Full Text of SB2972 102nd General Assembly
SB2972 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 SB2972 Introduced 12/15/2021, by Sen. Ann Gillespie SYNOPSIS AS INTRODUCED: |
| 305 ILCS 5/5A-2 | from Ch. 23, par. 5A-2 |
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Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning assessments.
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| | A BILL FOR |
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| 1 | | AN ACT concerning public aid.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5A-2 as follows: | 6 | | (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2) | 7 | | (Section scheduled to be repealed on December 31, 2022) | 8 | | Sec. 5A-2. Assessment.
| 9 | | (a)(1)
Subject to Sections 5A-3 and 5A-10, for State | 10 | | fiscal years 2009 through 2018, or as long as continued under | 11 | | Section 5A-16, an annual assessment on inpatient services is | 12 | | imposed on each hospital provider in an amount equal to | 13 | | $218.38 multiplied by the the difference of the hospital's | 14 | | occupied bed days less the hospital's Medicare bed days, | 15 | | provided, however, that the amount of $218.38 shall be | 16 | | increased by a uniform percentage to generate an amount equal | 17 | | to 75% of the State share of the payments authorized under | 18 | | Section 5A-12.5, with such increase only taking effect upon | 19 | | the date that a State share for such payments is required under | 20 | | federal law. For the period of April through June 2015, the | 21 | | amount of $218.38 used to calculate the assessment under this | 22 | | paragraph shall, by emergency rule under subsection (s) of | 23 | | Section 5-45 of the Illinois Administrative Procedure Act, be |
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| 1 | | increased by a uniform percentage to generate $20,250,000 in | 2 | | the aggregate for that period from all hospitals subject to | 3 | | the annual assessment under this paragraph. | 4 | | (2) In addition to any other assessments imposed under | 5 | | this Article, effective July 1, 2016 and semi-annually | 6 | | thereafter through June 2018, or as provided in Section 5A-16, | 7 | | in addition to any federally required State share as | 8 | | authorized under paragraph (1), the amount of $218.38 shall be | 9 | | increased by a uniform percentage to generate an amount equal | 10 | | to 75% of the ACA Assessment Adjustment, as defined in | 11 | | subsection (b-6) of this Section. | 12 | | For State fiscal years 2009 through 2018, or as provided | 13 | | in Section 5A-16, a hospital's occupied bed days and Medicare | 14 | | bed days shall be determined using the most recent data | 15 | | available from each hospital's 2005 Medicare cost report as | 16 | | contained in the Healthcare Cost Report Information System | 17 | | file, for the quarter ending on December 31, 2006, without | 18 | | regard to any subsequent adjustments or changes to such data. | 19 | | If a hospital's 2005 Medicare cost report is not contained in | 20 | | the Healthcare Cost Report Information System, then the | 21 | | Illinois Department may obtain the hospital provider's | 22 | | occupied bed days and Medicare bed days from any source | 23 | | available, including, but not limited to, records maintained | 24 | | by the hospital provider, which may be inspected at all times | 25 | | during business hours of the day by the Illinois Department or | 26 | | its duly authorized agents and employees. |
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| 1 | | (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State | 2 | | fiscal years 2019 and 2020, an annual assessment on inpatient | 3 | | services is imposed on each hospital provider in an amount | 4 | | equal to $197.19 multiplied by the difference of the | 5 | | hospital's occupied bed days less the hospital's Medicare bed | 6 | | days. For State fiscal years 2019 and 2020, a hospital's | 7 | | occupied bed days and Medicare bed days shall be determined | 8 | | using the most recent data available from each hospital's 2015 | 9 | | Medicare cost report as contained in the Healthcare Cost | 10 | | Report