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1     AN ACT concerning hospitals.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4
ARTICLE 5.

 
5     Section 5-1. Short title. This Article may be cited as the
6 Public Health Program Beneficiary Employer Disclosure Law.
7 References in this Article to "this Law" mean this Article.
 
8     Section 5-5. Definition. In this Law, "public health
9 program" means either of the following:
10         (1) The medical assistance program under Article V of
11     the Illinois Public Aid Code.
12         (2) The children's health insurance program under the
13     Children's Health Insurance Program Act.
 
14     Section 5-10. Disclosure of employer required. An
15 applicant for health care benefits under a public health
16 program, or a person requesting uncompensated care in a
17 hospital, may identify the employer or employers of the
18 proposed beneficiary of the health care benefits. If the
19 proposed public health program beneficiary is not employed, the
20 applicant may identify the employer or employers of any adult
21 who is responsible for providing all or some of the proposed
22 beneficiary's support.
 
23     Section 5-15. Reporting of employer-provided health
24 insurance information.
25     (a) Hospitals required to report information on the
26 uncompensated care they provide pursuant to federal Medicare
27 cost reporting shall determine, from information that may be
28 provided by a person receiving uncompensated or charity care,
29 whether that person is employed, and if the person is employed

 

 

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1 the identity of the employer. The hospital shall annually
2 submit to the Department a summary report of the employment
3 status information obtained from persons receiving
4 uncompensated or charity care, including available information
5 regarding the cost of the care provided and the number of
6 persons employed by each identified employer.
7     (b) Notwithstanding any other law to the contrary, the
8 Department of Public Aid or its successor agency, in
9 collaboration with the Department of Human Services and the
10 Department of Financial and Professional Regulation, shall
11 annually prepare a public health access program beneficiary
12 employer report to be submitted to the General Assembly. For
13 the purposes of this Section, a "public health access program
14 beneficiary" means a person who receives medical assistance
15 under Title XIX or XXI of the federal Social Security Act.
16     Subject to federal approval, the report shall provide the
17 following information for each employer who has more than 100
18 employees and 25 or more public health access program
19 beneficiaries:
20         (1) The name and address of the qualified employer.
21         (2) The number of public health access program
22     beneficiaries.
23         (3) The number of persons requesting uncompensated or
24     charity care from the hospitals required to report under
25     this Section and the cost of that care.
26         (4) The number of public health access program
27     beneficiaries who are spouses or dependents of employees of
28     the employer.
29         (5) Information on whether the employer offers health
30     insurance benefits to employees and their dependents.
31         (6) Information on whether the employer receives
32     health insurance benefits through the company.
33         (7) Whether an employer offers health insurance
34     benefits, and, if so, information on the level of premium
35     subsidies for such health insurance.
36         (8) The cost to the State of Illinois of providing

 

 

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1     public health access program benefits for the employer's
2     employees and enrolled dependents.
3     (c) The report shall include a description of the
4 methodology used in the collection of the data and an analysis
5 regarding the effect of employment and health coverage on the
6 assistance programs provided by the State. The Department shall
7 include available data regarding: the numbers of employees and
8 dependents of employees; the identity of employers by type of
9 industry and by public, private, profit, or non-profit status;
10 the employees' full-time or part-time status; and other
11 variables that the Department determines essential.
12     (d) The report shall not include the names of any
13 individual public health access program beneficiary and shall
14 be subject to privacy standards both in the Health Insurance
15 Portability and Accountability Act of 1996 and in Title XIX of
16 the federal Social Security Act.
17     (e) The first report shall be submitted on or before
18 October 1, 2006, and subsequent reports shall be submitted on
19 or before that date each year thereafter.
 
20     Section 5-90. Repeal. This Law is repealed on January 1,
21 2009.
 
22
ARTICLE 10.

 
23     Section 10-1. Short title. This Article may be cited as the
24 Illinois Adverse Health Care Events Reporting Law of 2005.
25 References in this Article to "this Law" mean this Article.
 
26     Section 10-5. Purpose. The sole purpose of this Law is to
27 establish an adverse health care event reporting system
28 designed to facilitate quality improvement in the health care
29 system through communication and collaboration between the
30 Department and health care facilities. The reporting system
31 established under this Law shall not be designed or, except as
32 provided in this Law, used to punish errors or to investigate

 

 

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1 or take disciplinary action against health care facilities,
2 health care practitioners, or health care facility employees.
 
