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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.