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Public Act 097-0584 | ||||
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
changing Sections 5-4.2, 5-5.4, 5B-2, 5B-4, and 5B-8 as | ||||
follows:
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(305 ILCS 5/5-4.2) (from Ch. 23, par. 5-4.2)
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Sec. 5-4.2. Ambulance services payments. | ||||
(a) For
ambulance
services provided to a recipient of aid | ||||
under this Article on or after
January 1, 1993, the Illinois | ||||
Department shall reimburse ambulance service
providers at | ||||
rates calculated in accordance with this Section. It is the | ||||
intent
of the General Assembly to provide adequate | ||||
reimbursement for ambulance
services so as to ensure adequate | ||||
access to services for recipients of aid
under this Article and | ||||
to provide appropriate incentives to ambulance service
| ||||
providers to provide services in an efficient and | ||||
cost-effective manner. Thus,
it is the intent of the General | ||||
Assembly that the Illinois Department implement
a | ||||
reimbursement system for ambulance services that, to the extent | ||||
practicable
and subject to the availability of funds | ||||
appropriated by the General Assembly
for this purpose, is | ||||
consistent with the payment principles of Medicare. To
ensure |
uniformity between the payment principles of Medicare and | ||
Medicaid, the
Illinois Department shall follow, to the extent | ||
necessary and practicable and
subject to the availability of | ||
funds appropriated by the General Assembly for
this purpose, | ||
the statutes, laws, regulations, policies, procedures,
| ||
principles, definitions, guidelines, and manuals used to | ||
determine the amounts
paid to ambulance service providers under | ||
Title XVIII of the Social Security
Act (Medicare).
| ||
(b) For ambulance services provided to a recipient of aid | ||
under this Article
on or after January 1, 1996, the Illinois | ||
Department shall reimburse ambulance
service providers based | ||
upon the actual distance traveled if a natural
disaster, | ||
weather conditions, road repairs, or traffic congestion | ||
necessitates
the use of a
route other than the most direct | ||
route.
| ||
(c) For purposes of this Section, "ambulance services" | ||
includes medical
transportation services provided by means of | ||
an ambulance, medi-car, service
car, or
taxi.
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(c-1) For purposes of this Section, "ground ambulance | ||
service" means medical transportation services that are | ||
described as ground ambulance services by the Centers for | ||
Medicare and Medicaid Services and provided in a vehicle that | ||
is licensed as an ambulance by the Illinois Department of | ||
Public Health pursuant to the Emergency Medical Services (EMS) | ||
Systems Act. | ||
(c-2) For purposes of this Section, "ground ambulance |
service provider" means a vehicle service provider as described | ||
in the Emergency Medical Services (EMS) Systems Act that | ||
operates licensed ambulances for the purpose of providing | ||
emergency ambulance services, or non-emergency ambulance | ||
services, or both. For purposes of this Section, this includes | ||
both ambulance providers and ambulance suppliers as described | ||
by the Centers for Medicare and Medicaid Services. | ||
(d) This Section does not prohibit separate billing by | ||
ambulance service
providers for oxygen furnished while | ||
providing advanced life support
services.
| ||
(e) Beginning with services rendered on or after July 1, | ||
2008, all providers of non-emergency medi-car and service car | ||
transportation must certify that the driver and employee | ||
attendant, as applicable, have completed a safety program | ||
approved by the Department to protect both the patient and the | ||
driver, prior to transporting a patient.
The provider must | ||
maintain this certification in its records. The provider shall | ||
produce such documentation upon demand by the Department or its | ||
representative. Failure to produce documentation of such | ||
training shall result in recovery of any payments made by the | ||
Department for services rendered by a non-certified driver or | ||
employee attendant. Medi-car and service car providers must | ||
maintain legible documentation in their records of the driver | ||
and, as applicable, employee attendant that actually | ||
transported the patient. Providers must recertify all drivers | ||
and employee attendants every 3 years.
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Notwithstanding the requirements above, any public | ||
transportation provider of medi-car and service car | ||
transportation that receives federal funding under 49 U.S.C. | ||
5307 and 5311 need not certify its drivers and employee | ||
attendants under this Section, since safety training is already | ||
federally mandated.
