Sen. Don Harmon

Filed: 3/14/2019

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 42

2    AMENDMENT NO. ______. Amend Senate Bill 42 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Nursing Home Medicaid Reimbursement Reform Act.
 
6    Section 5. Purposes. The purposes of this Act include:
7        (1) Establishing a framework for the provision of care
8    to frail elderly residents of facilities licensed under the
9    Nursing Home Care Act.
10        (2) Ensuring the coordination of regulation and
11    reimbursement for nursing home residents.
12        (3) Bolstering the viability of career paths for
13    employees of nursing homes.
14        (4) Strengthening the nursing home provider community.
15        (5) Supporting the highest possible quality of
16    resident-centered services and care.
 

 

 

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1    Section 10. Definitions. As used in this Act:
2    "Facility" has the same meaning ascribed to that term under
3the Nursing Home Care Act.
4    "Medical assistance" means health care benefits provided
5under Article V of the Illinois Public Aid Code.
6    "Medical Assistance Program" means the Medical Assistance
7Program administered by the Department of Healthcare and Family
8Services in accordance with Article V of the Illinois Public
9Aid Code.
10    "Resident" has the same meaning ascribed to that term under
11the Nursing Home Care Act.
 
12    Section 15. Resident rights.
13    (a) Notwithstanding any other provision of law or
14regulation, it shall be a matter of State policy that all
15residents of facilities licensed under the Nursing Home Care
16Act who meet the financial requirements for medical assistance
17shall be guaranteed the rights specified in this Section. Every
18financially qualified resident with a determination of need
19score of 29 or greater shall be guaranteed the right to:
20        (1) select the facility in which he or she receives
21    care;
22        (2) participate fully in the development of his or her
23    individualized care plan; and
24        (3) be informed in advance of any changes to his or her

 

 

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1    individualized care plan or to the status of his or her
2    nursing home stay.
3    (b) All medical treatment and services deemed medically
4necessary by a physician licensed to practice medicine in all
5of its branches, including the provision of prescription drugs
6not covered under a qualified Medicare Part D Prescription Drug
7Plan, shall be presumed to be available for any resident who is
8eligible for medical assistance and shall qualify for
9reimbursement under the Medical Assistance Program.
10    (c) Any medical services provided, as specified in this
11Act, to a resident of a facility licensed under the Nursing
12Home Care Act shall be reimbursed based on an aggregate rate
13composed of nursing, support, and capital components. The
14facility shall also be reimbursed an amount that equals the
15facility's actual real estate tax bill, if applicable.
16    (d) Any additional funds contained in the State Fiscal Year
172020 budget in excess of those expended in the State Fiscal
18Year 2019 budget shall be distributed by statute.
19    (e) All reimbursement payments for services covered under
20this Section are due and payable on the last day of each month
21for all claims submitted during the preceding calendar month.
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.".