3     Section 10-10. Definitions. As used in this Law, the
4 following terms have the following meanings:
5     "Adverse health care event" means any event described in
6 subsections (b) through (g) of Section 10-15.
7     "Department" means the Illinois Department of Public
8 Health.
9     "Health care facility" means a hospital maintained by the
10 State or any department or agency thereof where such department
11 or agency has authority under law to establish and enforce
12 standards for the hospital under its management and control, a
13 hospital maintained by any university or college established
14 under the laws of this State and supported principally by
15 public funds raised by taxation, a hospital licensed under the
16 Hospital Licensing Act, a hospital organized under the
17 University of Illinois Hospital Act, and an ambulatory surgical
18 treatment center licensed under the Ambulatory Surgical
19 Treatment Center Act.
 
20     Section 10-15. Health care facility requirements to
21 report, analyze, and correct.
22     (a) Reports of adverse health care events required. Each
23 health care facility shall report to the Department the
24 occurrence of any of the adverse health care events described
25 in subsections (b) through (g) no later than 30 days after
26 discovery of the event. The report shall be filed in a format
27 specified by the Department and shall identify the health care
28 facility, but shall not include any information identifying or
29 that tends to identify any of the health care professionals,
30 employees, or patients involved.
31     (b) Surgical events. Events reportable under this
32 subsection are:
33         (1) Surgery performed on a wrong body part that is not
34     consistent with the documented informed consent for that

 

 

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1     patient. Reportable events under this clause do not include
2     situations requiring prompt action that occur in the course
3     of surgery or situations whose urgency precludes obtaining
4     informed consent.
5         (2) Surgery performed on the wrong patient.
6         (3) The wrong surgical procedure performed on a patient
7     that is not consistent with the documented informed consent
8     for that patient. Reportable events under this clause do
9     not include situations requiring prompt action that occur
10     in the course of surgery or situations whose urgency
11     precludes obtaining informed consent.
12         (4) Retention of a foreign object in a patient after
13     surgery or other procedure, excluding objects
14     intentionally implanted as part of a planned intervention
15     and objects present prior to surgery that are intentionally
16     retained.
17         (5) Death during or immediately after surgery of a
18     normal, healthy patient who has no organic, physiologic,
19     biochemical, or psychiatric disturbance and for whom the
20     pathologic processes for which the operation is to be
21     performed are localized and do not entail a systemic
22     disturbance.
23     (c) Product or device events. Events reportable under this
24 subsection are:
25         (1) Patient death or serious disability associated
26     with the use of contaminated drugs, devices, or biologics
27     provided by the health care facility when the contamination
28     is the result of generally detectable contaminants in
29     drugs, devices, or biologics regardless of the source of
30     the contamination or the product.
31         (2) Patient death or serious disability associated
32     with the use or function of a device in patient care in
33     which the device is used or functions other than as
34     intended. "Device" includes, but is not limited to,
35     catheters, drains, and other specialized tubes, infusion
36     pumps, and ventilators.

 

 

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1         (3) Patient death or serious disability associated
2     with intravascular air embolism that occurs while being
3     cared for in a health care facility, excluding deaths
4     associated with neurosurgical procedures known to present
5     a high risk of intravascular air embolism.
6     (d) Patient protection events. Events reportable under
7 this subsection are:
8         (1) An infant discharged to the wrong person.
9         (2) Patient death or serious disability associated
10     with patient disappearance for more than 4 hours, excluding
11     events involving adults who have decision-making capacity.
12         (3) Patient suicide or attempted suicide resulting in
13     serious disability while being cared for in a health care
14     facility due to patient actions after admission to the
15     health care facility, excluding deaths resulting from
16     self-inflicted injuries that were the reason for admission
17     to the health care facility.
18     (e) Care management events. Events reportable under this
19 subsection are:
20         (1) Patient death or serious disability associated
21     with a medication error, including, but not limited to,
22     errors involving the wrong drug, the wrong dose, the wrong
23     patient, the wrong time, the wrong rate, the wrong
24     preparation, or the wrong route of administration,
25     excluding reasonable differences in clinical judgment on
26     drug selection and dose.
27         (2) Patient death or serious disability associated
28     with a hemolytic reaction due to the administration of
29     ABO-incompatible blood or blood products.
30         (3) Maternal death or serious disability associated
31     with labor or delivery in a low-risk pregnancy while being
32     cared for in a health care facility, excluding deaths from
33     pulmonary or amniotic fluid embolism, acute fatty liver of
34     pregnancy, or cardiomyopathy.
35         (4) Patient death or serious disability directly
36     related to hypoglycemia, the onset of which occurs while