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(f) With respect to any policy or program administered by | ||
the Department or its agent regarding approval of non-emergency | ||
medical transportation by ground ambulance service providers, | ||
including, but not limited to, the Non-Emergency | ||
Transportation Services Prior Approval Program (NETSPAP), the | ||
Department shall establish by rule a process by which ground | ||
ambulance service providers of non-emergency medical | ||
transportation may appeal any decision by the Department or its | ||
agent for which no denial was received prior to the time of | ||
transport that either (i) denies a request for approval for | ||
payment of non-emergency transportation by means of ground | ||
ambulance service or (ii) grants a request for approval of | ||
non-emergency transportation by means of ground ambulance | ||
service at a level of service that entitles the ground | ||
ambulance service provider to a lower level of compensation | ||
from the Department than the ground ambulance service provider | ||
would have received as compensation for the level of service | ||
requested. The rule shall be established within 12 months after | ||
the effective date of this amendatory Act of the 97th General | ||
Assembly and shall provide that, for any decision rendered by |
the Department or its agent on or after the date the rule takes | ||
effect, the ground ambulance service provider shall have 60 | ||
days from the date the decision is received to file an appeal. | ||
The rule established by the Department shall be, insofar as is | ||
practical, consistent with the Illinois Administrative | ||
Procedure Act. The Director's decision on an appeal under this | ||
Section shall be a final administrative decision subject to | ||
review under the Administrative Review Law. | ||
(Source: P.A. 95-501, eff. 8-28-07.)
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(305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4) | ||
Sec. 5-5.4. Standards of Payment - Department of Healthcare | ||
and Family Services.
The Department of Healthcare and Family | ||
Services shall develop standards of payment of
nursing facility | ||
and ICF/DD services in facilities providing such services
under | ||
this Article which:
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(1) Provide for the determination of a facility's payment
| ||
for nursing facility or ICF/DD services on a prospective basis.
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The amount of the payment rate for all nursing facilities | ||
certified by the
Department of Public Health under the MR/DD | ||
Community Care Act or the Nursing Home Care Act as Intermediate
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Care for the Developmentally Disabled facilities, Long Term | ||
Care for Under Age
22 facilities, Skilled Nursing facilities, | ||
or Intermediate Care facilities
under the
medical assistance | ||
program shall be prospectively established annually on the
| ||
basis of historical, financial, and statistical data |
reflecting actual costs
from prior years, which shall be | ||
applied to the current rate year and updated
for inflation, | ||
except that the capital cost element for newly constructed
| ||
facilities shall be based upon projected budgets. The annually | ||
established
payment rate shall take effect on July 1 in 1984 | ||
and subsequent years. No rate
increase and no
update for | ||
inflation shall be provided on or after July 1, 1994 and before
| ||
July 1, 2012, unless specifically provided for in this
Section.
| ||
The changes made by Public Act 93-841
extending the duration of | ||
the prohibition against a rate increase or update for inflation | ||
are effective retroactive to July 1, 2004.
| ||
For facilities licensed by the Department of Public Health | ||
under the Nursing
Home Care Act as Intermediate Care for the | ||
Developmentally Disabled facilities
or Long Term Care for Under | ||
Age 22 facilities, the rates taking effect on July
1, 1998 | ||
shall include an increase of 3%. For facilities licensed by the
| ||
Department of Public Health under the Nursing Home Care Act as | ||
Skilled Nursing
facilities or Intermediate Care facilities, | ||
the rates taking effect on July 1,
1998 shall include an | ||
increase of 3% plus $1.10 per resident-day, as defined by
the | ||
Department. For facilities licensed by the Department of Public | ||
Health under the Nursing Home Care Act as Intermediate Care | ||
Facilities for the Developmentally Disabled or Long Term Care | ||
for Under Age 22 facilities, the rates taking effect on January | ||
1, 2006 shall include an increase of 3%.
