by a uniform percentage to generate an | 23 | | amount equal to 25% of the State share of the payments | 24 | | authorized under Section 5A-12.5, with such increase only | 25 | | taking effect upon the date that a State share for such | 26 | | payments is required under federal law. For the period |
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| 1 | | beginning June 10, 2012 through June 30, 2012, the annual | 2 | | assessment on outpatient services shall be prorated by | 3 | | multiplying the assessment amount by a fraction, the numerator | 4 | | of which is 21 days and the denominator of which is 365 days. | 5 | | For the period of April through June 2015, the amount of | 6 | | .008766 used to calculate the assessment under this paragraph | 7 | | shall, by emergency rule under subsection (s) of Section 5-45 | 8 | | of the Illinois Administrative Procedure Act, be increased by a | 9 | | uniform percentage to generate $6,750,000 in the aggregate for | 10 | | that period from all hospitals subject to the annual assessment | 11 | | under this paragraph. | 12 | | (2) In addition to any other assessments imposed under this | 13 | | Article, effective July 1, 2016 and semi-annually thereafter | 14 | | through June 2018, in addition to any federally required State | 15 | | share as authorized under paragraph (1), the amount of .008766 | 16 | | shall be increased by a uniform percentage to generate an | 17 | | amount equal to 25% of the ACA Assessment Adjustment, as | 18 | | defined in subsection (b-6) of this Section. | 19 | | For the portion of State fiscal year 2012, beginning June | 20 | | 10, 2012 through June 30, 2012, and State fiscal years 2013 | 21 | | through 2018, or as provided in Section 5A-16, a hospital's | 22 | | outpatient gross revenue shall be determined using the most | 23 | | recent data available from each hospital's 2009 Medicare cost | 24 | | report as contained in the Healthcare Cost Report Information | 25 | | System file, for the quarter ending on June 30, 2011, without | 26 | | regard to any subsequent adjustments or changes to such data. |
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| 1 | | If a hospital's 2009 Medicare cost report is not contained in | 2 | | the Healthcare Cost Report Information System, then the | 3 | | Department may obtain the hospital provider's outpatient gross | 4 | | revenue from any source available, including, but not limited | 5 | | to, records maintained by the hospital provider, which may be | 6 | | inspected at all times during business hours of the day by the | 7 | | Department or its duly authorized agents and employees. | 8 | | (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State | 9 | | fiscal years 2019 and 2020, an annual assessment on outpatient | 10 | | services is imposed on each hospital provider in an amount | 11 | | equal to .01358 multiplied by the hospital's outpatient gross | 12 | | revenue. For State fiscal years 2019 and 2020, a hospital's | 13 | | outpatient gross revenue shall be determined using the most | 14 | | recent data available from each hospital's 2015 Medicare cost | 15 | | report as contained in the Healthcare Cost Report Information | 16 | | System file, for the quarter ending on March 31, 2017, without | 17 | | regard to any subsequent adjustments or changes to such data. | 18 | | If a hospital's 2015 Medicare cost report is not contained in | 19 | | the Healthcare Cost Report Information System, then the | 20 | | Department may obtain the hospital provider's outpatient gross | 21 | | revenue from any source available, including, but not limited | 22 | | to, records maintained by the hospital provider, which may be | 23 | | inspected at all times during business hours of the day by the | 24 | | Department or its duly authorized agents and employees. | 25 | | Notwithstanding any other provision in this Article, for a | 26 | | hospital provider that did not have a 2015 Medicare cost |