 

 

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1     the patient is being cared for in a health care facility
2     for a condition unrelated to hypoglycemia.
3     (f) Environmental events. Events reportable under this
4 subsection are:
5         (1) Patient death or serious disability associated
6     with an electric shock while being cared for in a health
7     care facility, excluding events involving planned
8     treatments such as electric countershock.
9         (2) Any incident in which a line designated for oxygen
10     or other gas to be delivered to a patient contains the
11     wrong gas or is contaminated by toxic substances.
12         (3) Patient death or serious disability associated
13     with a burn incurred from any source while being cared for
14     in a health care facility that is not consistent with the
15     documented informed consent for that patient. Reportable
16     events under this clause do not include situations
17     requiring prompt action that occur in the course of surgery
18     or situations whose urgency precludes obtaining informed
19     consent.
20         (4) Patient death associated with a fall while being
21     cared for in a health care facility.
22         (5) Patient death or serious disability associated
23     with the use of restraints or bedrails while being cared
24     for in a health care facility.
25     (g) Physical security events. Events reportable under this
26 subsection are:
27         (1) Any instance of care ordered by or provided by
28     someone impersonating a physician, nurse, pharmacist, or
29     other licensed health care provider.
30         (2) Abduction of a patient of any age.
31         (3) Sexual assault on a patient within or on the
32     grounds of a health care facility.
33         (4) Death or significant injury of a patient or staff
34     member resulting from a physical assault that occurs within
35     or on the grounds of a health care facility.
36     (h) Definitions. As used in this Section 10-15:

 

 

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1      "Death" means patient death related to an adverse event
2 and not related solely to the natural course of the patient's
3 illness or underlying condition. Events otherwise reportable
4 under this Section 10-15 shall be reported even if the death
5 might have otherwise occurred as the natural course of the
6 patient's illness or underlying condition.
7     "Serious disability" means a physical or mental
8 impairment, including loss of a body part, related to an
9 adverse event and not related solely to the natural course of
10 the patient's illness or underlying condition, that
11 substantially limits one or more of the major life activities
12 of an individual or a loss of bodily function, if the
13 impairment or loss lasts more than 7 days prior to discharge or
14 is still present at the time of discharge from an inpatient
15 health care facility.
 
16     Section 10-20. Root cause analysis; corrective action
17 plan. Following the occurrence of an adverse health care event,
18 the health care facility must conduct a root cause analysis of
19 the event. Following the analysis, the health care facility
20 must (i) implement a corrective action plan to address the
21 findings of the analysis or (ii) report to the Department any
22 reasons for not taking corrective action. A copy of the
23 findings of the root cause analysis and a copy of the
24 corrective action plan must be filed with the Department within
25 90 days after the submission of the report to the Department
26 under Section 10-15.
 
27     Section 10-25. Confidentiality. Other than the annual
28 report required under paragraph (4) of Section 10-35 of this
29 Law, adverse health care event reports, findings of root cause
30 analyses, and corrective action plans filed by a health care
31 facility under this Law and records created or obtained by the
32 Department in reviewing or investigating these reports,
33 findings, and plans shall not be available to the public and
34 shall not be discoverable or admissible in any civil, criminal,

 

 

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1 or administrative proceeding against a health care facility or
2 health care professional. No report or Department disclosure
3 under this Law may contain information identifying a patient,
4 employee, or licensed professional. Notwithstanding any other
5 provision of law, under no circumstances shall the Department
6 disclose information obtained from a health care facility that
7 is confidential under Part 21 of Article VIII of the Code of
8 Civil Procedure. Nothing in this Law shall preclude or alter
9 the reporting responsibilities of hospitals or ambulatory
10 surgical treatment centers under existing federal or State law.
 
