Full Text of SB2553 101st General Assembly
SB2553 101ST GENERAL ASSEMBLY |
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020 SB2553 Introduced 1/29/2020, by Sen. Heather A. Steans SYNOPSIS AS INTRODUCED: |
| 305 ILCS 5/5A-2 | from Ch. 23, par. 5A-2 |
| Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning an assessment on inpatient
services that is imposed on
hospital
providers.
|
| |
| | A BILL FOR |
|
| | | SB2553 | | LRB101 18760 KTG 68215 b |
|
| 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| changing Section 5A-2 as follows: | 6 | | (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2) | 7 | | (Section scheduled to be repealed on July 1, 2020) | 8 | | Sec. 5A-2. Assessment.
| 9 | | (a)(1)
Subject to Sections 5A-3 and 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 $218.38 | 13 | | multiplied by the difference of the hospital's occupied bed | 14 | | days less the hospital's Medicare bed days, provided, however, | 15 | | that the amount of $218.38 shall be increased by a uniform | 16 | | percentage to generate an amount equal to 75% of the State | 17 | | share of the payments authorized under Section 5A-12.5, with | 18 | | such increase only taking effect upon the date that a State | 19 | | share for such payments is required under federal law. For the | 20 | | period of April through June 2015, the amount of $218.38 used | 21 | | to calculate the assessment under this paragraph shall, by | 22 | | emergency rule under subsection (s) of Section 5-45 of the | 23 | | Illinois Administrative Procedure Act, be increased by a |
| | | SB2553 | - 2 - | LRB101 18760 KTG 68215 b |
|
| 1 | | uniform percentage to generate $20,250,000 in the aggregate for | 2 | | that period from all hospitals subject to the annual assessment | 3 | | under this paragraph. | 4 | | (2) In addition to any other assessments imposed under this | 5 | | Article, effective July 1, 2016 and semi-annually thereafter | 6 | | through June 2018, or as provided in Section 5A-16, in addition | 7 | | to any federally required State share as authorized under | 8 | | paragraph (1), the amount of $218.38 shall be increased by a | 9 | | uniform percentage to generate an amount equal to 75% of the | 10 | | ACA Assessment Adjustment, as defined in subsection (b-6) of | 11 | | this Section. | 12 | | For State fiscal years 2009 through 2018, or as provided in | 13 | | Section 5A-16, a hospital's occupied bed days and Medicare bed | 14 | | days shall be determined using the most recent data available | 15 | | from each hospital's 2005 Medicare cost report as contained in | 16 | | the Healthcare Cost Report Information System file, for the | 17 | | quarter ending on December 31, 2006, without regard to any | 18 | | subsequent adjustments or changes to such data. If a hospital's | 19 | | 2005 Medicare cost report is not contained in the Healthcare | 20 | | Cost Report Information System, then the Illinois Department | 21 | | may obtain the hospital provider's occupied bed days and | 22 | | Medicare bed days from any source available, including, but not | 23 | | limited to, records maintained by the hospital provider, which | 24 | | may be inspected at all times during business hours of the day | 25 | | by the Illinois Department or its duly authorized agents and | 26 | | employees. |
| | | SB2553 | - 3 - | LRB101 18760 KTG 68215 b |
|
| 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 hospital's | 5 | | occupied bed days less the hospital's Medicare bed days; | 6 | | however, for State fiscal year 2021, the amount of $197.19 | 7 | | shall be increased by a uniform percentage to generate an | 8 | | additional $6,250,000 in the aggregate for that period from all | 9 | | hospitals subject to the annual assessment under this | 10 | | paragraph. For State fiscal years 2019 and 2020, a hospital's | 11 | | occupied bed days and Medicare bed days shall be determined | 12 | | using the most recent data available from each hospital's 2015 | 13 | | Medicare cost report as contained in the Healthcare Cost Report | 14 | | Information System file, for the quarter ending on March 31, | 15 | | 2017, without regard to any subsequent adjustments or changes | 16 | | to such data. If a hospital's 2015 Medicare cost report is not | 17 | | contained in the Healthcare Cost Report Information System, | 18 | | then the Illinois Department may obtain the hospital provider's | 19 | | occupied bed days and Medicare bed days from any source | 20 | | available, including, but not limited to, records maintained by | 21 | | the hospital provider, which may be inspected at all times | 22 | | during business hours of the day by the Illinois Department or | 23 | | its duly authorized agents and employees. Notwithstanding any | 24 | | other provision in this Article, for a hospital provider that | 25 | | did not have a 2015 Medicare cost report, but paid an | 26 | | assessment in State fiscal year 2018 on the basis of |
| | | SB2553 | - 4 - | LRB101 18760 KTG 68215 b |
|