For facilities | ||
licensed by the Department of Public Health under the Nursing |
Home Care Act as Intermediate Care Facilities for the | ||
Developmentally Disabled or Long Term Care for Under Age 22 | ||
facilities, the rates taking effect on January 1, 2009 shall | ||
include an increase sufficient to provide a $0.50 per hour wage | ||
increase for non-executive staff. | ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as Intermediate Care for the | ||
Developmentally Disabled
facilities or Long Term Care for Under | ||
Age 22 facilities, the rates taking
effect on July 1, 1999 | ||
shall include an increase of 1.6% plus $3.00 per
resident-day, | ||
as defined by the Department. For facilities licensed by the
| ||
Department of Public Health under the Nursing Home Care Act as | ||
Skilled Nursing
facilities or Intermediate Care facilities, | ||
the rates taking effect on July 1,
1999 shall include an | ||
increase of 1.6% and, for services provided on or after
October | ||
1, 1999, shall be increased by $4.00 per resident-day, as | ||
defined by
the Department.
| ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as Intermediate Care for the | ||
Developmentally Disabled
facilities or Long Term Care for Under | ||
Age 22 facilities, the rates taking
effect on July 1, 2000 | ||
shall include an increase of 2.5% per resident-day,
as defined | ||
by the Department. For facilities licensed by the Department of
| ||
Public Health under the Nursing Home Care Act as Skilled | ||
Nursing facilities or
Intermediate Care facilities, the rates | ||
taking effect on July 1, 2000 shall
include an increase of 2.5% |
per resident-day, as defined by the Department.
| ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as skilled nursing facilities | ||
or intermediate care
facilities, a new payment methodology must | ||
be implemented for the nursing
component of the rate effective | ||
July 1, 2003. The Department of Public Aid
(now Healthcare and | ||
Family Services) shall develop the new payment methodology | ||
using the Minimum Data Set
(MDS) as the instrument to collect | ||
information concerning nursing home
resident condition | ||
necessary to compute the rate. The Department
shall develop the | ||
new payment methodology to meet the unique needs of
Illinois | ||
nursing home residents while remaining subject to the | ||
appropriations
provided by the General Assembly.
A transition | ||
period from the payment methodology in effect on June 30, 2003
| ||
to the payment methodology in effect on July 1, 2003 shall be | ||
provided for a
period not exceeding 3 years and 184 days after | ||
implementation of the new payment
methodology as follows:
| ||
(A) For a facility that would receive a lower
nursing | ||
component rate per patient day under the new system than | ||
the facility
received
effective on the date immediately | ||
preceding the date that the Department
implements the new | ||
payment methodology, the nursing component rate per | ||
patient
day for the facility
shall be held at
the level in | ||
effect on the date immediately preceding the date that the
| ||
Department implements the new payment methodology until a | ||
higher nursing
component rate of
reimbursement is achieved |
by that
facility.
| ||
(B) For a facility that would receive a higher nursing | ||
component rate per
patient day under the payment | ||
methodology in effect on July 1, 2003 than the
facility | ||
received effective on the date immediately preceding the | ||
date that the
Department implements the new payment | ||
methodology, the nursing component rate
per patient day for | ||
the facility shall be adjusted.
| ||
(C) Notwithstanding paragraphs (A) and (B), the | ||
nursing component rate per
patient day for the facility | ||
shall be adjusted subject to appropriations
provided by the | ||
General Assembly.
| ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as Intermediate Care for the | ||
Developmentally Disabled
facilities or Long Term Care for Under | ||
Age 22 facilities, the rates taking
effect on March 1, 2001 | ||
shall include a statewide increase of 7.85%, as
defined by the | ||
Department.