11     Section 10-30. Establishment of reporting system.
12     (a) The Department shall establish an adverse health event
13 reporting system that will be fully operational by January 1,
14 2008 and designed to facilitate quality improvement in the
15 health care system through communication and collaboration
16 among the Department and health care facilities. The reporting
17 system shall not be designed or used to punish errors or,
18 except to enforce this Law, investigate or take disciplinary
19 action against health care facilities, health care
20 practitioners, or health care facility employees. The
21 Department may not use the adverse health care event reports,
22 findings of the root cause analyses, and corrective action
23 plans filed under this Law for any purpose not stated in this
24 Law, including, but not limited to, using such information for
25 investigating possible violations of the reporting health care
26 facility's licensing act or its regulations. The Department is
27 not authorized to select from or between competing alternate
28 health care treatments, services, or practices.
29     (b) The reporting system shall consist of:
30         (1) Mandatory reporting by health care facilities of
31     adverse health care events.
32         (2) Mandatory completion of a root cause analysis and a
33     corrective action plan by the health care facility and
34     reporting of the findings of the analysis and the plan to
35     the Department or reporting of reasons for not taking

 

 

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1     corrective action.
2         (3) Analysis of reported information by the Department
3     to determine patterns of systemic failure in the health
4     care system and successful methods to correct these
5     failures.
6         (4) Sanctions against health care facilities for
7     failure to comply with reporting system requirements.
8         (5) Communication from the Department to health care
9     facilities, to maximize the use of the reporting system to
10     improve health care quality.
11     (c) In establishing the adverse health event reporting
12 system, including the design of the reporting format and annual
13 report, the Department must consult with and seek input from
14 experts and organizations specializing in patient safety.
15     (d) The Department must design the reporting system so that
16 a health care facility may file by electronic means the reports
17 required under this Law. The Department shall encourage a
18 health care facility to use the electronic filing option when
19 that option is feasible for the health care facility.
20     (e) Nothing in this Section prohibits a health care
21 facility from taking any remedial action in response to the
22 occurrence of an adverse health care event.
 
23     Section 10-35. Analysis of reports; communication of
24 findings. The Department shall do the following:
25         (1) Analyze adverse event reports, corrective action
26     plans, and findings of the root cause analyses to determine
27     patterns of systemic failure in the health care system and
28     successful methods to correct these failures.
29         (2) Communicate to individual health care facilities
30     the Department's conclusions, if any, regarding an adverse
31     event reported by the health care facility.
32         (3) Communicate to relevant health care facilities any
33     recommendations for corrective action resulting from the
34     Department's analysis of submissions from facilities.
35         (4) Publish an annual report that does the following:

 

 

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1             (i) Describes, by institution, adverse health care
2         events reported.
3             (ii) Summarizes, in aggregate form, the corrective
4         action plans and findings of root cause analyses
5         submitted by health care facilities.
6             (iii) Describes adopted recommendations for
7     quality improvement practices.
 
8     Section 10-40. Health Care Event Reporting Advisory
9 Committee. The Department shall appoint a 9-person Health Care
10 Event Reporting Advisory Committee with at least one member
11 from each of the following statewide organizations: one
12 representing hospitals; one representing ambulatory surgical
13 treatment centers; and one representing physicians licensed to
14 practice medicine in all its branches. The committee shall also
15 include other individuals who have expertise and experience in
16 system-based quality improvement and safety and shall include
17 one public member. At least 3 of the 9 members shall be
18 individuals who do not have a financial interest in, or a
19 business relationship with, hospitals or ambulatory surgical
20 treatment centers. The Health Care Event Reporting Advisory
21 Committee shall review the Department's recommendations for
22 potential quality improvement practices and modifications to
23 the list of reportable adverse health care events consistent
24 with national standards. In connection with its review of the
25 Department's recommendations, the committee shall conduct a
26 public hearing seeking input from health care facilities,
27 health care professionals, and the public.
 