Information System file, for the quarter ending on | 11 | | March 31, 2017, without regard to any subsequent adjustments | 12 | | or changes to such data. If a hospital's 2015 Medicare cost | 13 | | report is not contained in the Healthcare Cost Report | 14 | | Information System, then the Illinois Department may obtain | 15 | | the hospital provider's occupied bed days and Medicare bed | 16 | | days from any source available, including, but not limited to, | 17 | | records maintained by the hospital provider, which may be | 18 | | inspected at all times during business hours of the day by the | 19 | | Illinois Department or its duly authorized agents and | 20 | | employees. Notwithstanding any other provision in this | 21 | | Article, for a hospital provider that did not have a 2015 | 22 | | Medicare cost report, but paid an assessment in State fiscal | 23 | | year 2018 on the basis of hypothetical data, that assessment | 24 | | amount shall be used for State fiscal years 2019 and 2020. | 25 | | (4) Subject to Sections 5A-3 and 5A-10, for the period of | 26 | | July 1, 2020 through December 31, 2020 and calendar years 2021 |
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| 1 | | and 2022, an annual assessment on inpatient services is | 2 | | imposed on each hospital provider in an amount equal to | 3 | | $221.50 multiplied by the difference of the hospital's | 4 | | occupied bed days less the hospital's Medicare bed days, | 5 | | provided however: for the period of July 1, 2020 through | 6 | | December 31, 2020, (i) the assessment shall be equal to 50% of | 7 | | the annual amount; and (ii) the amount of $221.50 shall be | 8 | | retroactively adjusted by a uniform percentage to generate an | 9 | | amount equal to 50% of the Assessment Adjustment, as defined | 10 | | in subsection (b-7). For the period of July 1, 2020 through | 11 | | December 31, 2020 and calendar years 2021 and 2022, a | 12 | | hospital's occupied bed days and Medicare bed days shall be | 13 | | determined using the most recent data available from each | 14 | | hospital's 2015 Medicare cost report as contained in the | 15 | | Healthcare Cost Report Information System file, for the | 16 | | quarter ending on March 31, 2017, without regard to any | 17 | | subsequent adjustments or changes to such data. If a | 18 | | hospital's 2015 Medicare cost report is not contained in the | 19 | | Healthcare Cost Report Information System, then the Illinois | 20 | | Department may obtain the hospital provider's occupied bed | 21 | | days and Medicare bed days from any source available, | 22 | | including, but not limited to, records maintained by the | 23 | | hospital provider, which may be inspected at all times during | 24 | | business hours of the day by the Illinois Department or its | 25 | | duly authorized agents and employees. Should the change in the | 26 | | assessment methodology for fiscal years 2021 through December |
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| 1 | | 31, 2022 not be approved on or before June 30, 2020, the | 2 | | assessment and payments under this Article in effect for | 3 | | fiscal year 2020 shall remain in place until the new | 4 | | assessment is approved. If the assessment methodology for July | 5 | | 1, 2020 through December 31, 2022, is approved on or after July | 6 | | 1, 2020, it shall be retroactive to July 1, 2020, subject to | 7 | | federal approval and provided that the payments authorized | 8 | | under Section 5A-12.7 have the same effective date as the new | 9 | | assessment methodology. In giving retroactive effect to the | 10 | | assessment approved after June 30, 2020, credit toward the new | 11 | | assessment shall be given for any payments of the previous | 12 | | assessment for periods after June 30, 2020. Notwithstanding | 13 | | any other provision of this Article, for a hospital provider | 14 | | that did not have a 2015 Medicare cost report, but paid an | 15 | | assessment in State Fiscal Year 2020 on the basis of | 16 | | hypothetical data, the data that was the basis for the 2020 | 17 | | assessment shall be used to calculate the assessment under | 18 | | this paragraph. | 19 | | (b) (Blank).