| ||
Notwithstanding any other provision of this Section, for | ||
facilities licensed by the Department of Public Health under | ||
the
Nursing Home Care Act as skilled nursing facilities or | ||
intermediate care
facilities, except facilities participating | ||
in the Department's demonstration program pursuant to the | ||
provisions of Title 77, Part 300, Subpart T of the Illinois | ||
Administrative Code, the numerator of the ratio used by the | ||
Department of Healthcare and Family Services to compute the |
rate payable under this Section using the Minimum Data Set | ||
(MDS) methodology shall incorporate the following annual | ||
amounts as the additional funds appropriated to the Department | ||
specifically to pay for rates based on the MDS nursing | ||
component methodology in excess of the funding in effect on | ||
December 31, 2006: | ||
(i) For rates taking effect January 1, 2007, | ||
$60,000,000. | ||
(ii) For rates taking effect January 1, 2008, | ||
$110,000,000. | ||
(iii) For rates taking effect January 1, 2009, | ||
$194,000,000. | ||
(iv) For rates taking effect April 1, 2011, or the | ||
first day of the month that begins at least 45 days after | ||
the effective date of this amendatory Act of the 96th | ||
General Assembly, $416,500,000 or an amount as may be | ||
necessary to complete the transition to the MDS methodology | ||
for the nursing component of the rate. Increased payments | ||
under this item (iv) are not due and payable, however, | ||
until (i) the methodologies described in this paragraph are | ||
approved by the federal government in an appropriate State | ||
Plan amendment and (ii) the assessment imposed by Section | ||
5B-2 of this Code is determined to be a permissible tax | ||
under Title XIX of the Social Security Act. | ||
Notwithstanding any other provision of this Section, for | ||
facilities licensed by the Department of Public Health under |
the Nursing Home Care Act as skilled nursing facilities or | ||
intermediate care facilities, the support component of the | ||
rates taking effect on January 1, 2008 shall be computed using | ||
the most recent cost reports on file with the Department of | ||
Healthcare and Family Services no later than April 1, 2005, | ||
updated for inflation to January 1, 2006. | ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as Intermediate Care for the | ||
Developmentally Disabled
facilities or Long Term Care for Under | ||
Age 22 facilities, the rates taking
effect on April 1, 2002 | ||
shall include a statewide increase of 2.0%, as
defined by the | ||
Department.
This increase terminates on July 1, 2002;
beginning | ||
July 1, 2002 these rates are reduced to the level of the rates
| ||
in effect on March 31, 2002, as defined by the Department.
| ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as skilled nursing facilities | ||
or intermediate care
facilities, the rates taking effect on | ||
July 1, 2001 shall be computed using the most recent cost | ||
reports
on file with the Department of Public Aid no later than | ||
April 1, 2000,
updated for inflation to January 1, 2001. For | ||
rates effective July 1, 2001
only, rates shall be the greater | ||
of the rate computed for July 1, 2001
or the rate effective on | ||
June 30, 2001.
| ||
Notwithstanding any other provision of this Section, for | ||
facilities
licensed by the Department of Public Health under | ||
the Nursing Home Care Act
as skilled nursing facilities or |
intermediate care facilities, the Illinois
Department shall | ||
determine by rule the rates taking effect on July 1, 2002,
| ||
which shall be 5.9% less than the rates in effect on June 30, | ||
2002.
| ||
Notwithstanding any other provision of this Section, for | ||
facilities
licensed by the Department of Public Health under | ||
the Nursing Home Care Act as
skilled nursing
facilities or | ||
intermediate care facilities, if the payment methodologies | ||
required under Section 5A-12 and the waiver granted under 42 | ||
CFR 433.68 are approved by the United States Centers for | ||
Medicare and Medicaid Services, the rates taking effect on July | ||
1, 2004 shall be 3.0% greater than the rates in effect on June | ||
30, 2004. These rates shall take
effect only upon approval and
| ||
implementation of the payment methodologies required under | ||
Section 5A-12.
| ||
Notwithstanding any other provisions of this Section, for | ||
facilities licensed by the Department of Public Health under | ||
the Nursing Home Care Act as skilled nursing facilities or | ||
intermediate care facilities, the rates taking effect on | ||
January 1, 2005 shall be 3% more than the rates in effect on | ||
December 31, 2004.
| ||
Notwithstanding any other provision of this Section, for | ||
facilities licensed by the Department of Public Health under | ||
the Nursing Home Care Act as skilled nursing facilities or | ||
intermediate care facilities, effective January 1, 2009, the | ||
per diem support component of the rates effective on January 1, |
2008, computed using the most recent cost reports on file with | ||
the Department of Healthcare and Family Services no later than | ||
April 1, 2005, updated for inflation to January 1, 2006, shall | ||
be increased to the amount that would have been derived using | ||
standard Department of Healthcare and Family Services methods, | ||
procedures, and inflators. | ||
Notwithstanding any other provisions of this Section, for | ||
facilities licensed by the Department of Public Health under | ||
the Nursing Home Care Act as intermediate care facilities that | ||
are federally defined as Institutions for Mental Disease, a | ||
socio-development component rate equal to 6.6% of the | ||
facility's nursing component rate as of January 1, 2006 shall | ||
be established and paid effective July 1, 2006. The | ||
socio-development component of the rate shall be increased by a | ||
factor of 2.53 on the first day of the month that begins at | ||
least 45 days after January 11, 2008 (the effective date of | ||
Public Act 95-707). As of August 1, 2008, the socio-development | ||
component rate shall be equal to 6.6% of the facility's nursing | ||
component rate as of January 1, 2006, multiplied by a factor of | ||
3.53. For services provided on or after April 1, 2011, or the | ||
first day of the month that begins at least 45 days after the | ||
effective date of this amendatory Act of the 96th General | ||
Assembly, whichever is later, the Illinois Department may by | ||
rule adjust these socio-development component rates, and may | ||
use different adjustment methodologies for those facilities | ||
participating, and those not participating, in the Illinois |
Department's demonstration program pursuant to the provisions | ||
of Title 77, Part 300, Subpart T of the Illinois Administrative | ||
Code, but in no case may such rates be diminished below those | ||
in effect on August 1, 2008.