28     Section 10-45. Testing period.
29     (a) Prior to the testing period in subsection (b), the
30 Department shall adopt rules for implementing this Law in
31 consultation with the Health Care Event Reporting Advisory
32 Committee and individuals who have experience and expertise in
33 devising and implementing adverse health care event or other
34 heath care quality reporting systems. The rules shall establish

 

 

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1 the methodology and format for health care facilities reporting
2 information under this Law to the Department and shall be
3 finalized before the beginning of the testing period under
4 subsection (b).
5     (b) The Department shall conduct a testing period of at
6 least 6 months to test the reporting process to identify any
7 problems or deficiencies with the planned reporting process.
8     (c) None of the information reported and analyzed during
9 the testing period shall be used in any public report under
10 this Law.
11     (d) The Department must substantially address the problems
12 or deficiencies identified during the testing period before
13 fully implementing the reporting system.
14     (e) After the testing period, and after any corrections,
15 adjustments, or modifications are finalized, the Department
16 must give at least 30 days written notice to health care
17 facilities prior to full implementation of the reporting system
18 and collection of adverse event data that will be used in
19 public reports.
20     (f) Following the testing period, 4 calendar quarters of
21 data must be collected prior to the Department's publishing the
22 annual report of adverse events to the public under paragraph
23 (4) of Section 10-35.
24     (g) The process described in subsections (a) through (e)
25 must be completed by the Department no later than July 1, 2007.
26     (h) Notwithstanding any other provision of law, the
27 Department may contract with an entity for receiving all
28 adverse health care event reports, root cause analysis
29 findings, and corrective action plans that must be reported to
30 the Department under this Law and for the compilation of the
31 information and the provision of quarterly and annual reports
32 to the Department describing such information according to the
33 rules adopted by the Department under this Law.
 
34     Section 10-50. Validity of public reports. None of the
35 information the Department discloses to the public may be made

 

 

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1 available in any form or fashion unless such information is
2 shared with the health care facilities under review prior to
3 public dissemination of such information. Those health care
4 facilities shall have 30 days to make corrections and to add
5 helpful explanatory comments about the information before the
6 publication.
 
7
ARTICLE 90.

 
8     Section 90-5. The Ambulatory Surgical Treatment Center Act
9 is amended by changing Section 10d as follows:
 
10     (210 ILCS 5/10d)  (from Ch. 111 1/2, par. 157-8.10d)
11     Sec. 10d. Fines and penalties.
12     (a) When the Director determines that a facility has failed
13 to comply with this Act or the Illinois Adverse Health Care
14 Events Reporting Law of 2005 or any rule adopted under either
15 of those Acts hereunder, the Department may issue a notice of
16 fine assessment which shall specify the violations for which
17 the fine is assessed. The Department may assess a fine of up to
18 $500 per violation per day commencing on the date the violation
19 was identified and ending on the date the violation is
20 corrected, or action is taken to suspend, revoke or deny
21 renewal of the license, whichever comes first.
22     (b) In determining whether a fine is to be assessed or the
23 amount of such fine, the Director shall consider the following
24 factors:
25         (1) The gravity of the violation, including the
26     probability that death or serious physical or mental harm
27     to a patient will result or has resulted, the severity of
28     the actual or potential harm, and the extent to which the
29     provisions of the applicable statutes or rules were
30     violated;
31         (2) The reasonable diligence exercised by the licensee
32     and efforts to correct violations;
33         (3) Any previous violations committed by the licensee;

 

 

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1     and
2         (4) The financial benefit to the facility of committing
3     or continuing the violation.
4 (Source: P.A. 86-1292.)
 
5     Section 90-10. The Hospital Licensing Act is amended by
6 changing Section 7 as follows:
 
7     (210 ILCS 85/7)  (from Ch. 111 1/2, par. 148)
8     Sec. 7. (a) The Director after notice and opportunity for
9 hearing to the applicant or licensee may deny, suspend, or
10 revoke a permit to establish a hospital or deny, suspend, or
11 revoke a license to open, conduct, operate, and maintain a
12 hospital in any case in which he finds that there has been a
13 substantial failure to comply with the provisions of this Act,
14 or the Hospital Report Card Act, or the Illinois Adverse Health
15 Care Events Reporting Law of 2005 or the standards, rules, and
16 regulations established by virtue of any either of those Acts.
17     (b) Such notice shall be effected by registered mail or by
18 personal service setting forth the particular reasons for the
19 proposed action and fixing a date, not less than 15 days from
20 the date of such mailing or service, at which time the
21 applicant or licensee shall be given an opportunity for a
22 hearing. Such hearing shall be conducted by the Director or by
23 an employee of the Department designated in writing by the
24 Director as Hearing Officer to conduct the hearing. On the
25 basis of any such hearing, or upon default of the applicant or
26 licensee, the Director shall make a determination specifying
27 his findings and conclusions. In case of a denial to an
28 applicant of a permit to establish a hospital, such
29 determination shall specify the subsection of Section 6 under
30 which the permit was denied and shall contain findings of fact
31 forming the basis of such denial. A copy of such determination
32 shall be sent by registered mail or served personally upon the
33 applicant or licensee. The decision denying, suspending, or
34 revoking a permit or a license shall become final 35 days after

