Full Text of SB3380 103rd General Assembly
SB3380sam001 103RD GENERAL ASSEMBLY | Sen. Sara Feigenholtz Filed: 5/16/2024 | | 10300SB3380sam001 | | LRB103 38150 KTG 73610 a |
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| 1 | | AMENDMENT TO SENATE BILL 3380
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 3380 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 5-5.2 as follows: | 6 | | (305 ILCS 5/5-5.2) | 7 | | Sec. 5-5.2. Payment. | 8 | | (a) All nursing facilities that are grouped pursuant to | 9 | | Section 5-5.1 of this Act shall receive the same rate of | 10 | | payment for similar services. | 11 | | (b) It shall be a matter of State policy that the Illinois | 12 | | Department shall utilize a uniform billing cycle throughout | 13 | | the State for the long-term care providers. | 14 | | (c) (Blank). | 15 | | (c-1) Notwithstanding any other provisions of this Code, | 16 | | the methodologies for reimbursement of nursing services as |
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| 1 | | provided under this Article shall no longer be applicable for | 2 | | bills payable for nursing services rendered on or after a new | 3 | | reimbursement system based on the Patient Driven Payment Model | 4 | | (PDPM) has been fully operationalized, which shall take effect | 5 | | for services provided on or after the implementation of the | 6 | | PDPM reimbursement system begins. For the purposes of Public | 7 | | Act 102-1035 this amendatory Act of the 102nd General | 8 | | Assembly , the implementation date of the PDPM reimbursement | 9 | | system and all related provisions shall be July 1, 2022 if the | 10 | | following conditions are met: (i) the Centers for Medicare and | 11 | | Medicaid Services has approved corresponding changes in the | 12 | | reimbursement system and bed assessment; and (ii) the | 13 | | Department has filed rules to implement these changes no later | 14 | | than June 1, 2022. Failure of the Department to file rules to | 15 | | implement the changes provided in Public Act 102-1035 this | 16 | | amendatory Act of the 102nd General Assembly no later than | 17 | | June 1, 2022 shall result in the implementation date being | 18 | | delayed to October 1, 2022. | 19 | | (d) The new nursing services reimbursement methodology | 20 | | utilizing the Patient Driven Payment Model, which shall be | 21 | | referred to as the PDPM reimbursement system, taking effect | 22 | | July 1, 2022, upon federal approval by the Centers for | 23 | | Medicare and Medicaid Services, shall be based on the | 24 | | following: | 25 | | (1) The methodology shall be resident-centered, | 26 | | facility-specific, cost-based, and based on guidance from |
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| 1 | | the Centers for Medicare and Medicaid Services. | 2 | | (2) Costs shall be annually rebased and case mix index | 3 | | quarterly updated. The nursing services methodology will | 4 | | be assigned to the Medicaid enrolled residents on record | 5 | | as of 30 days prior to the beginning of the rate period in | 6 | | the Department's Medicaid Management Information System | 7 | | (MMIS) as present on the last day of the second quarter | 8 | | preceding the rate period based upon the Assessment | 9 | | Reference Date of the Minimum Data Set (MDS). | 10 | | (3) Regional wage adjustors based on the Health | 11 | | Service Areas (HSA) groupings and adjusters in effect on | 12 | | April 30, 2012 shall be included, except no adjuster shall | 13 | | be lower than 1.06. | 14 | | (4) PDPM nursing case mix indices in effect on March | 15 | | 1, 2022 shall be assigned to each resident class at no less | 16 | | than 0.7858 of the Centers for Medicare and Medicaid | 17 | | Services PDPM unadjusted case mix values, in effect on | 18 | | March 1, 2022. | 19 | | (5) The pool of funds available for distribution by | 20 | | case mix and the base facility rate shall be determined | 21 | | using the formula contained in subsection (d-1). | 22 | | (6) The Department shall establish a variable per diem | 23 | | staffing add-on in accordance with the most recent | 24 | | available federal staffing report, currently the Payroll | 25 | | Based Journal, for the same period of time, and if | 26 | | applicable adjusted for acuity using the same quarter's |