| 20 | | (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the | 21 | | portion of State fiscal year 2012, beginning June 10, 2012 | 22 | | through June 30, 2012, and for State fiscal years 2013 through | 23 | | 2018, or as provided in Section 5A-16, an annual assessment on | 24 | | outpatient services is imposed on each hospital provider in an | 25 | | amount equal to .008766 multiplied by the hospital's | 26 | | outpatient gross revenue, provided, however, that the amount |
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| 1 | | of .008766 shall be increased by a uniform percentage to | 2 | | generate an amount equal to 25% of the State share of the | 3 | | payments authorized under Section 5A-12.5, with such increase | 4 | | only taking effect upon the date that a State share for such | 5 | | payments is required under federal law. For the period | 6 | | beginning June 10, 2012 through June 30, 2012, the annual | 7 | | assessment on outpatient services shall be prorated by | 8 | | multiplying the assessment amount by a fraction, the numerator | 9 | | of which is 21 days and the denominator of which is 365 days. | 10 | | For the period of April through June 2015, the amount of | 11 | | .008766 used to calculate the assessment under this paragraph | 12 | | shall, by emergency rule under subsection (s) of Section 5-45 | 13 | | of the Illinois Administrative Procedure Act, be increased by | 14 | | a uniform percentage to generate $6,750,000 in the aggregate | 15 | | for that period from all hospitals subject to the annual | 16 | | assessment under this paragraph. | 17 | | (2) In addition to any other assessments imposed under | 18 | | this Article, effective July 1, 2016 and semi-annually | 19 | | thereafter through June 2018, in addition to any federally | 20 | | required State share as authorized under paragraph (1), the | 21 | | amount of .008766 shall be increased by a uniform percentage | 22 | | to generate an amount equal to 25% of the ACA Assessment | 23 | | Adjustment, as defined in subsection (b-6) of this Section. | 24 | | For the portion of State fiscal year 2012, beginning June | 25 | | 10, 2012 through June 30, 2012, and State fiscal years 2013 | 26 | | through 2018, or as provided in Section 5A-16, a hospital's |
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| 1 | | outpatient gross revenue shall be determined using the most | 2 | | recent data available from each hospital's 2009 Medicare cost | 3 | | report as contained in the Healthcare Cost Report Information | 4 | | System file, for the quarter ending on June 30, 2011, without | 5 | | regard to any subsequent adjustments or changes to such data. | 6 | | If a hospital's 2009 Medicare cost report is not contained in | 7 | | the Healthcare Cost Report Information System, then the | 8 | | Department may obtain the hospital provider's outpatient gross | 9 | | revenue from any source available, including, but not limited | 10 | | to, records maintained by the hospital provider, which may be | 11 | | inspected at all times during business hours of the day by the | 12 | | Department or its duly authorized agents and employees. | 13 | | (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State | 14 | | fiscal years 2019 and 2020, an annual assessment on outpatient | 15 | | services is imposed on each hospital provider in an amount | 16 | | equal to .01358 multiplied by the hospital's outpatient gross | 17 | | revenue. For State fiscal years 2019 and 2020, a hospital's | 18 | | outpatient gross revenue shall be determined using the most | 19 | | recent data available from each hospital's 2015 Medicare cost | 20 | | report as contained in the Healthcare Cost Report Information | 21 | | System file, for the quarter ending on March 31, 2017, without | 22 | | regard to any subsequent adjustments or changes to such data. | 23 | | If a hospital's 2015 Medicare cost report is not contained in | 24 | | the Healthcare Cost Report Information System, then the | 25 | | Department may obtain the hospital provider's outpatient gross | 26 | | revenue from any source available, including, but not limited |
