State of Illinois
92nd General Assembly
Legislation

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92_SB0812

 
                                               LRB9208087DJgc

 1        AN ACT in relation to 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 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 - Department of  Public
 8    Aid.  The Department of Public Aid shall develop standards of
 9    payment  of skilled nursing and intermediate care services in
10    facilities providing such services under this Article which:
11        (1)  Provides  for  the  determination  of  a  facility's
12    payment for skilled nursing and intermediate care services on
13    a prospective basis.  The amount of the payment rate for  all
14    nursing  facilities  certified  under  the medical assistance
15    program shall be prospectively established  annually  on  the
16    basis   of   historical,   financial,  and  statistical  data
17    reflecting actual costs from  prior  years,  which  shall  be
18    applied  to  the current rate year and updated for inflation,
19    except that the capital cost element  for  newly  constructed
20    facilities  shall  be  based  upon  projected  budgets.   The
21    annually established payment rate shall take effect on July 1
22    in  1984  and  subsequent  years.   Rate  increases  shall be
23    provided annually thereafter on July 1 in 1984  and  on  each
24    subsequent July 1 in the following years, except that no rate
25    increase  and no update for inflation shall be provided on or
26    after  July  1,  1994  and  before  July  1,   2001,   unless
27    specifically provided for in this Section.
28        For  facilities  licensed  by  the  Department  of Public
29    Health under the Nursing Home Care Act as  Intermediate  Care
30    for the Developmentally Disabled facilities or Long Term Care
31    for  Under Age 22 facilities, the rates taking effect on July
 
                            -2-                LRB9208087DJgc
 1    1, 1998 shall include an  increase  of  3%.   For  facilities
 2    licensed by the Department of Public Health under the Nursing
 3    Home  Care  Act as Skilled Nursing facilities or Intermediate
 4    Care facilities, the rates taking  effect  on  July  1,  1998
 5    shall  include an increase of 3% plus $1.10 per resident-day,
 6    as defined by the Department.
 7        For facilities  licensed  by  the  Department  of  Public
 8    Health  under  the Nursing Home Care Act as Intermediate Care
 9    for the Developmentally Disabled facilities or Long Term Care
10    for Under Age 22 facilities, the rates taking effect on  July
11    1,  1999  shall  include  an  increase of 1.6% plus $3.00 per
12    resident-day, as defined by the Department.   For  facilities
13    licensed by the Department of Public Health under the Nursing
14    Home  Care  Act as Skilled Nursing facilities or Intermediate
15    Care facilities, the rates taking  effect  on  July  1,  1999
16    shall  include an increase of 1.6% and, for services provided
17    on or after October 1, 1999, shall be increased by $4.00  per
18    resident-day, as defined by the Department.
19        For  facilities  licensed  by  the  Department  of Public
20    Health under the Nursing Home Care Act as  Intermediate  Care
21    for the Developmentally Disabled facilities or Long Term Care
22    for  Under Age 22 facilities, the rates taking effect on July
23    1, 2000 shall include an increase of 2.5%  per  resident-day,
24    as defined by the Department.  For facilities licensed by the
25    Department  of  Public Health under the Nursing Home Care Act
26    as  Skilled   Nursing   facilities   or   Intermediate   Care
27    facilities,  the  rates  taking  effect on July 1, 2000 shall
28    include an increase of 2.5% per resident-day, as  defined  by
29    the Department.
30        Rates  established  effective  each  July  1 shall govern
31    payment for services rendered throughout  that  fiscal  year,
32    except  that  rates  established  on  July  1,  1996 shall be
33    increased by 6.8% for services provided on or  after  January
34    1, 1997, and except that for those facilities with rates less
 
                            -3-                LRB9208087DJgc
 1    than  the actual, audited costs, rates established on July 1,
 2    2001 shall be increased to no less  than  the  lower  of  the
 3    average costs in the facility's geographic area as defined by
 4    the   Department  or  the  facility's  1998  actual  audited,
 5    adjusted costs.  In no case shall a facility's July  1,  2001
 6    rate  be  less than its January 1, 1999 rate. Such rates will
 7    be based upon the rates calculated  for  the  year  beginning
 8    July  1,  1990,  and for subsequent years thereafter shall be
 9    based on the facility cost reports for  the  facility  fiscal
10    year ending at any point in time during the previous calendar
11    year,  updated  to  the  midpoint of the rate year.  The cost
12    report shall be on file with the  Department  no  later  than
13    April 1 of the current rate year.  Should the cost report not
14    be  on file by April 1, the Department shall base the rate on
15    the latest cost report filed by each  skilled  care  facility
16    and  intermediate  care  facility, updated to the midpoint of
17    the current rate year.  In  determining  rates  for  services
18    rendered  on  and after July 1, 1985, fixed time shall not be
19    computed at less than zero.  The Department  shall  not  make
20    any   alterations  of  regulations  which  would  reduce  any
21    component of the Medicaid rate to a  level  below  what  that
22    component  would have been utilizing in the rate effective on
23    July 1, 1984.
24        (2)  Shall take into account the actual costs incurred by
25    facilities in providing services for  recipients  of  skilled
26    nursing  and  intermediate  care  services  under the medical
27    assistance program.
28        (3)  Shall   take   into   account   the   medical    and
29    psycho-social characteristics and needs of the patients.
30        (4)  Shall take into account the actual costs incurred by
31    facilities  in  meeting licensing and certification standards
32    imposed and prescribed by the State of Illinois, any  of  its
33    political  subdivisions  or  municipalities  and  by the U.S.
34    Department of Health and Human Services pursuant to Title XIX
 
                            -4-                LRB9208087DJgc
 1    of the Social Security Act.
 2        The  Department  of  Public  Aid  shall  develop  precise
 3    standards for payments to reimburse  nursing  facilities  for
 4    any  utilization  of appropriate rehabilitative personnel for
 5    the provision of rehabilitative services which is  authorized
 6    by  federal regulations, including reimbursement for services
 7    provided by qualified therapists or qualified assistants, and
 8    which is in accordance with accepted professional  practices.
 9    Reimbursement  also  may  be  made  for  utilization of other
10    supportive personnel under appropriate supervision.
11    (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98;  91-24,
12    eff. 7-1-99; 91-712, eff. 7-1-00.)

13        Section  99.   Effective  date.  This Act takes effect on
14    July 1, 2001.

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