| ||
For facilities
licensed
by the
Department of Public Health | ||
under the Nursing Home Care Act as Intermediate
Care for
the | ||
Developmentally Disabled facilities or as long-term care | ||
facilities for
residents under 22 years of age, the rates | ||
taking effect on July 1,
2003 shall
include a statewide | ||
increase of 4%, as defined by the Department.
| ||
For facilities licensed by the Department of Public Health | ||
under the
Nursing Home Care Act as Intermediate Care for the | ||
Developmentally Disabled
facilities or Long Term Care for Under | ||
Age 22 facilities, the rates taking
effect on the first day of | ||
the month that begins at least 45 days after the effective date | ||
of this amendatory Act of the 95th General Assembly shall | ||
include a statewide increase of 2.5%, as
defined by the | ||
Department. | ||
Notwithstanding any other provision of this Section, for | ||
facilities licensed by the Department of Public Health under | ||
the Nursing Home Care Act as skilled nursing facilities or | ||
intermediate care facilities, effective January 1, 2005, | ||
facility rates shall be increased by the difference between (i) | ||
a facility's per diem property, liability, and malpractice | ||
insurance costs as reported in the cost report filed with the | ||
Department of Public Aid and used to establish rates effective |
July 1, 2001 and (ii) those same costs as reported in the | ||
facility's 2002 cost report. These costs shall be passed | ||
through to the facility without caps or limitations, except for | ||
adjustments required under normal auditing procedures.
| ||
Rates established effective each July 1 shall govern | ||
payment
for services rendered throughout that fiscal year, | ||
except that rates
established on July 1, 1996 shall be | ||
increased by 6.8% for services
provided on or after January 1, | ||
1997. Such rates will be based
upon the rates calculated for | ||
the year beginning July 1, 1990, and for
subsequent years | ||
thereafter until June 30, 2001 shall be based on the
facility | ||
cost reports
for the facility fiscal year ending at any point | ||
in time during the previous
calendar year, updated to the | ||
midpoint of the rate year. The cost report
shall be on file | ||
with the Department no later than April 1 of the current
rate | ||
year. Should the cost report not be on file by April 1, the | ||
Department
shall base the rate on the latest cost report filed | ||
by each skilled care
facility and intermediate care facility, | ||
updated to the midpoint of the
current rate year. In | ||
determining rates for services rendered on and after
July 1, | ||
1985, fixed time shall not be computed at less than zero. The
| ||
Department shall not make any alterations of regulations which | ||
would reduce
any component of the Medicaid rate to a level | ||
below what that component would
have been utilizing in the rate | ||
effective on July 1, 1984.
| ||
(2) Shall take into account the actual costs incurred by |
facilities
in providing services for recipients of skilled | ||
nursing and intermediate
care services under the medical | ||
assistance program.
| ||
(3) Shall take into account the medical and psycho-social
| ||
characteristics and needs of the patients.
| ||
(4) Shall take into account the actual costs incurred by | ||
facilities in
meeting licensing and certification standards | ||
imposed and prescribed by the
State of Illinois, any of its | ||
political subdivisions or municipalities and by
the U.S. | ||
Department of Health and Human Services pursuant to Title XIX | ||
of the
Social Security Act.