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| 1 | | MDS. The Department shall rely on Payroll Based Journals | 2 | | provided to the Department of Public Health to make a | 3 | | determination of non-submission. If the Department is | 4 | | notified by a facility of missing or inaccurate Payroll | 5 | | Based Journal data or an incorrect calculation of | 6 | | staffing, the Department must make a correction as soon as | 7 | | the error is verified for the applicable quarter. | 8 | | Facilities with at least 70% of the staffing indicated | 9 | | by the STRIVE study shall be paid a per diem add-on of $9, | 10 | | increasing by equivalent steps for each whole percentage | 11 | | point until the facilities reach a per diem of $14.88. | 12 | | Facilities with at least 80% of the staffing indicated by | 13 | | the STRIVE study shall be paid a per diem add-on of $14.88, | 14 | | increasing by equivalent steps for each whole percentage | 15 | | point until the facilities reach a per diem add-on of | 16 | | $23.80. Facilities with at least 92% of the staffing | 17 | | indicated by the STRIVE study shall be paid a per diem | 18 | | add-on of $23.80, increasing by equivalent steps for each | 19 | | whole percentage point until the facilities reach a per | 20 | | diem add-on of $29.75. Facilities with at least 100% of | 21 | | the staffing indicated by the STRIVE study shall be paid a | 22 | | per diem add-on of $29.75, increasing by equivalent steps | 23 | | for each whole percentage point until the facilities reach | 24 | | a per diem add-on of $35.70. Facilities with at least 110% | 25 | | of the staffing indicated by the STRIVE study shall be | 26 | | paid a per diem add-on of $35.70, increasing by equivalent |
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| 1 | | steps for each whole percentage point until the facilities | 2 | | reach a per diem add-on of $38.68. Facilities with at | 3 | | least 125% or higher of the staffing indicated by the | 4 | | STRIVE study shall be paid a per diem add-on of $38.68. | 5 | | Beginning April 1, 2023, no nursing facility's variable | 6 | | staffing per diem add-on shall be reduced by more than 5% | 7 | | in 2 consecutive quarters. For the quarters beginning July | 8 | | 1, 2022 and October 1, 2022, no facility's variable per | 9 | | diem staffing add-on shall be calculated at a rate lower | 10 | | than 85% of the staffing indicated by the STRIVE study. No | 11 | | facility below 70% of the staffing indicated by the STRIVE | 12 | | study shall receive a variable per diem staffing add-on | 13 | | after December 31, 2022. | 14 | | Because the federal Centers for Medicare and Medicaid | 15 | | Services no longer allows updates to the STRIVE staffing | 16 | | referenced in the preceding paragraph using data from the | 17 | | Resource Utilization Group Version IV, the Department | 18 | | shall pay, beginning July 1, 2024, the staffing per diem | 19 | | add-on computed for the quarter beginning April 1, 2024. | 20 | | The payment shall remain the same until a replacement | 21 | | methodology is incorporated into this Section by law | 22 | | unless the facility does not meet the maintenance of | 23 | | effort as described in this Section. | 24 | | For the purposes of this Section, "maintenance of | 25 | | effort" refers to a requirement that if any facility's per | 26 | | diem staffing hours, as computed from the data reported in |