| 1 | | hypothetical data, that assessment amount shall be used for | 2 | | State fiscal years 2019 and 2020; however, for State fiscal | 3 | | year 2021, the assessment amount shall be increased by the | 4 | | proportion that it represents of the total annual assessment | 5 | | that is generated from all hospitals in order to generate | 6 | | $6,250,000 in the aggregate for that period from all hospitals | 7 | | subject to the annual assessment under this paragraph. | 8 | | Subject to Sections 5A-3 and 5A-10, for State fiscal years | 9 | | 2021 through 2024, an annual assessment on inpatient services | 10 | | is imposed on each hospital provider in an amount equal to | 11 | | $197.19 multiplied by the difference of the hospital's occupied | 12 | | bed days less the hospital's Medicare bed days, provided | 13 | | however, that the amount of $197.19 used to calculate the | 14 | | assessment under this paragraph shall, by rule, be adjusted by | 15 | | a uniform percentage to generate the same total annual | 16 | | assessment that was generated in State fiscal year 2020 from | 17 | | all hospitals subject to the annual assessment under this | 18 | | paragraph plus $6,250,000. For State fiscal years 2021 and | 19 | | 2022, a hospital's occupied bed days and Medicare bed days | 20 | | shall be determined using the most recent data available from | 21 | | each hospital's 2017 Medicare cost report as contained in the | 22 | | Healthcare Cost Report Information System file, for the quarter | 23 | | ending on March 31, 2019, without regard to any subsequent | 24 | | adjustments or changes to such data. For State fiscal years | 25 | | 2023 and 2024, a hospital's occupied bed days and Medicare bed | 26 | | days shall be determined using the most recent data available |
| | | SB2553 | - 5 - | LRB101 18760 KTG 68215 b |
|
| 1 | | from each hospital's 2019 Medicare cost report as contained in | 2 | | the Healthcare Cost Report Information System file, for the | 3 | | quarter ending on March 31, 2021, without regard to any | 4 | | subsequent adjustments or changes to such data. | 5 | | (b) (Blank).
| 6 | | (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the | 7 | | portion of State fiscal year 2012, beginning June 10, 2012 | 8 | | through June 30, 2012, and for State fiscal years 2013 through | 9 | | 2018, or as provided in Section 5A-16, an annual assessment on | 10 | | outpatient services is imposed on each hospital provider in an | 11 | | amount equal to .008766 multiplied by the hospital's outpatient | 12 | | gross revenue, provided, however, that the amount of .008766 | 13 | | shall be increased by a uniform percentage to generate an | 14 | | amount equal to 25% of the State share of the payments | 15 | | authorized under Section 5A-12.5, with such increase only | 16 | | taking effect upon the date that a State share for such | 17 | | payments is required under federal law. For the period | 18 | | beginning June 10, 2012 through June 30, 2012, the annual | 19 | | assessment on outpatient services shall be prorated by | 20 | | multiplying the assessment amount by a fraction, the numerator | 21 | | of which is 21 days and the denominator of which is 365 days. | 22 | | For the period of April through June 2015, the amount of | 23 | | .008766 used to calculate the assessment under this paragraph | 24 | | shall, by emergency rule under subsection (s) of Section 5-45 | 25 | | of the Illinois Administrative Procedure Act, be increased by a | 26 | | uniform percentage to generate $6,750,000 in the aggregate for |
| | | SB2553 | - 6 - | LRB101 18760 KTG 68215 b |
|
| 1 | | that period from all hospitals subject to the annual assessment | 2 | | under this paragraph. | 3 | | (2) In addition to any other assessments imposed under this | 4 | | Article, effective July 1, 2016 and semi-annually thereafter | 5 | | through June 2018, in addition to any federally required State | 6 | | share as authorized under paragraph (1), the amount of .008766 | 7 | | shall be increased by a uniform percentage to generate an | 8 | | amount equal to 25% of the ACA Assessment Adjustment, as | 9 | | defined in subsection (b-6) of this Section. | 10 | | For the portion of State fiscal year 2012, beginning June | 11 | | 10, 2012 through June 30, 2012, and State fiscal years 2013 | 12 | | through 2018, or as provided in Section 5A-16, a hospital's | 13 | | outpatient gross revenue shall be determined using the most | 14 | | recent data available from each hospital's 2009 Medicare cost | 15 | | report as contained in the Healthcare Cost Report Information | 16 | | System file, for the quarter ending on June 30, 2011, without | 17 | | regard to any subsequent adjustments or changes to such data. | 18 | | If a hospital's 2009 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 | | (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State | 26 | | fiscal years 2019 and 2020, an annual assessment on outpatient |
| | | SB2553 | - 7 - | LRB101 18760 KTG 68215 b |
|
