Full Text of HB3286 98th General Assembly
HB3286 98TH GENERAL ASSEMBLY |
| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014 HB3286 Introduced , by Rep. Naomi D. Jakobsson SYNOPSIS AS INTRODUCED: | | 305 ILCS 5/5-5e | | 305 ILCS 5/5-5e.1 | |
|
Amends the Medical Assistance Article of the Illinois Public Aid Code. In addition to other specified criteria, provides that a Safety-Net Hospital is an Illinois hospital that is licensed by the Department of Public Health as a general acute care, psychiatric, or pediatric hospital (rather than a general acute care or pediatric hospital).
Includes psychiatric hospitals to the types of hospitals that shall experience a 3.5% reduction in rates or payments for hospital services. Effective immediately. |
| |
| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
|
| | | HB3286 | | LRB098 09443 KTG 41676 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 Sections 5-5e and 5-5e.1 as follows: | 6 | | (305 ILCS 5/5-5e) | 7 | | Sec. 5-5e. Adjusted rates of reimbursement. | 8 | | (a) Rates or payments for services in effect on June 30, | 9 | | 2012 shall be adjusted and
services shall be affected as | 10 | | required by any other provision of this amendatory Act of
the | 11 | | 97th General Assembly. In addition, the Department shall do the | 12 | | following: | 13 | | (1) Delink the per diem rate paid for supportive living | 14 | | facility services from the per diem rate paid for nursing | 15 | | facility services, effective for services provided on or | 16 | | after May 1, 2011. | 17 | | (2) Cease payment for bed reserves in nursing | 18 | | facilities, specialized mental health rehabilitation | 19 | | facilities, and, except in the instance of residents who | 20 | | are under 21 years of age, intermediate care facilities for | 21 | | persons with developmental disabilities. | 22 | | (3) Cease payment of the $10 per day add-on payment to | 23 | | nursing facilities for certain residents with |
| | | HB3286 | - 2 - | LRB098 09443 KTG 41676 b |
|
| 1 | | developmental disabilities. | 2 | | (b) After the application of subsection (a), | 3 | | notwithstanding any other provision of this
Code to the | 4 | | contrary and to the extent permitted by federal law, on and | 5 | | after July 1,
2012, the rates of reimbursement for services and | 6 | | other payments provided under this
Code shall further be | 7 | | reduced as follows: | 8 | | (1) Rates or payments for physician services, dental | 9 | | services, or community health center services reimbursed | 10 | | through an encounter rate, and services provided under the | 11 | | Medicaid Rehabilitation Option of the Illinois Title XIX | 12 | | State Plan shall not be further reduced. | 13 | | (2) Rates or payments, or the portion thereof, paid to | 14 | | a provider that is operated by a unit of local government | 15 | | or State University that provides the non-federal share of | 16 | | such services shall not be further reduced. | 17 | | (3) Rates or payments for hospital services delivered | 18 | | by a hospital defined as a Safety-Net Hospital under | 19 | | Section 5-5e.1 of this Code shall not be further reduced. | 20 | | (4) Rates or payments for hospital services delivered | 21 | | by a Critical Access Hospital, which is an Illinois | 22 | | hospital designated as a critical care hospital by the | 23 | | Department of Public Health in accordance with 42 CFR 485, | 24 | | Subpart F, shall not be further reduced. | 25 | | (5) Rates or payments for Nursing Facility Services | 26 | | shall only be further adjusted pursuant to Section 5-5.2 of |
| | | HB3286 | - 3 - | LRB098 09443 KTG 41676 b |
|
| 1 | | this Code. | 2 | | (6) Rates or payments for services delivered by long | 3 | | term care facilities licensed under the ID/DD Community | 4 | | Care Act and developmental training services shall not be | 5 | | further reduced. | 6 | | (7) Rates or payments for services provided under | 7 | | capitation rates shall be adjusted taking into | 8 | | consideration the rates reduction and covered services | 9 | | required by this amendatory Act of the 97th General | 10 | | Assembly. | 11 | | (8) For hospitals not previously described in this | 12 | | subsection or for a psychiatric hospital defined as a | 13 | | Safety-Net Hospital under Section 5-5e.1 of this Code , the | 14 | | rates or payments for hospital services shall be further | 15 | | reduced by 3.5%, except for payments authorized under | 16 | | Section 5A-12.4 of this Code. | 17 | | (9) For all other rates or payments for services | 18 | | delivered by providers not specifically referenced in | 19 | | paragraphs (1) through (8), rates or payments shall be | 20 | | further reduced by 2.7%. | 21 | | (c) Any assessment imposed by this Code shall continue and | 22 | | nothing in this Section shall be construed to cause it to | 23 | | cease.
| 24 | | (Source: P.A. 97-689, eff. 6-14-12.) | 25 | | (305 ILCS 5/5-5e.1) |
| | | HB3286 | - 4 - | LRB098 09443 KTG 41676 b |
|
| 1 | | Sec. 5-5e.1. Safety-Net Hospitals. | 2 | | (a) A Safety-Net Hospital is an Illinois hospital that: | 3 | | (1) is licensed by the Department of Public Health as a | 4 | | general acute care , psychiatric, or pediatric hospital; | 5 | | and | 6 | | (2) is a disproportionate share hospital, as described | 7 | | in Section 1923 of the federal Social Security Act, as | 8 | | determined by the Department; and | 9 | | (3) meets one of the following: | 10 | | (A) has a MIUR of at least 40% and a charity | 11 | | percent of at least 4%; or | 12 | | (B) has a MIUR of at least 50%. | 13 | | (b) Definitions. As used in this Section: | 14 | | (1) "Charity percent" means the ratio of (i) the | 15 | | hospital's charity charges for services provided to | 16 | | individuals without health insurance or another source of | 17 | | third party coverage to (ii) the Illinois total hospital | 18 | | charges, each as reported on the hospital's OBRA form. | 19 | | (2) "MIUR" means Medicaid Inpatient Utilization Rate | 20 | | and is defined as a fraction, the numerator of which is the | 21 | | number of a hospital's inpatient days provided in the | 22 | | hospital's fiscal year ending 3 years prior to the rate | 23 | | year, to patients who, for such days, were eligible for | 24 | | Medicaid under Title XIX of the federal Social Security | 25 | | Act, 42 USC 1396a et seq., and the denominator of which is | 26 | | the total number of the hospital's inpatient days in that |
| | | HB3286 | - 5 - | LRB098 09443 KTG 41676 b |
|
| 1 | | same period. | 2 | | (3) "OBRA form" means form HFS-3834, OBRA '93 data | 3 | | collection form, for the rate year. | 4 | | (4) "Rate year" means the 12-month period beginning on | 5 | | October 1. | 6 | | (c) For the 27-month period beginning July 1, 2012, a | 7 | | hospital that would have qualified for the rate year beginning | 8 | | October 1, 2011, shall be a Safety-Net Hospital. | 9 | | (d) No later than August 15 preceding the rate year, each | 10 | | hospital shall submit the OBRA form to the Department. Prior to | 11 | | October 1, the Department shall notify each hospital whether it | 12 | | has qualified as a Safety-Net Hospital. | 13 | | (e) The Department may promulgate rules in order to | 14 | | implement this Section.
| 15 | | (Source: P.A. 97-689, eff. 6-14-12.) | 16 | | Section 99. Effective date. This Act takes effect upon | 17 | | becoming law. |
|