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| 1 | | the federal Payroll Based Journal for any quarter during | 2 | | the period in which no replacement methodology has been | 3 | | enacted into law, falls 15% or more from the reported per | 4 | | diem staffing hours used to compute the staffing per diem | 5 | | add-on for the quarter beginning April 1, 2024, the | 6 | | facility shall have a 5% reduction in the per diem paid | 7 | | staffing add-on for that quarter. The percentage below the | 8 | | April 1, 2024 staffing shall be computed by subtracting | 9 | | the April 1, 2024 reported staffing hours from the current | 10 | | quarter's reported staffing hours and dividing the result | 11 | | by the April 1, 2024 quarter's reported staffing hours. An | 12 | | additional 5% reduction in the staffing incentive shall be | 13 | | assessed for every additional 5% reduction in the per diem | 14 | | staffing hours for that quarter. Each quarter's staffing | 15 | | per diem hours shall be compared independently to the per | 16 | | diem staffing hours used to compute the staffing per diem | 17 | | add-on for the quarter beginning April 1, 2024, for any | 18 | | reduction in payment of the staffing per diem add-on. | 19 | | (7) For dates of services beginning July 1, 2022, the | 20 | | PDPM nursing component per diem for each nursing facility | 21 | | shall be the product of the facility's (i) statewide PDPM | 22 | | nursing base per diem rate, $92.25, adjusted for the | 23 | | facility average PDPM case mix index calculated quarterly | 24 | | and (ii) the regional wage adjuster, and then add the | 25 | | Medicaid access adjustment as defined in (e-3) of this | 26 | | Section. Transition rates for services provided between |
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| 1 | | July 1, 2022 and October 1, 2023 shall be the greater of | 2 | | the PDPM nursing component per diem or: | 3 | | (A) for the quarter beginning July 1, 2022, the | 4 | | RUG-IV nursing component per diem; | 5 | | (B) for the quarter beginning October 1, 2022, the | 6 | | sum of the RUG-IV nursing component per diem | 7 | | multiplied by 0.80 and the PDPM nursing component per | 8 | | diem multiplied by 0.20; | 9 | | (C) for the quarter beginning January 1, 2023, the | 10 | | sum of the RUG-IV nursing component per diem | 11 | | multiplied by 0.60 and the PDPM nursing component per | 12 | | diem multiplied by 0.40; | 13 | | (D) for the quarter beginning April 1, 2023, the | 14 | | sum of the RUG-IV nursing component per diem | 15 | | multiplied by 0.40 and the PDPM nursing component per | 16 | | diem multiplied by 0.60; | 17 | | (E) for the quarter beginning July 1, 2023, the | 18 | | sum of the RUG-IV nursing component per diem | 19 | | multiplied by 0.20 and the PDPM nursing component per | 20 | | diem multiplied by 0.80; or | 21 | | (F) for the quarter beginning October 1, 2023 and | 22 | | each subsequent quarter, the transition rate shall end | 23 | | and a nursing facility shall be paid 100% of the PDPM | 24 | | nursing component per diem. | 25 | | (d-1) Calculation of base year Statewide RUG-IV nursing | 26 | | base per diem rate. |
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| 1 | | (1) Base rate spending pool shall be: | 2 | | (A) The base year resident days which are | 3 | | calculated by multiplying the number of Medicaid | 4 | | residents in each nursing home as indicated in the MDS | 5 | | data defined in paragraph (4) by 365. | 6 | | (B) Each facility's nursing component per diem in | 7 | | effect on July 1, 2012 shall be multiplied by | 8 | | subsection (A). | 9 | | (C) Thirteen million is added to the product of | 10 | | subparagraph (A) and subparagraph (B) to adjust for | 11 | | the exclusion of nursing homes defined in paragraph | 12 | | (5). | 13 | | (2) For each nursing home with Medicaid residents as | 14 | | indicated by the MDS data defined in paragraph (4), | 15 | | weighted days adjusted for case mix and regional wage | 16 | | adjustment shall be calculated. For each home this | 17 | | calculation is the product of: | 18 | | (A) Base year resident days as calculated in | 19 | | subparagraph (A) of paragraph (1). | 20 | | (B) The nursing home's regional wage adjustor | 21 | | based on the Health Service Areas (HSA) groupings and | 22 | | adjustors in effect on April 30, 2012. | 23 | | (C) Facility weighted case mix which is the number | 24 | | of Medicaid residents as indicated by the MDS data | 25 | | defined in paragraph (4) multiplied by the associated | 26 | | case weight for the RUG-IV 48 grouper model using |