| 1 | | services is imposed on each hospital provider in an amount | 2 | | equal to .01358 multiplied by the hospital's outpatient gross | 3 | | revenue; however, for State fiscal year 2021, the amount of | 4 | | .01358 shall be increased by a uniform percentage to generate | 5 | | an additional $6,250,000 in the aggregate for that period from | 6 | | all hospitals subject to the annual assessment under this | 7 | | paragraph. For State fiscal years 2019 and 2020, a hospital's | 8 | | outpatient gross revenue shall be determined using the most | 9 | | recent data available from each hospital's 2015 Medicare cost | 10 | | report as contained in the Healthcare Cost Report Information | 11 | | System file, for the quarter ending on March 31, 2017, without | 12 | | regard to any subsequent adjustments or changes to such data. | 13 | | If a hospital's 2015 Medicare cost report is not contained in | 14 | | the Healthcare Cost Report Information System, then the | 15 | | Department may obtain the hospital provider's outpatient gross | 16 | | revenue from any source available, including, but not limited | 17 | | to, records maintained by the hospital provider, which may be | 18 | | inspected at all times during business hours of the day by the | 19 | | Department or its duly authorized agents and employees. | 20 | | Notwithstanding any other provision in this Article, for a | 21 | | hospital provider that did not have a 2015 Medicare cost | 22 | | report, but paid an assessment in State fiscal year 2018 on the | 23 | | basis of hypothetical data, that assessment amount shall be | 24 | | used for State fiscal years 2019 and 2020; however, for State | 25 | | fiscal year 2021, the assessment amount shall be increased by | 26 | | the proportion that it represents of the total annual |
| | | SB2553 | - 8 - | LRB101 18760 KTG 68215 b |
|
| 1 | | assessment that is generated from all hospitals in order to | 2 | | generate $6,250,000 in the aggregate for that period from all | 3 | | hospitals subject to the annual assessment under this | 4 | | paragraph. | 5 | | Subject to Sections 5A-3 and 5A-10, for State fiscal years | 6 | | 2021 through 2024, an annual assessment on outpatient services | 7 | | is imposed on each hospital provider in an amount equal to | 8 | | .01358 multiplied by the hospital's outpatient gross revenue, | 9 | | provided however, that the amount of .01358 used to calculate | 10 | | the assessment under this paragraph shall, by rule, be adjusted | 11 | | by a uniform percentage to generate the same total annual | 12 | | assessment that was generated in State fiscal year 2020 from | 13 | | all hospitals subject to the annual assessment under this | 14 | | paragraph plus $6,250,000. For State fiscal years 2021 and | 15 | | 2022, a hospital's outpatient gross revenue shall be determined | 16 | | using the most recent data available from each hospital's 2017 | 17 | | Medicare cost report as contained in the Healthcare Cost Report | 18 | | Information System file, for the quarter ending on March 31, | 19 | | 2019, without regard to any subsequent adjustments or changes | 20 | | to such data. For State fiscal years 2023 and 2024, a | 21 | | hospital's outpatient gross revenue shall be determined using | 22 | | the most recent data available from each hospital's 2019 | 23 | | Medicare cost report as contained in the Healthcare Cost Report | 24 | | Information System file, for the quarter ending on March 31, | 25 | | 2021, without regard to any subsequent adjustments or changes | 26 | | to such data. |
| | | SB2553 | - 9 - | LRB101 18760 KTG 68215 b |
|
| 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 31, | 4 | | 2016, the product of .19125 multiplied by the sum of the | 5 | | fee-for-service payments to hospitals as authorized under | 6 | | 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 31, | 25 | | 2017, the product of .19125 multiplied by the sum of the | 26 | | fee-for-service payments to hospitals as authorized under |
| | | SB2553 | - 10 - | LRB101 18760 KTG 68215 b |
|
| 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 2017 multiplied by 6, except that the amount | 5 | | calculated under this subparagraph (C) shall be adjusted, | 6 | | either positively or negatively, to account for the | 7 | | 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 subparagraph | 26 | | (C); and |
| | | SB2553 | - 11 - | LRB101 18760 KTG 68215 b |
|
| 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, if | 24 | | for any reason the scheduled payments under subsection (b) of | 25 | | Section 5A-12.5 are not issued in full by the final day of the | 26 | | period authorized under subsection (b) of Section 5A-12.5, |
| | | SB2553 | - 12 - | LRB101 18760 KTG 68215 b |
|
| 1 | | funds collected from each hospital pursuant to subparagraph (D) | 2 | | of paragraph (1) and pursuant to paragraph (2), attributable to | 3 | | the scheduled payments authorized under subsection (b) of | 4 | | Section 5A-12.5 that are not issued in full by the final day of | 5 | | the period attributable to each payment authorized under | 6 | | subsection (b) of Section 5A-12.5, shall be refunded. | 7 | | (4) The increases authorized under paragraph (2) of | 8 | | subsection (a) and paragraph (2) of subsection (b-5) shall be | 9 | | limited to the federally required State share of the total | 10 | | payments authorized under Section 5A-12.5 if the sum of such | 11 | | payments yields an annualized amount equal to or less than | 12 | | $450,000,000, or if the adjustments authorized under | 13 | | subsection (t) of Section 5A-12.2 are found not to be | 14 | | actuarially sound; however, this limitation shall not apply to | 15 | | the fee-for-service payments described in subsection (b) of | 16 | | Section 5A-12.5. | 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 |
| | | SB2553 | - 13 - | LRB101 18760 KTG 68215 b |
|
| 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.)
|
|