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| 1 | | to, records maintained by the hospital provider, which may be | 2 | | inspected at all times during business hours of the day by the | 3 | | Department or its duly authorized agents and employees. | 4 | | Notwithstanding any other provision in this Article, for a | 5 | | hospital provider that did not have a 2015 Medicare cost | 6 | | report, but paid an assessment in State fiscal year 2018 on the | 7 | | basis of hypothetical data, that assessment amount shall be | 8 | | used for State fiscal years 2019 and 2020. | 9 | | (4) Subject to Sections 5A-3 and 5A-10, for the period of | 10 | | July 1, 2020 through December 31, 2020 and calendar years 2021 | 11 | | and 2022, an annual assessment on outpatient services is | 12 | | imposed on each hospital provider in an amount equal to .01525 | 13 | | multiplied by the hospital's outpatient gross revenue, | 14 | | provided however: (i) for the period of July 1, 2020 through | 15 | | December 31, 2020, the assessment shall be equal to 50% of the | 16 | | annual amount; and (ii) the amount of .01525 shall be | 17 | | retroactively adjusted by a uniform percentage to generate an | 18 | | amount equal to 50% of the Assessment Adjustment, as defined | 19 | | in subsection (b-7). For the period of July 1, 2020 through | 20 | | December 31, 2020 and calendar years 2021 and 2022, a | 21 | | hospital's outpatient gross revenue shall be determined using | 22 | | the most recent data available from each hospital's 2015 | 23 | | Medicare cost report as contained in the Healthcare Cost | 24 | | Report Information System file, for the quarter ending on | 25 | | March 31, 2017, without regard to any subsequent adjustments | 26 | | or changes to such data. If a hospital's 2015 Medicare cost |
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| 1 | | report is not contained in the Healthcare Cost Report | 2 | | Information System, then the Illinois Department may obtain | 3 | | the hospital provider's outpatient revenue data from any | 4 | | source available, including, but not limited to, records | 5 | | maintained by the hospital provider, which may be inspected at | 6 | | all times during business hours of the day by the Illinois | 7 | | Department or its duly authorized agents and employees. Should | 8 | | the change in the assessment methodology above for fiscal | 9 | | years 2021 through calendar year 2022 not be approved prior to | 10 | | July 1, 2020, the assessment and payments under this Article | 11 | | in effect for fiscal year 2020 shall remain in place until the | 12 | | new assessment is approved. If the change in the assessment | 13 | | methodology above for July 1, 2020 through December 31, 2022, | 14 | | is approved after June 30, 2020, it shall have a retroactive | 15 | | effective date of July 1, 2020, subject to federal approval | 16 | | and provided that the payments authorized under Section 12A-7 | 17 | | have the same effective date as the new assessment | 18 | | methodology. In giving retroactive effect to the assessment | 19 | | approved after June 30, 2020, credit toward the new assessment | 20 | | shall be given for any payments of the previous assessment for | 21 | | periods after June 30, 2020. Notwithstanding any other | 22 | | provision of this Article, for a hospital provider that did | 23 | | not have a 2015 Medicare cost report, but paid an assessment in | 24 | | State Fiscal Year 2020 on the basis of hypothetical data, the | 25 | | data that was the basis for the 2020 assessment shall be used | 26 | | to calculate the assessment under this paragraph. |
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| 1 | | (b-6)(1) As used in this Section, "ACA Assessment | 2 | | Adjustment" means: | 3 | | (A) For the period of July 1, 2016 through December | 4 | | 31, 2016, the product of .19125 multiplied by the sum of | 5 | | the fee-for-service payments to hospitals as authorized | 6 | | under Section 5A-12.5 and the adjustments authorized under | 7 | | subsection (t) of Section 5A-12.2 to managed care | 8 | | organizations for hospital services due and payable in the | 9 | | month of April 2016 multiplied by 6. | 10 | | (B) For the period of January 1, 2017 through June 30, | 11 | | 2017, the product of .19125 multiplied by the sum of the | 12 | | fee-for-service payments to hospitals as authorized under | 13 | | Section 5A-12.5 and the adjustments authorized under | 14 | | subsection (t) of Section 5A-12.2 to managed care | 15 | | organizations for hospital services due and payable in the | 16 | | month of October 2016 multiplied by 6, except that the | 17 | | amount calculated under this subparagraph (B) shall be | 18 | | adjusted, either positively or negatively, to account for | 19 | | the difference between the actual payments issued under | 20 | | Section 5A-12.5 for the period beginning July 1, 2016 | 21 | | through December 31, 2016 and the estimated payments due | 22 | | and payable in the month of April 2016 multiplied by 6 as | 23 | | described in subparagraph (A). | 24 | | (C) For the period of July 1, 2017 through December | 25 | | 31, 2017, the product of .19125 multiplied by the sum of | 26 | | the fee-for-service payments to hospitals as authorized |
