Full Text of SB3689 103rd General Assembly
SB3689sam001 103RD GENERAL ASSEMBLY | Sen. Kimberly A. Lightford Filed: 3/4/2024 | | 10300SB3689sam001 | | LRB103 38237 KTG 69755 a |
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| 1 | | AMENDMENT TO SENATE BILL 3689
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 3689 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 5-5e.1 as follows: | 6 | | (305 ILCS 5/5-5e.1) | 7 | | Sec. 5-5e.1. Safety-Net Hospitals. | 8 | | (a) A Safety-Net Hospital is an Illinois hospital that: | 9 | | (1) is licensed by the Department of Public Health as | 10 | | a general acute care or pediatric hospital; and | 11 | | (2) is a disproportionate share hospital, as described | 12 | | in Section 1923 of the federal Social Security Act, as | 13 | | determined by the Department; and | 14 | | (3) meets one of the following: | 15 | | (A) has a MIUR of at least 40% and a charity | 16 | | percent of at least 4%; or |
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| 1 | | (B) has a MIUR of at least 50%. | 2 | | (b) Definitions. As used in this Section: | 3 | | (1) "Charity percent" means the ratio of (i) the | 4 | | hospital's charity charges for services provided to | 5 | | individuals without health insurance or another source of | 6 | | third party coverage to (ii) the Illinois total hospital | 7 | | charges, each as reported on the hospital's OBRA form. | 8 | | (2) "MIUR" means Medicaid Inpatient Utilization Rate | 9 | | and is defined as a fraction, the numerator of which is the | 10 | | number of a hospital's inpatient days provided in the | 11 | | hospital's fiscal year ending 3 years prior to the rate | 12 | | year, to patients who, for such days, were eligible for | 13 | | Medicaid under Title XIX of the federal Social Security | 14 | | Act, 42 USC 1396a et seq., excluding those persons | 15 | | eligible for medical assistance pursuant to 42 U.S.C. | 16 | | 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of | 17 | | Section 5-2 of this Article, and the denominator of which | 18 | | is the total number of the hospital's inpatient days in | 19 | | that same period, excluding those persons eligible for | 20 | | medical assistance pursuant to 42 U.S.C. | 21 | | 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of | 22 | | Section 5-2 of this Article. | 23 | | (3) "OBRA form" means form HFS-3834, OBRA '93 data | 24 | | collection form, for the rate year. | 25 | | (4) "Rate year" means the 12-month period beginning on | 26 | | October 1. |
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| 1 | | (c) Beginning July 1, 2012 and ending on December 31, | 2 | | 2026, a hospital that would have qualified for the rate year | 3 | | beginning October 1, 2011 or October 1, 2012 shall be a | 4 | | Safety-Net Hospital. | 5 | | (c-5) Beginning July 1, 2020 and ending on December 31, | 6 | | 2026, a hospital that would have qualified for the rate year | 7 | | beginning October 1, 2020 and was designated a federal rural | 8 | | referral center under 42 CFR 412.96 as of October 1, 2020 shall | 9 | | be a Safety-Net Hospital. | 10 | | (d) No later than August 15 preceding the rate year, each | 11 | | hospital shall submit the OBRA form to the Department. Prior | 12 | | to October 1, the Department shall notify each hospital | 13 | | whether it has qualified as a Safety-Net Hospital. | 14 | | (e) The Department may promulgate rules in order to | 15 | | implement this Section. | 16 | | (f) Nothing in this Section shall be construed as limiting | 17 | | the ability of the Department to include the Safety-Net | 18 | | Hospitals in the hospital rate reform mandated by Section | 19 | | 14-11 of this Code and implemented under Section 14-12 of this | 20 | | Code and by administrative rulemaking. | 21 | | (g) Notwithstanding any other provision of this Code, | 22 | | effective for dates of service on and after January 1, 2025, | 23 | | subject to federal approval, reimbursement rates for | 24 | | safety-net hospitals shall be revised as follows: | 25 | | (1) For inpatient hospital services, reimbursement | 26 | | rates in effect January 1, 2024 under the All Patient |
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| 1 | | Refined-Diagnosis Related Groups system shall be increased | 2 | | by 10% for safety-net hospitals. | 3 | | (2) For outpatient hospital services, reimbursement | 4 | | rates in effect January 1, 2024 under the Enhanced | 5 | | Ambulatory Procedure Grouping system shall be increased by | 6 | | 10% for safety-net hospitals. | 7 | | The Department shall take all actions necessary to ensure | 8 | | the rate increases for safety-net hospitals authorized by this | 9 | | amendatory Act of the 103rd General Assembly are in effect for | 10 | | dates of service on and after January 1, 2025, including | 11 | | publishing all appropriate public notices, applying for | 12 | | federal approval of amendments to the Illinois Title XIX State | 13 | | Plan, and adopting administrative rules if necessary. | 14 | | (Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21; | 15 | | 102-886, eff. 5-17-22.) | 16 | | Section 99. Effective date. This Act takes effect upon | 17 | | becoming law.". |
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