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| 1 | | report, but paid an assessment in State fiscal year 2018 on the | 2 | | basis of hypothetical data, that assessment amount shall be | 3 | | used for State fiscal years 2019 and 2020. | 4 | | (4) Subject to Sections 5A-3 and 5A-10, for the period of | 5 | | July 1, 2020 through December 31, 2020 and calendar years 2021 | 6 | | and 2022, an annual assessment on outpatient services is | 7 | | imposed on each hospital provider in an amount equal to .01525 | 8 | | multiplied by the hospital's outpatient gross revenue, | 9 | | provided however: (i) for the period of July 1, 2020 through | 10 | | December 31, 2020, the assessment shall be equal to 50% of the | 11 | | annual amount; and (ii) the amount of .01525 shall be | 12 | | retroactively adjusted by a uniform percentage to generate an | 13 | | amount equal to 50% of the Assessment Adjustment, as defined in | 14 | | subsection (b-7). For the period of July 1, 2020 through | 15 | | December 31, 2020 and calendar years 2021 and 2022, a | 16 | | hospital's outpatient gross revenue shall be determined using | 17 | | the most recent data available from each hospital's 2015 | 18 | | Medicare cost report as contained in the Healthcare Cost Report | 19 | | Information System file, for the quarter ending on March 31, | 20 | | 2017, without regard to any subsequent adjustments or changes | 21 | | to such data. If a hospital's 2015 Medicare cost report is not | 22 | | contained in the Healthcare Cost Report Information System, | 23 | | then the Illinois Department may obtain the hospital provider's | 24 | | outpatient revenue data from any source available, including, | 25 | | but not limited to, records maintained by the hospital | 26 | | provider, which may be inspected at all times during business |
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| 1 | | hours of the day by the Illinois Department or its duly | 2 | | authorized agents and employees. Should the change in the | 3 | | assessment methodology above for fiscal years 2021 through | 4 | | calendar year 2022 not be approved prior to July 1, 2020, the | 5 | | assessment and payments under this Article in effect for fiscal | 6 | | year 2020 shall remain in place until the new assessment is | 7 | | approved. If the change in the assessment methodology above for | 8 | | July 1, 2020 through December 31, 2022, is approved after June | 9 | | 30, 2020, it shall have a retroactive effective date of July 1, | 10 | | 2020, subject to federal approval and provided that the | 11 | | payments authorized under Section 12A-7 have the same effective | 12 | | date as the new assessment methodology. In giving retroactive | 13 | | effect to the assessment approved after June 30, 2020, credit | 14 | | toward the new assessment shall be given for any payments of | 15 | | the previous assessment for periods after June 30, 2020. | 16 | | Notwithstanding any other provision of this Article, for a | 17 | | hospital provider that did not have a 2015 Medicare cost | 18 | | report, but paid an assessment in State Fiscal Year 2020 on the | 19 | | basis of hypothetical data, the data that was the basis for the | 20 | | 2020 assessment shall be used to calculate the assessment under | 21 | | this paragraph. | 22 | | (b-6)(1) As used in this Section, "ACA Assessment | 23 | | Adjustment" means: | 24 | | (A) For the period of July 1, 2016 through December 31, | 25 | | 2016, the product of .19125 multiplied by the sum of the | 26 | | fee-for-service payments to hospitals as authorized under |
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| 1 | | Section 5A-12.5 and the adjustments authorized under | 2 | | subsection (t) of Section 5A-12.2 to managed care | 3 | | organizations for hospital services due and payable in the | 4 | | month of April 2016 multiplied by 6. | 5 | | (B) For the period of January 1, 2017 through June 30, | 6 | | 2017, the product of .19125 multiplied by the sum of the | 7 | | fee-for-service payments to hospitals as authorized under | 8 | | Section 5A-12.5 and the adjustments authorized under | 9 | | subsection (t) of Section 5A-12.2 to managed care | 10 | | organizations for hospital services due and payable in the | 11 | | month of October 2016 multiplied by 6, except that the | 12 | | amount calculated under this subparagraph (B) shall be | 13 | | adjusted, either positively or negatively, to account for | 14 | | the difference between the actual payments issued under | 15 | | Section 5A-12.5 for the period beginning July 1, 2016 | 16 | | through December 31, 2016 and the estimated payments due | 17 | | and payable in the month of April 2016 multiplied by 6 as | 18 | | described in subparagraph (A). | 19 | | (C) For the period of July 1, 2017 through December 31, | 20 | | 2017, the product of .19125 multiplied by the sum of the | 21 | | fee-for-service payments to hospitals as authorized under | 22 | | Section 5A-12.5 and the adjustments authorized under | 23 | | subsection (t) of Section 5A-12.2 to managed care | 24 | | organizations for hospital services due and payable in the | 25 | | month of April 2017 multiplied by 6, except that the amount | 26 | | calculated under this subparagraph (C) shall be adjusted, |