| ||
The Department of Healthcare and Family Services
shall | ||
develop precise standards for
payments to reimburse nursing | ||
facilities for any utilization of
appropriate rehabilitative | ||
personnel for the provision of rehabilitative
services which is | ||
authorized by federal regulations, including
reimbursement for | ||
services provided by qualified therapists or qualified
| ||
assistants, and which is in accordance with accepted | ||
professional
practices. Reimbursement also may be made for | ||
utilization of other
supportive personnel under appropriate | ||
supervision.
| ||
The Department shall develop enhanced payments to offset | ||
the additional costs incurred by a
facility serving exceptional | ||
need residents and shall allocate at least $8,000,000 of the | ||
funds
collected from the assessment established by Section 5B-2 | ||
of this Code for such payments. For
the purpose of this |
Section, "exceptional needs" means, but need not be limited to, | ||
ventilator care, tracheotomy care,
bariatric care, complex | ||
wound care, and traumatic brain injury care. The enhanced | ||
payments for exceptional need residents under this paragraph | ||
are not due and payable, however, until (i) the methodologies | ||
described in this paragraph are approved by the federal | ||
government in an appropriate State Plan amendment and (ii) the | ||
assessment imposed by Section 5B-2 of this Code is determined | ||
to be a permissible tax under Title XIX of the Social Security | ||
Act. | ||
(5) Beginning July 1, 2012 the methodologies for | ||
reimbursement of nursing facility services as provided under | ||
this Section 5-5.4 shall no longer be applicable for bills | ||
payable for State fiscal years 2012 and thereafter. | ||
(6) No payment increase under this Section for the MDS | ||
methodology, exceptional care residents, or the | ||
socio-development component rate established by Public Act | ||
96-1530 of the 96th General Assembly and funded by the | ||
assessment imposed under Section 5B-2 of this Code shall be due | ||
and payable until after the Department notifies the long-term | ||
care providers, in writing, that the payment methodologies to | ||
long-term care providers required under this Section have been | ||
approved by the Centers for Medicare and Medicaid Services of | ||
the U.S. Department of Health and Human Services and the | ||
waivers under 42 CFR 433.68 for the assessment imposed by this | ||
Section, if necessary, have been granted by the Centers for |
Medicare and Medicaid Services of the U.S. Department of Health | ||
and Human Services. Upon notification to the Department of | ||
approval of the payment methodologies required under this | ||
Section and the waivers granted under 42 CFR 433.68, all | ||
increased payments otherwise due under this Section prior to | ||
the date of notification shall be due and payable within 90 | ||
days of the date federal approval is received. | ||
(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707, | ||
eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09; | ||
96-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff. 7-2-10; | ||
96-1530, eff. 2-16-11.)
| ||
(305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
| ||
Sec. 5B-2. Assessment; no local authorization to tax.
| ||
(a) For the privilege of engaging in the occupation of | ||
long-term care
provider, beginning July 1, 2011 an assessment | ||
is imposed upon each long-term care provider in an amount equal | ||
to $6.07 times the number of occupied bed days due and payable | ||
each month. Notwithstanding any provision of any other Act to | ||
the
contrary, this assessment shall be construed as a tax, but | ||
shall not be billed or passed on to any resident of a nursing | ||
home operated by the nursing home provider may not be added
to | ||
the charges of an individual's nursing home care that is paid | ||
for in
whole, or in part, by a federal, State, or combined | ||
federal-state medical
care program .
| ||
(b) Nothing in this amendatory Act of 1992 shall be |
construed to
authorize any home rule unit or other unit of | ||
local government to license
for revenue or impose a tax or | ||
assessment upon long-term care providers or
the occupation of | ||
long-term care provider, or a tax or assessment measured
by the | ||
income or earnings or occupied bed days of a long-term care | ||
provider.
| ||
(c) The assessment imposed by this Section shall not be due | ||
and payable, however, until after the Department notifies the | ||
long-term care providers, in writing, that the payment | ||
methodologies to long-term care providers required under | ||
Section 5-5.4 of this Code have been approved by the Centers | ||
for Medicare and Medicaid Services of the U.S. Department of | ||
Health and Human Services and the waivers under 42 CFR 433.68 | ||
for the assessment imposed by this Section, if necessary, have | ||
been granted by the Centers for Medicare and Medicaid Services | ||
of the U.S. Department of Health and Human Services. | ||
(Source: P.A. 96-1530, eff. 2-16-11.)
| ||
(305 ILCS 5/5B-4) (from Ch. 23, par. 5B-4)
| ||
Sec. 5B-4. Payment of assessment; penalty.
| ||
(a) The assessment imposed by Section 5B-2 shall be due and | ||
payable monthly, on the last State business day of the month | ||
for occupied bed days reported for the preceding third month | ||
prior to the month in which the tax is payable and due. A | ||
facility that has delayed payment due to the State's failure to | ||
reimburse for services rendered may request an extension on the |
due date for payment pursuant to subsection (b) and shall pay | ||
the assessment within 30 days of reimbursement by the | ||
Department.
