Public Act 098-1166
 
SB3171 EnrolledLRB098 18157 KTG 53286 b

    AN ACT concerning public aid.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Public Aid Code is amended by
changing Section 5-5e as follows:
 
    (305 ILCS 5/5-5e)
    Sec. 5-5e. Adjusted rates of reimbursement.
    (a) Rates or payments for services in effect on June 30,
2012 shall be adjusted and services shall be affected as
required by any other provision of this amendatory Act of the
97th General Assembly. In addition, the Department shall do the
following:
        (1) Delink the per diem rate paid for supportive living
    facility services from the per diem rate paid for nursing
    facility services, effective for services provided on or
    after May 1, 2011.
        (2) Cease payment for bed reserves in nursing
    facilities and specialized mental health rehabilitation
    facilities; for purposes of therapeutic home visits for
    individuals scoring as TBI on the MDS 3.0, beginning June
    1, 2015, the Department shall approve payments for bed
    reserves in nursing facilities and specialized mental
    health rehabilitation facilities that have at least a 90%
    occupancy level and at least 80% of their residents are
    Medicaid eligible. Payment shall be at a daily rate of 75%
    of an individual's current Medicaid per diem and shall not
    exceed 10 days in a calendar month.
        (2.5) Cease payment for bed reserves for purposes of
    inpatient hospitalizations to intermediate care facilities
    for persons with development disabilities, except in the
    instance of residents who are under 21 years of age.
        (3) Cease payment of the $10 per day add-on payment to
    nursing facilities for certain residents with
    developmental disabilities.
    (b) After the application of subsection (a),
notwithstanding any other provision of this Code to the
contrary and to the extent permitted by federal law, on and
after July 1, 2012, the rates of reimbursement for services and
other payments provided under this Code shall further be
reduced as follows:
        (1) Rates or payments for physician services, dental
    services, or community health center services reimbursed
    through an encounter rate, and services provided under the
    Medicaid Rehabilitation Option of the Illinois Title XIX
    State Plan shall not be further reduced.
        (2) Rates or payments, or the portion thereof, paid to
    a provider that is operated by a unit of local government
    or State University that provides the non-federal share of
    such services shall not be further reduced.
        (3) Rates or payments for hospital services delivered
    by a hospital defined as a Safety-Net Hospital under
    Section 5-5e.1 of this Code shall not be further reduced.
        (4) Rates or payments for hospital services delivered
    by a Critical Access Hospital, which is an Illinois
    hospital designated as a critical care hospital by the
    Department of Public Health in accordance with 42 CFR 485,
    Subpart F, shall not be further reduced.
        (5) Rates or payments for Nursing Facility Services
    shall only be further adjusted pursuant to Section 5-5.2 of
    this Code.
        (6) Rates or payments for services delivered by long
    term care facilities licensed under the ID/DD Community
    Care Act and developmental training services shall not be
    further reduced.
        (7) Rates or payments for services provided under
    capitation rates shall be adjusted taking into
    consideration the rates reduction and covered services
    required by this amendatory Act of the 97th General
    Assembly.
        (8) For hospitals not previously described in this
    subsection, the rates or payments for hospital services
    shall be further reduced by 3.5%, except for payments
    authorized under Section 5A-12.4 of this Code.
        (9) For all other rates or payments for services
    delivered by providers not specifically referenced in
    paragraphs (1) through (8), rates or payments shall be
    further reduced by 2.7%.
    (c) Any assessment imposed by this Code shall continue and
nothing in this Section shall be construed to cause it to
cease.
    (d) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for services provided for the purpose
of transitioning children from a hospital to home placement or
other appropriate setting by a children's community-based
health care center authorized under the Alternative Health Care
Delivery Act shall be $683 per day.
    (e) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for home health visits shall be $72.
    (f) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for the certified nursing assistant
component of the home health agency rate shall be $20.
(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13;
98-651, eff. 6-16-14.)
 
    Section 99. Effective date. This Act takes effect June 1,
2015.