 

 

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1 it is so mailed or served, unless the applicant or licensee,
2 within such 35 day period, petitions for review pursuant to
3 Section 13.
4     (c) The procedure governing hearings authorized by this
5 Section shall be in accordance with rules promulgated by the
6 Department and approved by the Hospital Licensing Board. A full
7 and complete record shall be kept of all proceedings, including
8 the notice of hearing, complaint, and all other documents in
9 the nature of pleadings, written motions filed in the
10 proceedings, and the report and orders of the Director and
11 Hearing Officer. All testimony shall be reported but need not
12 be transcribed unless the decision is appealed pursuant to
13 Section 13. A copy or copies of the transcript may be obtained
14 by any interested party on payment of the cost of preparing
15 such copy or copies.
16     (d) The Director or Hearing Officer shall upon his own
17 motion, or on the written request of any party to the
18 proceeding, issue subpoenas requiring the attendance and the
19 giving of testimony by witnesses, and subpoenas duces tecum
20 requiring the production of books, papers, records, or
21 memoranda. All subpoenas and subpoenas duces tecum issued under
22 the terms of this Act may be served by any person of full age.
23 The fees of witnesses for attendance and travel shall be the
24 same as the fees of witnesses before the Circuit Court of this
25 State, such fees to be paid when the witness is excused from
26 further attendance. When the witness is subpoenaed at the
27 instance of the Director, or Hearing Officer, such fees shall
28 be paid in the same manner as other expenses of the Department,
29 and when the witness is subpoenaed at the instance of any other
30 party to any such proceeding the Department may require that
31 the cost of service of the subpoena or subpoena duces tecum and
32 the fee of the witness be borne by the party at whose instance
33 the witness is summoned. In such case, the Department in its
34 discretion, may require a deposit to cover the cost of such
35 service and witness fees. A subpoena or subpoena duces tecum
36 issued as aforesaid shall be served in the same manner as a

 

 

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1 subpoena issued out of a court.
2     (e) Any Circuit Court of this State upon the application of
3 the Director, or upon the application of any other party to the
4 proceeding, may, in its discretion, compel the attendance of
5 witnesses, the production of books, papers, records, or
6 memoranda and the giving of testimony before the Director or
7 Hearing Officer conducting an investigation or holding a
8 hearing authorized by this Act, by an attachment for contempt,
9 or otherwise, in the same manner as production of evidence may
10 be compelled before the court.
11     (f) The Director or Hearing Officer, or any party in an
12 investigation or hearing before the Department, may cause the
13 depositions of witnesses within the State to be taken in the
14 manner prescribed by law for like depositions in civil actions
15 in courts of this State, and to that end compel the attendance
16 of witnesses and the production of books, papers, records, or
17 memoranda.
18 (Source: P.A. 93-563, eff. 1-1-04.)
 
19     Section 90-15. The Illinois Public Aid Code is amended by
20 changing Sections 5A-1, 5A-2, 5A-3, 5A-4, 5A-5, 5A-7, 5A-8,
21 5A-10, 5A-13, and 5A-14 and by adding Section 5A-12.1 as
22 follows:
 
23     (305 ILCS 5/5A-1)  (from Ch. 23, par. 5A-1)
24     Sec. 5A-1. Definitions. As used in this Article, unless
25 the context requires otherwise:
26     "Adjusted gross hospital revenue" shall be determined
27 separately for inpatient and outpatient services for each
28 hospital conducted, operated or maintained by a hospital
29 provider, and means the hospital provider's total gross
30 revenues less: (i) gross revenue attributable to non-hospital
31 based services including home dialysis services, durable
32 medical equipment, ambulance services, outpatient clinics and
33 any other non-hospital based services as determined by the
34 Illinois Department by rule; and (ii) gross revenues

 

 