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| 1 | | standard RUG-IV procedures for index maximization. | 2 | | (D) The sum of the products calculated for each | 3 | | nursing home in subparagraphs (A) through (C) above | 4 | | shall be the base year case mix, rate adjusted | 5 | | weighted days. | 6 | | (3) The Statewide RUG-IV nursing base per diem rate: | 7 | | (A) on January 1, 2014 shall be the quotient of the | 8 | | paragraph (1) divided by the sum calculated under | 9 | | subparagraph (D) of paragraph (2); | 10 | | (B) on and after July 1, 2014 and until July 1, | 11 | | 2022, shall be the amount calculated under | 12 | | subparagraph (A) of this paragraph (3) plus $1.76; and | 13 | | (C) beginning July 1, 2022 and thereafter, $7 | 14 | | shall be added to the amount calculated under | 15 | | subparagraph (B) of this paragraph (3) of this | 16 | | Section. | 17 | | (4) Minimum Data Set (MDS) comprehensive assessments | 18 | | for Medicaid residents on the last day of the quarter used | 19 | | to establish the base rate. | 20 | | (5) Nursing facilities designated as of July 1, 2012 | 21 | | by the Department as "Institutions for Mental Disease" | 22 | | shall be excluded from all calculations under this | 23 | | subsection. The data from these facilities shall not be | 24 | | used in the computations described in paragraphs (1) | 25 | | through (4) above to establish the base rate. | 26 | | (e) Beginning July 1, 2014, the Department shall allocate |
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| 1 | | funding in the amount up to $10,000,000 for per diem add-ons to | 2 | | the RUGS methodology for dates of service on and after July 1, | 3 | | 2014: | 4 | | (1) $0.63 for each resident who scores in I4200 | 5 | | Alzheimer's Disease or I4800 non-Alzheimer's Dementia. | 6 | | (2) $2.67 for each resident who scores either a "1" or | 7 | | "2" in any items S1200A through S1200I and also scores in | 8 | | RUG groups PA1, PA2, BA1, or BA2. | 9 | | (e-1) (Blank). | 10 | | (e-2) For dates of services beginning January 1, 2014 and | 11 | | ending September 30, 2023, the RUG-IV nursing component per | 12 | | diem for a nursing home shall be the product of the statewide | 13 | | RUG-IV nursing base per diem rate, the facility average case | 14 | | mix index, and the regional wage adjustor. For dates of | 15 | | service beginning July 1, 2022 and ending September 30, 2023, | 16 | | the Medicaid access adjustment described in subsection (e-3) | 17 | | shall be added to the product. | 18 | | (e-3) A Medicaid Access Adjustment of $4 adjusted for the | 19 | | facility average PDPM case mix index calculated quarterly | 20 | | shall be added to the statewide PDPM nursing per diem for all | 21 | | facilities with annual Medicaid bed days of at least 70% of all | 22 | | occupied bed days adjusted quarterly. For each new calendar | 23 | | year and for the 6-month period beginning July 1, 2022, the | 24 | | percentage of a facility's occupied bed days comprised of | 25 | | Medicaid bed days shall be determined by the Department | 26 | | quarterly. For dates of service beginning January 1, 2023, the |
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| 1 | | Medicaid Access Adjustment shall be increased to $4.75. This | 2 | | subsection shall be inoperative on and after January 1, 2028. | 3 | | (e-4) Subject to federal approval, on and after January 1, | 4 | | 2024, the Department shall increase the rate add-on at | 5 | | paragraph (7) subsection (a) under 89 Ill. Adm. Code 147.335 | 6 | | for ventilator services from $208 per day to $481 per day. | 7 | | Payment is subject to the criteria and requirements under 89 | 8 | | Ill. Adm. Code 147.335. | 9 | | (f) (Blank). | 10 | | (g) Notwithstanding any other provision of this Code, on | 11 | | and after July 1, 2012, for facilities not designated by the | 12 | | Department of Healthcare and Family Services as "Institutions | 13 | | for Mental Disease", rates effective May 1, 2011 shall be | 14 | | adjusted as