Full Text of HB5139 103rd General Assembly
HB5139ham001 103RD GENERAL ASSEMBLY | Rep. Elizabeth "Lisa" Hernandez Filed: 5/8/2024 | | 10300HB5139ham001 | | LRB103 39083 KTG 73071 a |
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| 1 | | AMENDMENT TO HOUSE BILL 5139
| 2 | | AMENDMENT NO. ______. Amend House Bill 5139 by replacing | 3 | | everything after the enacting clause with the following: | 4 | | "Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5.5 as follows: | 6 | | (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5) | 7 | | Sec. 5-5.5. Elements of Payment Rate. | 8 | | (a) The Department of Healthcare and Family Services shall | 9 | | develop a prospective method for determining payment rates for | 10 | | nursing facility and ICF/DD services in nursing facilities | 11 | | composed of the following cost elements: | 12 | | (1) Standard Services, with the cost of this component | 13 | | being determined by taking into account the actual costs | 14 | | to the facilities of these services subject to cost | 15 | | ceilings to be defined in the Department's rules. | 16 | | (2) Resident Services, with the cost of this component |
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| 1 | | being determined by taking into account the actual costs, | 2 | | needs and utilization of these services, as derived from | 3 | | an assessment of the resident needs in the nursing | 4 | | facilities. | 5 | | (3) Ancillary Services, with the payment rate being | 6 | | developed for each individual type of service. Payment | 7 | | shall be made only when authorized under procedures | 8 | | developed by the Department of Healthcare and Family | 9 | | Services. | 10 | | (4) Nurse's Aide Training, with the cost of this | 11 | | component being determined by taking into account the | 12 | | actual cost to the facilities of such training. | 13 | | (5) Real Estate Taxes, with the cost of this component | 14 | | being determined by taking into account the figures | 15 | | contained in the most currently available cost reports | 16 | | (with no imposition of maximums) updated to the midpoint | 17 | | of the current rate year for long term care services | 18 | | rendered between July 1, 1984 and June 30, 1985, and with | 19 | | the cost of this component being determined by taking into | 20 | | account the actual 1983 taxes for which the nursing homes | 21 | | were assessed (with no imposition of maximums) updated to | 22 | | the midpoint of the current rate year for long term care | 23 | | services rendered between July 1, 1985 and June 30, 1986. | 24 | | (b) In developing a prospective method for determining | 25 | | payment rates for nursing facility and ICF/DD services in | 26 | | nursing facilities and ICF/DDs, the Department of Healthcare |
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| 1 | | and Family Services shall consider the following cost | 2 | | elements: | 3 | | (1) Reasonable capital cost determined by utilizing | 4 | | incurred interest rate and the current value of the | 5 | | investment, including land, utilizing composite rates, or | 6 | | by utilizing such other reasonable cost related methods | 7 | | determined by the Department. However, beginning with the | 8 | | rate reimbursement period effective July 1, 1987, the | 9 | | Department shall be prohibited from establishing, | 10 | | including, and implementing any depreciation factor in | 11 | | calculating the capital cost element. | 12 | | (2) Profit, with the actual amount being produced and | 13 | | accruing to the providers in the form of a return on their | 14 | | total investment, on the basis of their ability to | 15 | | economically and efficiently deliver a type of service. | 16 | | The method of payment may assure the opportunity for a | 17 | | profit, but shall not guarantee or establish a specific | 18 | | amount as a cost. | 19 | | (c) The Illinois Department may implement the amendatory | 20 | | changes to this Section made by this amendatory Act of 1991 | 21 | | through the use of emergency rules in accordance with the | 22 | | provisions of Section 5.02 of the Illinois Administrative | 23 | | Procedure Act. For purposes of the Illinois Administrative | 24 | | Procedure Act, the adoption of rules to implement the | 25 | | amendatory changes to this Section made by this amendatory Act | 26 | | of 1991 shall be deemed an emergency and necessary for the |
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| 1 | | public interest, safety and welfare. | 2 | | (d) No later than January 1, 2001, the Department of | 3 | | Public Aid shall file with the Joint Committee on | 4 | | Administrative Rules, pursuant to the Illinois Administrative | 5 | | Procedure Act, a proposed rule, or a proposed amendment to an | 6 | | existing rule, regarding payment for appropriate services, | 7 | | including assessment, care planning, discharge planning, and | 8 | | treatment provided by nursing facilities to residents who have | 9 | | a serious mental illness. | 10 | | (e) On and after July 1, 2012, the Department shall reduce | 11 | | any rate of reimbursement for services or other payments or | 12 | | alter any methodologies authorized by this Code to reduce any | 13 | | rate of reimbursement for services or other payments in | 14 | | accordance with Section 5-5e. | 15 | | (f) Beginning July 1, 2024, and every year thereafter, the | 16 | | real estate tax component of the payment rate shall be updated | 17 | | using the most recent cost report on file with the Department | 18 | | as of April 1 of each year for facilities licensed under the | 19 | | Nursing Home Care Act and facilities licensed under the | 20 | | Specialized Mental Health Rehabilitation Act of 2013. The per | 21 | | diem rate shall be computed by dividing the real estate tax | 22 | | costs reported in the cost report inflated to the midpoint of | 23 | | the rate year by the total number of patient days reported in | 24 | | the same cost report. When computing the facility per diem | 25 | | real estate tax component, there shall be no adjustment to the | 26 | | total patient days reported in the facility cost report based |
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| 1 | | upon any occupancy standard. | 2 | | (Source: P.A. 96-1123, eff. 1-1-11; 96-1530, eff. 2-16-11; | 3 | | 97-689, eff. 6-14-12.) | 4 | | Section 99. Effective date. This Act takes effect July 1, | 5 | | 2024.". |
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