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1 attributable to the routine services provided to persons
2 receiving skilled or intermediate long-term care services
3 within the meaning of Title XVIII or XIX of the Social Security
4 Act; and (iii) Medicare gross revenue (excluding the Medicare
5 gross revenue attributable to clauses (i) and (ii) of this
6 paragraph and the Medicare gross revenue attributable to the
7 routine services provided to patients in a psychiatric
8 hospital, a rehabilitation hospital, a distinct part
9 psychiatric unit, a distinct part rehabilitation unit, or swing
10 beds). Adjusted gross hospital revenue shall be determined
11 using the most recent data available from each hospital's 2003
12 Medicare cost report as contained in the Healthcare Cost Report
13 Information System file, for the quarter ending on December 31,
14 2004, without regard to any subsequent adjustments or changes
15 to such data. If a hospital's 2003 Medicare cost report is not
16 contained in the Healthcare Cost Report Information System, the
17 hospital provider shall furnish such cost report or the data
18 necessary to determine its adjusted gross hospital revenue as
19 required by rule by the Illinois Department.
20     "Fund" means the Hospital Provider Fund.
21     "Hospital" means an institution, place, building, or
22 agency located in this State that is subject to licensure by
23 the Illinois Department of Public Health under the Hospital
24 Licensing Act, whether public or private and whether organized
25 for profit or not-for-profit.
26     "Hospital provider" means a person licensed by the
27 Department of Public Health to conduct, operate, or maintain a
28 hospital, regardless of whether the person is a Medicaid
29 provider. For purposes of this paragraph, "person" means any
30 political subdivision of the State, municipal corporation,
31 individual, firm, partnership, corporation, company, limited
32 liability company, association, joint stock association, or
33 trust, or a receiver, executor, trustee, guardian, or other
34 representative appointed by order of any court.
35     "Occupied bed days" means the sum of the number of days
36 that each bed was occupied by a patient for all beds during

 

 

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1 calendar year 2001. Occupied bed days shall be computed
2 separately for each hospital operated or maintained by a
3 hospital provider.
4     "Proration factor" means a fraction, the numerator of which
5 is 53 and the denominator of which is 365.
6 (Source: P.A. 93-659, eff. 2-3-04; 93-1066, eff. 1-15-05.)
 
7     (305 ILCS 5/5A-2)  (from Ch. 23, par. 5A-2)
8     (Section scheduled to be repealed on July 1, 2005)
9     Sec. 5A-2. Assessment; no local authorization to tax.
10     (a) Subject to Sections 5A-3 and 5A-10, an annual
11 assessment on inpatient services is imposed on each hospital
12 provider in an amount equal to the hospital's occupied bed days
13 multiplied by $84.19 multiplied by the proration factor for
14 State fiscal year 2004 and the hospital's occupied bed days
15 multiplied by $84.19 for State fiscal year 2005.
16     The Department of Public Aid shall use the number of
17 occupied bed days as reported by each hospital on the Annual
18 Survey of Hospitals conducted by the Department of Public
19 Health to calculate the hospital's annual assessment. If the
20 sum of a hospital's occupied bed days is not reported on the
21 Annual Survey of Hospitals or if there are data errors in the
22 reported sum of a hospital's occupied bed days as determined by
23 the Department of Public Aid, then the Department of Public Aid
24 may obtain the sum of occupied bed days from any source
25 available, including, but not limited to, records maintained by
26 the hospital provider, which may be inspected at all times
27 during business hours of the day by the Department of Public
28 Aid or its duly authorized agents and employees.
29     Subject to Sections 5A-3 and 5A-10, for the privilege of
30 engaging in the occupation of hospital provider, beginning
31 August 1, 2005, an annual assessment is imposed on each
32 hospital provider for State fiscal years 2006, 2007, and 2008,
33 in an amount equal to 2.5835% of the hospital provider's
34 adjusted gross hospital revenue for inpatient services and
35 2.5835% of the hospital provider's adjusted gross hospital

 

 

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1 revenue for outpatient services. If the hospital provider's
2 adjusted gross hospital revenue is not available, then the
3 Illinois Department may obtain the hospital provider's
4 adjusted gross hospital revenue from any source available,
5 including, but not limited to, records maintained by the
6 hospital provider, which may be inspected at all times during
7 business hours of the day by the Illinois Department or its
8 duly authorized agents and employees.
9     (b) Nothing in this Article amendatory Act of the 93rd
10 General Assembly shall be construed to authorize any home rule
11 unit or other unit of local government to license for revenue
12 or to impose a tax or assessment upon hospital providers or the
13 occupation of hospital provider, or a tax or assessment
14 measured by the income or earnings of a hospital provider.
15     (c) As provided in Section 5A-14, this Section is repealed
16 on July 1, 2008 2005.
17 (Source: P.A. 93-659, eff. 2-3-04; 93-841, eff. 7-30-04;
18 93-1066, eff. 1-15-05.)
 