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| 1 | | under 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 2017 multiplied by 6, except that the | 5 | | amount calculated under this subparagraph (C) shall be | 6 | | adjusted, either positively or negatively, to account for | 7 | | the difference between the actual payments issued under | 8 | | Section 5A-12.5 for the period beginning January 1, 2017 | 9 | | through June 30, 2017 and the estimated payments due and | 10 | | payable in the month of October 2016 multiplied by 6 as | 11 | | described in subparagraph (B). | 12 | | (D) For the period of January 1, 2018 through June 30, | 13 | | 2018, the product of .19125 multiplied by the sum of the | 14 | | fee-for-service payments to hospitals as authorized under | 15 | | Section 5A-12.5 and the adjustments authorized under | 16 | | subsection (t) of Section 5A-12.2 to managed care | 17 | | organizations for hospital services due and payable in the | 18 | | month of October 2017 multiplied by 6, except that: | 19 | | (i) the amount calculated under this subparagraph | 20 | | (D) shall be adjusted, either positively or | 21 | | negatively, to account for the difference between the | 22 | | actual payments issued under Section 5A-12.5 for the | 23 | | period of July 1, 2017 through December 31, 2017 and | 24 | | the estimated payments due and payable in the month of | 25 | | April 2017 multiplied by 6 as described in | 26 | | subparagraph (C); and |
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| 1 | | (ii) the amount calculated under this subparagraph | 2 | | (D) shall be adjusted to include the product of .19125 | 3 | | multiplied by the sum of the fee-for-service payments, | 4 | | if any, estimated to be paid to hospitals under | 5 | | subsection (b) of Section 5A-12.5. | 6 | | (2) The Department shall complete and apply a final | 7 | | reconciliation of the ACA Assessment Adjustment prior to June | 8 | | 30, 2018 to account for: | 9 | | (A) any differences between the actual payments issued | 10 | | or scheduled to be issued prior to June 30, 2018 as | 11 | | authorized in Section 5A-12.5 for the period of January 1, | 12 | | 2018 through June 30, 2018 and the estimated payments due | 13 | | and payable in the month of October 2017 multiplied by 6 as | 14 | | described in subparagraph (D); and | 15 | | (B) any difference between the estimated | 16 | | fee-for-service payments under subsection (b) of Section | 17 | | 5A-12.5 and the amount of such payments that are actually | 18 | | scheduled to be paid. | 19 | | The Department shall notify hospitals of any additional | 20 | | amounts owed or reduction credits to be applied to the June | 21 | | 2018 ACA Assessment Adjustment. This is to be considered the | 22 | | final reconciliation for the ACA Assessment Adjustment. | 23 | | (3) Notwithstanding any other provision of this Section, | 24 | | if for any reason the scheduled payments under subsection (b) | 25 | | of Section 5A-12.5 are not issued in full by the final day of | 26 | | the period authorized under subsection (b) of Section 5A-12.5, |
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| 1 | | funds collected from each hospital pursuant to subparagraph | 2 | | (D) of paragraph (1) and pursuant to paragraph (2), | 3 | | attributable to the scheduled payments authorized under | 4 | | subsection (b) of Section 5A-12.5 that are not issued in full | 5 | | by the final day of the period attributable to each payment | 6 | | authorized under subsection (b) of Section 5A-12.5, shall be | 7 | | refunded. | 8 | | (4) The increases authorized under paragraph (2) of | 9 | | subsection (a) and paragraph (2) of subsection (b-5) shall be | 10 | | limited to the federally required State share of the total | 11 | | payments authorized under Section 5A-12.5 if the sum of such | 12 | | payments yields an annualized amount equal to or less than | 13 | | $450,000,000, or if the adjustments authorized under | 14 | | subsection (t) of Section 5A-12.2 are found not to be | 15 | | actuarially sound; however, this limitation shall not apply to | 16 | | the fee-for-service payments described in subsection (b) of | 17 | | Section 5A-12.5. | 18 | | (b-7)(1) As used in this Section, "Assessment Adjustment" | 19 | | means: | 20 | | (A) For the period of July 1, 2020 through December | 21 | | 31, 2020, the product of .3853 multiplied by the total of | 22 | | the actual payments made under subsections (c) through (k) | 23 | | of Section 5A-12.7 attributable to the period, less the | 24 | | total of the assessment imposed under subsections (a) and | 25 | | (b-5) of this Section for the period. | 26 | | (B) For each calendar quarter beginning on and after |