follows: | 15 | | (1) (Blank); | 16 | | (2) (Blank); | 17 | | (3) Facility rates for the capital and support | 18 | | components shall be reduced by 1.7%. | 19 | | (h) Notwithstanding any other provision of this Code, on | 20 | | and after July 1, 2012, nursing facilities designated by the | 21 | | Department of Healthcare and Family Services as "Institutions | 22 | | for Mental Disease" and "Institutions for Mental Disease" that | 23 | | are facilities licensed under the Specialized Mental Health | 24 | | Rehabilitation Act of 2013 shall have the nursing, | 25 | | socio-developmental, capital, and support components of their | 26 | | reimbursement rate effective May 1, 2011 reduced in total by |
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| 1 | | 2.7%. | 2 | | (i) On and after July 1, 2014, the reimbursement rates for | 3 | | the support component of the nursing facility rate for | 4 | | facilities licensed under the Nursing Home Care Act as skilled | 5 | | or intermediate care facilities shall be the rate in effect on | 6 | | June 30, 2014 increased by 8.17%. | 7 | | (i-1) Subject to federal approval, on and after January 1, | 8 | | 2024, the reimbursement rates for the support component of the | 9 | | nursing facility rate for facilities licensed under the | 10 | | Nursing Home Care Act as skilled or intermediate care | 11 | | facilities shall be the rate in effect on June 30, 2023 | 12 | | increased by 12%. | 13 | | (j) Notwithstanding any other provision of law, subject to | 14 | | federal approval, effective July 1, 2019, sufficient funds | 15 | | shall be allocated for changes to rates for facilities | 16 | | licensed under the Nursing Home Care Act as skilled nursing | 17 | | facilities or intermediate care facilities for dates of | 18 | | services on and after July 1, 2019: (i) to establish, through | 19 | | June 30, 2022 a per diem add-on to the direct care per diem | 20 | | rate not to exceed $70,000,000 annually in the aggregate | 21 | | taking into account federal matching funds for the purpose of | 22 | | addressing the facility's unique staffing needs, adjusted | 23 | | quarterly and distributed by a weighted formula based on | 24 | | Medicaid bed days on the last day of the second quarter | 25 | | preceding the quarter for which the rate is being adjusted. | 26 | | Beginning July 1, 2022, the annual $70,000,000 described in |
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| 1 | | the preceding sentence shall be dedicated to the variable per | 2 | | diem add-on for staffing under paragraph (6) of subsection | 3 | | (d); and (ii) in an amount not to exceed $170,000,000 annually | 4 | | in the aggregate taking into account federal matching funds to | 5 | | permit the support component of the nursing facility rate to | 6 | | be updated as follows: | 7 | | (1) 80%, or $136,000,000, of the funds shall be used | 8 | | to update each facility's rate in effect on June 30, 2019 | 9 | | using the most recent cost reports on file, which have had | 10 | | a limited review conducted by the Department of Healthcare | 11 | | and Family Services and will not hold up enacting the rate | 12 | | increase, with the Department of Healthcare and Family | 13 | | Services. | 14 | | (2) After completing the calculation in paragraph (1), | 15 | | any facility whose rate is less than the rate in effect on | 16 | | June 30, 2019 shall have its rate restored to the rate in | 17 | | effect on June 30, 2019 from the 20% of the funds set | 18 | | aside. | 19 | | (3) The remainder of the 20%, or $34,000,000, shall be | 20 | | used to increase each facility's rate by an equal | 21 | | percentage. | 22 | | (k) During the first quarter of State Fiscal Year 2020, | 23 | | the Department of Healthcare of Family Services must convene a | 24 | | technical advisory group consisting of members of all trade | 25 | | associations representing Illinois skilled nursing providers | 26 | | to discuss changes necessary with federal implementation of |