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| 1 | | either positively or negatively, to account for the | 2 | | difference between the actual payments issued under | 3 | | Section 5A-12.5 for the period beginning January 1, 2017 | 4 | | through June 30, 2017 and the estimated payments due and | 5 | | payable in the month of October 2016 multiplied by 6 as | 6 | | described in subparagraph (B). | 7 | | (D) For the period of January 1, 2018 through June 30, | 8 | | 2018, the product of .19125 multiplied by the sum of the | 9 | | fee-for-service payments to hospitals as authorized under | 10 | | Section 5A-12.5 and the adjustments authorized under | 11 | | subsection (t) of Section 5A-12.2 to managed care | 12 | | organizations for hospital services due and payable in the | 13 | | month of October 2017 multiplied by 6, except that: | 14 | | (i) the amount calculated under this subparagraph | 15 | | (D) shall be adjusted, either positively or | 16 | | negatively, to account for the difference between the | 17 | | actual payments issued under Section 5A-12.5 for the | 18 | | period of July 1, 2017 through December 31, 2017 and | 19 | | the estimated payments due and payable in the month of | 20 | | April 2017 multiplied by 6 as described in subparagraph | 21 | | (C); and | 22 | | (ii) the amount calculated under this subparagraph | 23 | | (D) shall be adjusted to include the product of .19125 | 24 | | multiplied by the sum of the fee-for-service payments, | 25 | | if any, estimated to be paid to hospitals under | 26 | | subsection (b) of Section 5A-12.5. |
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| 1 | | (2) The Department shall complete and apply a final | 2 | | reconciliation of the ACA Assessment Adjustment prior to June | 3 | | 30, 2018 to account for: | 4 | | (A) any differences between the actual payments issued | 5 | | or scheduled to be issued prior to June 30, 2018 as | 6 | | authorized in Section 5A-12.5 for the period of January 1, | 7 | | 2018 through June 30, 2018 and the estimated payments due | 8 | | and payable in the month of October 2017 multiplied by 6 as | 9 | | described in subparagraph (D); and | 10 | | (B) any difference between the estimated | 11 | | fee-for-service payments under subsection (b) of Section | 12 | | 5A-12.5 and the amount of such payments that are actually | 13 | | scheduled to be paid. | 14 | | The Department shall notify hospitals of any additional | 15 | | amounts owed or reduction credits to be applied to the June | 16 | | 2018 ACA Assessment Adjustment. This is to be considered the | 17 | | final reconciliation for the ACA Assessment Adjustment. | 18 | | (3) Notwithstanding any other provision of this Section, if | 19 | | for any reason the scheduled payments under subsection (b) of | 20 | | Section 5A-12.5 are not issued in full by the final day of the | 21 | | period authorized under subsection (b) of Section 5A-12.5, | 22 | | funds collected from each hospital pursuant to subparagraph (D) | 23 | | of paragraph (1) and pursuant to paragraph (2), attributable to | 24 | | the scheduled payments authorized under subsection (b) of | 25 | | Section 5A-12.5 that are not issued in full by the final day of | 26 | | the period attributable to each payment authorized under |
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| 1 | | subsection (b) of Section 5A-12.5, shall be refunded. | 2 | | (4) The increases authorized under paragraph (2) of | 3 | | subsection (a) and paragraph (2) of subsection (b-5) shall be | 4 | | limited to the federally required State share of the total | 5 | | payments authorized under Section 5A-12.5 if the sum of such | 6 | | payments yields an annualized amount equal to or less than | 7 | | $450,000,000, or if the adjustments authorized under | 8 | | subsection (t) of Section 5A-12.2 are found not to be | 9 | | actuarially sound; however, this limitation shall not apply to | 10 | | the fee-for-service payments