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| 1 | | January 1, 2021, the product of .3853 multiplied by the | 2 | | total of the actual payments made under subsections (c) | 3 | | through (k) of Section 5A-12.7 attributable to the period, | 4 | | less the total of the assessment imposed under subsections | 5 | | (a) and (b-5) of this Section for the period. | 6 | | (2) The Department shall calculate and notify each | 7 | | hospital of the total Assessment Adjustment and any additional | 8 | | assessment owed by the hospital or refund owed to the hospital | 9 | | on either a semi-annual or annual basis. Such notice shall be | 10 | | issued at least 30 days prior to any period in which the | 11 | | assessment will be adjusted. Any additional assessment owed by | 12 | | the hospital or refund owed to the hospital shall be uniformly | 13 | | applied to the assessment owed by the hospital in monthly | 14 | | installments for the subsequent semi-annual period or calendar | 15 | | year. If no assessment is owed in the subsequent year, any | 16 | | amount owed by the hospital or refund due to the hospital, | 17 | | shall be paid in a lump sum. | 18 | | (3) The Department shall publish all details of the | 19 | | Assessment Adjustment calculation performed each year on its | 20 | | website within 30 days of completing the calculation, and also | 21 | | submit the details of the Assessment Adjustment calculation as | 22 | | part of the Department's annual report to the General | 23 | | Assembly. | 24 | | (c) (Blank).
| 25 | | (d) Notwithstanding any of the other provisions of this | 26 | | Section, the Department is authorized to adopt rules to reduce |
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| 1 | | the rate of any annual assessment imposed under this Section, | 2 | | as authorized by Section 5-46.2 of the Illinois Administrative | 3 | | Procedure Act.
| 4 | | (e) Notwithstanding any other provision of this Section, | 5 | | any plan providing for an assessment on a hospital provider as | 6 | | a permissible tax under Title XIX of the federal Social | 7 | | Security Act and Medicaid-eligible payments to hospital | 8 | | providers from the revenues derived from that assessment shall | 9 | | be reviewed by the Illinois Department of Healthcare and | 10 | | Family Services, as the Single State Medicaid Agency required | 11 | | by federal law, to determine whether those assessments and | 12 | | hospital provider payments meet federal Medicaid standards. If | 13 | | the Department determines that the elements of the plan may | 14 | | meet federal Medicaid standards and a related State Medicaid | 15 | | Plan Amendment is prepared in a manner and form suitable for | 16 | | submission, that State Plan Amendment shall be submitted in a | 17 | | timely manner for review by the Centers for Medicare and | 18 | | Medicaid Services of the United States Department of Health | 19 | | and Human Services and subject to approval by the Centers for | 20 | | Medicare and Medicaid Services of the United States Department | 21 | | of Health and Human Services. No such plan shall become | 22 | | effective without approval by the Illinois General Assembly by | 23 | | the enactment into law of related legislation. Notwithstanding | 24 | | any other provision of this Section, the Department is | 25 | | authorized to adopt rules to reduce the rate of any annual | 26 | | assessment imposed under this Section. Any such rules may be |
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| 1 | | adopted by the Department under Section 5-50 of the Illinois | 2 | | Administrative Procedure Act. | 3 | | (Source: P.A. 100-581, eff. 3-12-18; 101-10, eff. 6-5-19; | 4 | | 101-650, eff. 7-7-20; reenacted by P.A. 101-655, eff. | 5 | | 3-12-21.)
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