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| 1 | | Medicare's Patient-Driven Payment Model. Implementation of | 2 | | Medicare's Patient-Driven Payment Model shall, by September 1, | 3 | | 2020, end the collection of the MDS data that is necessary to | 4 | | maintain the current RUG-IV Medicaid payment methodology. The | 5 | | technical advisory group must consider a revised reimbursement | 6 | | methodology that takes into account transparency, | 7 | | accountability, actual staffing as reported under the | 8 | | federally required Payroll Based Journal system, changes to | 9 | | the minimum wage, adequacy in coverage of the cost of care, and | 10 | | a quality component that rewards quality improvements. | 11 | | (l) The Department shall establish per diem add-on | 12 | | payments to improve the quality of care delivered by | 13 | | facilities, including: | 14 | | (1) Incentive payments determined by facility | 15 | | performance on specified quality measures in an initial | 16 | | amount of $70,000,000. Nothing in this subsection shall be | 17 | | construed to limit the quality of care payments in the | 18 | | aggregate statewide to $70,000,000, and, if quality of | 19 | | care has improved across nursing facilities, the | 20 | | Department shall adjust those add-on payments accordingly. | 21 | | The quality payment methodology described in this | 22 | | subsection must be used for at least State Fiscal Year | 23 | | 2023. Beginning with the quarter starting July 1, 2023, | 24 | | the Department may add, remove, or change quality metrics | 25 | | and make associated changes to the quality payment | 26 | | methodology as outlined in subparagraph (E). Facilities |
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| 1 | | designated by the Centers for Medicare and Medicaid | 2 | | Services as a special focus facility or a hospital-based | 3 | | nursing home do not qualify for quality payments. | 4 | | (A) Each quality pool must be distributed by | 5 | | assigning a quality weighted score for each nursing | 6 | | home which is calculated by multiplying the nursing | 7 | | home's quality base period Medicaid days by the | 8 | | nursing home's star rating weight in that period. | 9 | | (B) Star rating weights are assigned based on the | 10 | | nursing home's star rating for the LTS quality star | 11 | | rating. As used in this subparagraph, "LTS quality | 12 | | star rating" means the long-term stay quality rating | 13 | | for each nursing facility, as assigned by the Centers | 14 | | for Medicare and Medicaid Services under the Five-Star | 15 | | Quality Rating System. The rating is a number ranging | 16 | | from 0 (lowest) to 5 (highest). | 17 | | (i) Zero-star or one-star rating has a weight | 18 | | of 0. | 19 | | (ii) Two-star rating has a weight of 0.75. | 20 | | (iii) Three-star rating has a weight of 1.5. | 21 | | (iv) Four-star rating has a weight of 2.5. | 22 | | (v) Five-star rating has a weight of 3.5. | 23 | | (C) Each nursing home's quality weight score is | 24 | | divided by the sum of all quality weight scores for | 25 | | qualifying nursing homes to determine the proportion | 26 | | of the quality pool to be paid to the nursing home. |
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| 1 | | (D) The quality pool is no less than $70,000,000 | 2 | | annually or $17,500,000 per quarter. The Department | 3 | | shall publish on its website the estimated payments | 4 | | and the associated weights for each facility 45 days | 5 | | prior to when the initial payments for the quarter are | 6 | | to be paid. The Department shall assign each facility | 7 | | the most recent and applicable quarter's STAR value | 8 | | unless the facility notifies the Department within 15 | 9 | | days of an issue and the facility provides reasonable | 10 | | evidence demonstrating its timely compliance with | 11 | | federal data submission requirements for the quarter | 12 | | of record. If such evidence cannot be provided to the | 13 | | Department, the STAR rating assigned to the facility | 14 | | shall be reduced by one from the prior quarter. | 15 | | (E) The Department shall review quality metrics | 16 | | used for payment of the quality pool and make | 17 | | recommendations for any associated changes to the | 18 | | methodology for distributing quality pool payments in | 19 | | consultation with associations representing long-term | 20 | | care providers, consumer advocates, organizations | 21 | | representing workers of long-term care facilities, and | 22 | | payors. The Department may establish, by rule, changes | 23 | | to the methodology for distributing quality pool | 24 | | payments. | 25 | | (F) The Department shall disburse quality pool | 26 | | payments from the Long-Term Care Provider Fund on a |