The Illinois Department may provide that county | ||
nursing homes directed and
maintained pursuant to Section | ||
5-1005 of the Counties Code may meet their
assessment | ||
obligation by certifying to the Illinois Department that county
| ||
expenditures have been obligated for the operation of the | ||
county nursing
home in an amount at least equal to the amount | ||
of the assessment.
| ||
(a-5) Each assessment payment shall be accompanied by an | ||
assessment report to be completed by the long-term care | ||
provider. A separate report shall be completed for each | ||
long-term care facility in this State operated by a long-term | ||
care provider. The report shall be in a form and manner | ||
prescribed by the Illinois Department and shall at a minimum | ||
provide for the reporting of the number of occupied bed days of | ||
the long-term care facility for the reporting period and other | ||
reasonable information the Illinois Department requires for | ||
the administration of its responsibilities under this Code. To | ||
the extent practicable, the Department shall coordinate the | ||
assessment reporting requirements with other reporting | ||
required of long-term care facilities. | ||
(b) The Illinois Department is authorized to establish
| ||
delayed payment schedules for long-term care providers that are
| ||
unable to make assessment payments when due under this Section
| ||
due to financial difficulties, as determined by the Illinois
|
Department. The Illinois Department may not deny a request for | ||
delay of payment of the assessment imposed under this Article | ||
if the long-term care provider has not been paid for services | ||
provided during the month on which the assessment is levied.
| ||
(c) If a long-term care provider fails to pay the full
| ||
amount of an assessment payment when due (including any | ||
extensions
granted under subsection (b)), there shall, unless | ||
waived by the
Illinois Department for reasonable cause, be | ||
added to the
assessment imposed by Section 5B-2 a
penalty | ||
assessment equal to the lesser of (i) 5% of the amount of
the | ||
assessment payment not paid on or before the due date plus 5% | ||
of the
portion thereof remaining unpaid on the last day of each | ||
month
thereafter or (ii) 100% of the assessment payment amount | ||
not paid on or
before the due date. For purposes of this | ||
subsection, payments
will be credited first to unpaid | ||
assessment payment amounts (rather than
to penalty or | ||
interest), beginning with the most delinquent assessment | ||
payments. Payment cycles of longer than 60 days shall be one | ||
factor the Director takes into account in granting a waiver | ||
under this Section.
| ||
(c-5) If a long-term care provider fails to file its report | ||
with payment, there shall, unless waived by the Illinois | ||
Department for reasonable cause, be added to the assessment due | ||
a penalty assessment equal to 25% of the assessment due. | ||
(d) Nothing in this amendatory Act of 1993 shall be | ||
construed to prevent
the Illinois Department from collecting |
all amounts due under this Article
pursuant to an assessment | ||
imposed before the effective date of this amendatory
Act of | ||
1993.
| ||
(e) Nothing in this amendatory Act of the 96th General | ||
Assembly shall be construed to prevent
the Illinois Department | ||
from collecting all amounts due under this Code
pursuant to an | ||
assessment, tax, fee, or penalty imposed before the effective | ||
date of this amendatory
Act of the 96th General Assembly. | ||
(f) No installment of the assessment imposed by Section | ||
5B-2 shall be due and payable until after the Department | ||
notifies the long-term care providers, in writing, that the | ||
payment methodologies to long-term care providers required | ||
under Section 5-5.4 of this Code have been approved by the | ||
Centers for Medicare and Medicaid Services of the U.S. | ||
Department of Health and Human Services and the waivers under | ||
42 CFR 433.68 for the assessment imposed by this Section, if | ||
necessary, have been granted by the Centers for Medicare and | ||
Medicaid Services of the U.S. Department of Health and Human | ||
Services. Upon notification to the Department of approval of | ||
the payment methodologies required under Section 5-5.4 of this | ||
Code and the waivers granted under 42 CFR 433.68, all | ||
installments otherwise due under Section 5B-4 prior to the date | ||
of notification shall be due and payable to the Department upon | ||
written direction from the Department within 90 days after | ||
issuance by the Comptroller of the payments required under | ||
Section 5-5.4 of this Code. |
(Source: P.A. 96-444, eff. 8-14-09; 96-1530, eff. 2-16-11.)
