State of Illinois
90th General Assembly
Legislation

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[ Introduced ][ Engrossed ][ House Amendment 002 ]
[ Senate Amendment 001 ]

90_SB1420ham001

                                             LRB9009801DJksam
 1                    AMENDMENT TO SENATE BILL 1420
 2        AMENDMENT NO.     .  Amend Senate Bill 1420 as follows:
 3    by replacing the title with the following:
 4        "AN ACT to amend the Illinois Public Aid Code by changing
 5    Section 5-5.4."; and
 6    by replacing everything after the enacting  clause  with  the
 7    following:
 8        "Section  5.   The Illinois Public Aid Code is amended by
 9    changing Section 5-5.4 as follows:
10        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
11        Sec. 5-5.4.  Standards of Payment - Department of  Public
12    Aid.  The Department of Public Aid shall develop standards of
13    payment  of skilled nursing and intermediate care services in
14    facilities providing such services under this Article which:
15        (1)  Provides  for  the  determination  of  a  facility's
16    payment for skilled nursing and intermediate care services on
17    a prospective basis.  The amount of the payment rate for  all
18    nursing  facilities  certified  under  the medical assistance
19    program shall be prospectively established  annually  on  the
20    basis   of   historical,   financial,  and  statistical  data
21    reflecting actual costs from  prior  years,  which  shall  be
                            -2-              LRB9009801DJksam
 1    applied  to  the current rate year and updated for inflation,
 2    except that the capital cost element  for  newly  constructed
 3    facilities  shall  be  based  upon  projected  budgets.   The
 4    annually established payment rate shall take effect on July 1
 5    in  1984  and  subsequent  years.   Rate  increases  shall be
 6    provided annually thereafter on July 1 in 1984  and  on  each
 7    subsequent July 1 in the following years, except that no rate
 8    increase  and no update for inflation shall be provided on or
 9    after July 1, 1994.  Rates established effective each July  1
10    shall  govern  payment  for services rendered throughout that
11    fiscal year, except that rates established on  July  1,  1996
12    shall  be increased by 6.8% for services provided on or after
13    January 1, 1997.  Such rates will be  based  upon  the  rates
14    calculated  for  the  year  beginning  July  1, 1990, and for
15    subsequent years thereafter shall be based  on  the  facility
16    cost reports for the facility fiscal year ending at any point
17    in  time  during  the  previous calendar year, updated to the
18    midpoint of the rate year. Rates established on July 1,  1998
19    shall  be based on the facility cost reports on file with the
20    Department on April 1, 1996,  and  reimbursement  based  upon
21    those  rates  shall  be  payable  for services provided on or
22    after  October  1,  1998.  Effective  October  1,  1998,  the
23    Department shall reimburse for the actual cost of real estate
24    taxes paid by  the  facility,  prorated  for  the  facility's
25    Medicaid  census.  The  cost report shall be on file with the
26    Department no later than April 1 of the  current  rate  year.
27    Should  the  cost  report  not  be  on  file  by April 1, the
28    Department shall base the rate  on  the  latest  cost  report
29    filed  by  each  skilled  care facility and intermediate care
30    facility, updated to the midpoint of the current  rate  year.
31    In  determining rates for services rendered on and after July
32    1, 1985, fixed time shall not be computed at less than  zero.
33    The  Department shall not make any alterations of regulations
34    which would reduce any component of the Medicaid  rate  to  a
                            -3-              LRB9009801DJksam
 1    level  below what that component would have been utilizing in
 2    the rate effective on July 1, 1984.
 3        (2)  Shall take into account the actual costs incurred by
 4    facilities in providing services for  recipients  of  skilled
 5    nursing  and  intermediate  care  services  under the medical
 6    assistance program.
 7        (3)  Shall   take   into   account   the   medical    and
 8    psycho-social characteristics and needs of the patients.
 9        (4)  Shall take into account the actual costs incurred by
10    facilities  in meeting, licensing and certification standards
11    imposed and prescribed by the State of Illinois, any  of  its
12    political  subdivisions  or  municipalities and by the United
13    States Department of Health, Education and  Welfare  pursuant
14    to Title XIX of the Social Security Act.
15        The  Department  of  Public  Aid  shall  develop  precise
16    standards  for  payments  to reimburse nursing facilities for
17    any utilization of appropriate rehabilitative  personnel  for
18    the  provision of rehabilitative services which is authorized
19    by federal regulations, including reimbursement for  services
20    provided by qualified therapists or qualified assistants, and
21    which  is in accordance with accepted professional practices.
22    Reimbursement also may  be  made  for  utilization  of  other
23    supportive personnel under appropriate supervision.
24    (Source: P.A. 89-21, eff. 7-1-95; 89-499, eff. 6-28-96; 90-9,
25    eff. 7-1-97.)
26        Section  99.  Effective date.  This Act takes effect upon
27    becoming law.".

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