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| 1 | | monthly basis in amounts proportional to the total | 2 | | quality pool payment determined for the quarter. | 3 | | (G) The Department shall publish any changes in | 4 | | the methodology for distributing quality pool payments | 5 | | prior to the beginning of the measurement period or | 6 | | quality base period for any metric added to the | 7 | | distribution's methodology. | 8 | | (2) Payments based on CNA tenure, promotion, and CNA | 9 | | training for the purpose of increasing CNA compensation. | 10 | | It is the intent of this subsection that payments made in | 11 | | accordance with this paragraph be directly incorporated | 12 | | into increased compensation for CNAs. As used in this | 13 | | paragraph, "CNA" means a certified nursing assistant as | 14 | | that term is described in Section 3-206 of the Nursing | 15 | | Home Care Act, Section 3-206 of the ID/DD Community Care | 16 | | Act, and Section 3-206 of the MC/DD Act. The Department | 17 | | shall establish, by rule, payments to nursing facilities | 18 | | equal to Medicaid's share of the tenure wage increments | 19 | | specified in this paragraph for all reported CNA employee | 20 | | hours compensated according to a posted schedule | 21 | | consisting of increments at least as large as those | 22 | | specified in this paragraph. The increments are as | 23 | | follows: an additional $1.50 per hour for CNAs with at | 24 | | least one and less than 2 years' experience plus another | 25 | | $1 per hour for each additional year of experience up to a | 26 | | maximum of $6.50 for CNAs with at least 6 years of |
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| 1 | | experience. For purposes of this paragraph, Medicaid's | 2 | | share shall be the ratio determined by paid Medicaid bed | 3 | | days divided by total bed days for the applicable time | 4 | | period used in the calculation. In addition, and additive | 5 | | to any tenure increments paid as specified in this | 6 | | paragraph, the Department shall establish, by rule, | 7 | | payments supporting Medicaid's share of the | 8 | | promotion-based wage increments for CNA employee hours | 9 | | compensated for that promotion with at least a $1.50 | 10 | | hourly increase. Medicaid's share shall be established as | 11 | | it is for the tenure increments described in this | 12 | | paragraph. Qualifying promotions shall be defined by the | 13 | | Department in rules for an expected 10-15% subset of CNAs | 14 | | assigned intermediate, specialized, or added roles such as | 15 | | CNA trainers, CNA scheduling "captains", and CNA | 16 | | specialists for resident conditions like dementia or | 17 | | memory care or behavioral health. | 18 | | (m) The Department shall work with nursing facility | 19 | | industry representatives to design policies and procedures to | 20 | | permit facilities to address the integrity of data from | 21 | | federal reporting sites used by the Department in setting | 22 | | facility rates. | 23 | | (Source: P.A. 102-77, eff. 7-9-21; 102-558, eff. 8-20-21; | 24 | | 102-1035, eff. 5-31-22; 102-1118, eff. 1-18-23; 103-102, | 25 | | Article 40, Section 40-5, eff. 1-1-24; 103-102, Article 50, | 26 | | Section 50-5, eff. 1-1-24; revised 12-15-23.) |
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| 1 | | Section 99. Effective date. This Act takes effect July 1, | 2 | | 2024.". |
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