| ||
(305 ILCS 5/5B-8) (from Ch. 23, par. 5B-8)
| ||
Sec. 5B-8. Long-Term Care Provider Fund.
| ||
(a) There is created in the State Treasury the Long-Term
| ||
Care Provider Fund. Interest earned by the Fund shall be
| ||
credited to the Fund. The Fund shall not be used to replace any
| ||
moneys appropriated to the Medicaid program by the General | ||
Assembly.
| ||
(b) The Fund is created for the purpose of receiving and
| ||
disbursing moneys in accordance with this Article. | ||
Disbursements
from the Fund shall be made only as follows:
| ||
(1) For payments to nursing
facilities, including | ||
county nursing facilities but excluding
State-operated | ||
facilities, under Title XIX of the Social Security
Act and | ||
Article V of this Code.
| ||
(2) For the reimbursement of moneys collected by the
| ||
Illinois Department through error or mistake.
| ||
(3) For payment of administrative expenses incurred by | ||
the
Illinois Department or its agent in performing the | ||
activities
authorized by this Article.
| ||
(3.5) For reimbursement of expenses incurred by | ||
long-term care facilities, and payment of administrative | ||
expenses incurred by the Department of Public Health, in | ||
relation to the conduct and analysis of background checks | ||
for identified offenders under the Nursing Home Care Act.
|
(4) For payments of any amounts that are reimbursable | ||
to the
federal government for payments from this Fund that | ||
are required
to be paid by State warrant.
| ||
(5) For making transfers to the General Obligation Bond
| ||
Retirement and Interest Fund, as those transfers are | ||
authorized
in the proceedings authorizing debt under the | ||
Short Term Borrowing Act,
but transfers made under this | ||
paragraph (5) shall not exceed the
principal amount of debt | ||
issued in anticipation of the receipt by
the State of | ||
moneys to be deposited into the Fund.
| ||
(6) For making transfers, at the direction of the | ||
Director of the Governor's Office of Management and Budget | ||
during each fiscal year beginning on or after July 1, 2011, | ||
to other State funds in an annual amount of $20,000,000 of | ||
the tax collected pursuant to this Article for the purpose | ||
of enforcement of nursing home standards, support of the | ||
ombudsman program, and efforts to expand home and | ||
community-based services. No transfer under this paragraph | ||
shall occur until (i) the payment methodologies created by | ||
Public Act 96-1530 under Section 5-5.4 of this Code have | ||
been approved by the Centers for Medicare and Medicaid | ||
Services of the U.S. Department of Health and Human | ||
Services and (ii) the assessment imposed by Section 5B-2 of | ||
this Code is determined to be a permissible tax under Title | ||
XIX of the Social Security Act. | ||
Disbursements from the Fund, other than transfers made |
pursuant to paragraphs (5) and (6) of this subsection, shall be | ||
by
warrants drawn by the State Comptroller upon receipt of | ||
vouchers
duly executed and certified by the Illinois | ||
Department.
| ||
(c) The Fund shall consist of the following:
| ||
(1) All moneys collected or received by the Illinois
| ||
Department from the long-term care provider assessment | ||
imposed by
this Article.
| ||
(2) All federal matching funds received by the Illinois
| ||
Department as a result of expenditures made by the Illinois
| ||
Department that are attributable to moneys deposited in the | ||
Fund.
| ||
(3) Any interest or penalty levied in conjunction with | ||
the
administration of this Article.
| ||
(4) (Blank).
| ||
(5) All other monies received for the Fund from any | ||
other source,
including interest earned thereon.
| ||
(Source: P.A. 95-707, eff. 1-11-08; 96-1530, eff. 2-16-11.)
| ||
Section 99. Effective date. This Act takes effect upon | ||
becoming law. |