described in subsection (b) of | 11 | | Section 5A-12.5. | 12 | | (b-7)(1) As used in this Section, "Assessment Adjustment" | 13 | | means: | 14 | | (A) For the period of July 1, 2020 through December 31, | 15 | | 2020, the product of .3853 multiplied by the total of the | 16 | | actual payments made under subsections (c) through (k) of | 17 | | Section 5A-12.7 attributable to the period, less the total | 18 | | of the assessment imposed under subsections (a) and (b-5) | 19 | | of this Section for the period. | 20 | | (B) For each calendar quarter beginning on and after | 21 | | January 1, 2021, the product of .3853 multiplied by the | 22 | | total of the actual payments made under subsections (c) | 23 | | through (k) of Section 5A-12.7 attributable to the period, | 24 | | less the total of the assessment imposed under subsections | 25 | | (a) and (b-5) of this Section for the period. | 26 | | (2) The Department shall calculate and notify each hospital |
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| 1 | | of the total Assessment Adjustment and any additional | 2 | | assessment owed by the hospital or refund owed to the hospital | 3 | | on either a semi-annual or annual basis. Such notice shall be | 4 | | issued at least 30 days prior to any period in which the | 5 | | assessment will be adjusted. Any additional assessment owed by | 6 | | the hospital or refund owed to the hospital shall be uniformly | 7 | | applied to the assessment owed by the hospital in monthly | 8 | | installments for the subsequent semi-annual period or calendar | 9 | | year. If no assessment is owed in the subsequent year, any | 10 | | amount owed by the hospital or refund due to the hospital, | 11 | | shall be paid in a lump sum. | 12 | | (3) The Department shall publish all details of the | 13 | | Assessment Adjustment calculation performed each year on its | 14 | | website within 30 days of completing the calculation, and also | 15 | | submit the details of the Assessment Adjustment calculation as | 16 | | part of the Department's annual report to the General Assembly. | 17 | | (c) (Blank).
| 18 | | (d) Notwithstanding any of the other provisions of this | 19 | | Section, the Department is authorized to adopt rules to reduce | 20 | | the rate of any annual assessment imposed under this Section, | 21 | | as authorized by Section 5-46.2 of the Illinois Administrative | 22 | | Procedure Act.
| 23 | | (e) Notwithstanding any other provision of this Section, | 24 | | any plan providing for an assessment on a hospital provider as | 25 | | a permissible tax under Title XIX of the federal Social | 26 | | Security Act and Medicaid-eligible payments to hospital |
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| 1 | | providers from the revenues derived from that assessment shall | 2 | | be reviewed by the Illinois Department of Healthcare and Family | 3 | | Services, as the Single State Medicaid Agency required by | 4 | | federal law, to determine whether those assessments and | 5 | | hospital provider payments meet federal Medicaid standards. If | 6 | | the Department determines that the elements of the plan may | 7 | | meet federal Medicaid standards and a related State Medicaid | 8 | | Plan Amendment is prepared in a manner and form suitable for | 9 | | submission, that State Plan Amendment shall be submitted in a | 10 | | timely manner for review by the Centers for Medicare and | 11 | | Medicaid Services of the United States Department of Health and | 12 | | Human Services and subject to approval by the Centers for | 13 | | Medicare and Medicaid Services of the United States Department | 14 | | of Health and Human Services. No such plan shall become | 15 | | effective without approval by the Illinois General Assembly by | 16 | | the enactment into law of related legislation. Notwithstanding | 17 | | any other provision of this Section, the Department is | 18 | | authorized to adopt rules to reduce the rate of any annual | 19 | | assessment imposed under this Section. Any such rules may be | 20 | | adopted by the Department under Section 5-50 of the Illinois | 21 | | Administrative Procedure Act. | 22 | | (Source: P.A. 100-581, eff. 3-12-18; 101-10, eff. 6-5-19; | 23 | | 101-650, eff. 7-7-20.)
| 24 | | Section 99. Effective date. This Act takes effect upon | 25 | | becoming law.".
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