State of Illinois
92nd General Assembly
Legislation

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92_HB2092

 
                                               LRB9207455DJdv

 1        AN ACT in relation to persons with disabilities.

 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 5-5.4 as follows:

 6        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 7        Sec. 5-5.4.  Standards of payment; Payment Department  of
 8    Public  Aid.    The  Department  of  Public Aid shall develop
 9    standards of payment of skilled nursing and intermediate care
10    services in facilities providing  such  services  under  this
11    Article which:
12        (1)  Provides  for  the  determination  of  a  facility's
13    payment for skilled nursing and intermediate care services on
14    a  prospective basis.  The amount of the payment rate for all
15    nursing facilities certified  under  the  medical  assistance
16    program  shall  be  prospectively established annually on the
17    basis  of  historical,  financial,   and   statistical   data
18    reflecting  actual  costs  from  prior  years, which shall be
19    applied to the current rate year and updated  for  inflation,
20    except  that  the  capital cost element for newly constructed
21    facilities  shall  be  based  upon  projected  budgets.   The
22    annually established payment rate shall take effect on July 1
23    in 1984  and  subsequent  years.   Rate  increases  shall  be
24    provided  annually  thereafter  on July 1 in 1984 and on each
25    subsequent July 1 in the following years, except that no rate
26    increase and no update for inflation shall be provided on  or
27    after   July   1,  1994  and  before  July  1,  2001,  unless
28    specifically provided for in this Section.
29        For facilities  licensed  by  the  Department  of  Public
30    Health  under  the Nursing Home Care Act as Intermediate Care
31    for the Developmentally Disabled facilities or Long Term Care
 
                            -2-                LRB9207455DJdv
 1    for Under Age 22 facilities, the rates taking effect on  July
 2    1,  1998  shall  include  an  increase of 3%.  For facilities
 3    licensed by the Department of Public Health under the Nursing
 4    Home Care Act as Skilled Nursing facilities  or  Intermediate
 5    Care  facilities,  the  rates  taking  effect on July 1, 1998
 6    shall include an increase of 3% plus $1.10 per  resident-day,
 7    as defined by the Department.
 8        For  facilities  licensed  by  the  Department  of Public
 9    Health under the Nursing Home Care Act as  Intermediate  Care
10    for the Developmentally Disabled facilities or Long Term Care
11    for  Under Age 22 facilities, the rates taking effect on July
12    1, 1999 shall include an increase  of  1.6%  plus  $3.00  per
13    resident-day,  as  defined by the Department.  For facilities
14    licensed by the Department of Public Health under the Nursing
15    Home Care Act as Skilled Nursing facilities  or  Intermediate
16    Care  facilities,  the  rates  taking  effect on July 1, 1999
17    shall include an increase of 1.6% and, for services  provided
18    on  or after October 1, 1999, shall be increased by $4.00 per
19    resident-day, as defined by the Department.
20        For facilities  licensed  by  the  Department  of  Public
21    Health  under  the Nursing Home Care Act as Intermediate Care
22    for the Developmentally Disabled facilities or Long Term Care
23    for Under Age 22 facilities, the rates taking effect on  July
24    1,  2000  shall include an increase of 2.5% per resident-day,
25    as defined by the Department.  For facilities licensed by the
26    Department of Public Health under the Nursing Home  Care  Act
27    as   Skilled   Nursing   facilities   or   Intermediate  Care
28    facilities, the rates taking effect on  July  1,  2000  shall
29    include  an  increase of 2.5% per resident-day, as defined by
30    the Department.
31        Rates established effective  each  July  1  shall  govern
32    payment  for  services  rendered throughout that fiscal year,
33    except that rates  established  on  July  1,  1996  shall  be
34    increased  by  6.8% for services provided on or after January
 
                            -3-                LRB9207455DJdv
 1    1, 1997.  Such rates will be based upon the rates  calculated
 2    for the year beginning July 1, 1990, and for subsequent years
 3    thereafter  shall  be  based on the facility cost reports for
 4    the facility fiscal year ending at any point in  time  during
 5    the  previous  calendar  year, updated to the midpoint of the
 6    rate year.  The  cost  report  shall  be  on  file  with  the
 7    Department  no  later  than April 1 of the current rate year.
 8    Should the cost report  not  be  on  file  by  April  1,  the
 9    Department  shall  base  the  rate  on the latest cost report
10    filed by each skilled care  facility  and  intermediate  care
11    facility,  updated  to the midpoint of the current rate year.
12    In determining rates for services rendered on and after  July
13    1,  1985, fixed time shall not be computed at less than zero.
14    The Department shall not make any alterations of  regulations
15    which  would  reduce  any component of the Medicaid rate to a
16    level below what that component would have been utilizing  in
17    the rate effective on July 1, 1984.
18        (2)  Shall take into account the actual costs incurred by
19    facilities  in  providing  services for recipients of skilled
20    nursing and intermediate  care  services  under  the  medical
21    assistance program.
22        (3)  Shall    take   into   account   the   medical   and
23    psycho-social characteristics and needs of the patients.
24        (4)  Shall take into account the actual costs incurred by
25    facilities in meeting licensing and  certification  standards
26    imposed  and  prescribed by the State of Illinois, any of its
27    political subdivisions or  municipalities  and  by  the  U.S.
28    Department of Health and Human Services pursuant to Title XIX
29    of the Social Security Act.
30        The  Department  of  Public  Aid  shall  develop  precise
31    standards  for  payments  to reimburse nursing facilities for
32    any utilization of appropriate rehabilitative  personnel  for
33    the  provision of rehabilitative services which is authorized
34    by federal regulations, including reimbursement for  services
 
                            -4-                LRB9207455DJdv
 1    provided by qualified therapists or qualified assistants, and
 2    which  is in accordance with accepted professional practices.
 3    Reimbursement also may  be  made  for  utilization  of  other
 4    supportive personnel under appropriate supervision.
 5    (Source:  P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24,
 6    eff. 7-1-99; 91-712, eff. 7-1-00.)

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