19     (305 ILCS 5/5A-3)  (from Ch. 23, par. 5A-3)
20     Sec. 5A-3. Exemptions.
21     (a) (Blank).
22     (b) A hospital provider that is a State agency, a State
23 university, or a county with a population of 3,000,000 or more
24 is exempt from the assessment imposed by Section 5A-2.
25     (b-2) A hospital provider that is a county with a
26 population of less than 3,000,000 or a township, municipality,
27 hospital district, or any other local governmental unit is
28 exempt from the assessment imposed by Section 5A-2.
29     (b-5) (Blank).
30     (b-10) For State fiscal years 2004 and 2005, a A hospital
31 provider whose hospital does not charge for its services is
32 exempt from the assessment imposed by Section 5A-2, unless the
33 exemption is adjudged to be unconstitutional or otherwise
34 invalid, in which case the hospital provider shall pay the
35 assessment imposed by Section 5A-2.

 

 

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1     (b-15) For State fiscal years 2004 and 2005, a A hospital
2 provider whose hospital is licensed by the Department of Public
3 Health as a psychiatric hospital is exempt from the assessment
4 imposed by Section 5A-2, unless the exemption is adjudged to be
5 unconstitutional or otherwise invalid, in which case the
6 hospital provider shall pay the assessment imposed by Section
7 5A-2.
8     (b-20) For State fiscal years 2004 and 2005, a A hospital
9 provider whose hospital is licensed by the Department of Public
10 Health as a rehabilitation hospital is exempt from the
11 assessment imposed by Section 5A-2, unless the exemption is
12 adjudged to be unconstitutional or otherwise invalid, in which
13 case the hospital provider shall pay the assessment imposed by
14 Section 5A-2.
15     (b-25) For State fiscal years 2004 and 2005, a A hospital
16 provider whose hospital (i) is not a psychiatric hospital,
17 rehabilitation hospital, or children's hospital and (ii) has an
18 average length of inpatient stay greater than 25 days is exempt
19 from the assessment imposed by Section 5A-2, unless the
20 exemption is adjudged to be unconstitutional or otherwise
21 invalid, in which case the hospital provider shall pay the
22 assessment imposed by Section 5A-2.
23     (c) (Blank).
24 (Source: P.A. 93-659, eff. 2-3-04.)
 
25     (305 ILCS 5/5A-4)  (from Ch. 23, par. 5A-4)
26     Sec. 5A-4. Payment of assessment; penalty.
27     (a) The annual assessment imposed by Section 5A-2 for State
28 fiscal year 2004 shall be due and payable on June 18 of the
29 year. The assessment imposed by Section 5A-2 for State fiscal
30 year 2005 shall be due and payable in quarterly installments,
31 each equalling one-fourth of the assessment for the year, on
32 July 19, October 19, January 18, and April 19 of the year. The
33 assessment imposed by Section 5A-2 for State fiscal year 2006
34 and each subsequent State fiscal year shall be due and payable
35 in quarterly installments, each equaling one-fourth of the

 

 

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1 assessment for the year, on the fourteenth State business day
2 of September, December, March, and May. No installment payment
3 of an assessment imposed by Section 5A-2 shall be due and
4 payable, however, until after: (i) the hospital provider
5 receives written notice from the Department of Public Aid that
6 the payment methodologies to hospitals required under Section
7 5A-12 or Section 5A-12.1, whichever is applicable for that
8 fiscal year, have been approved by the Centers for Medicare and
9 Medicaid Services of the U.S. Department of Health and Human
10 Services and the waiver under 42 CFR 433.68 for the assessment
11 imposed by Section 5A-2, if necessary, has been granted by the
12 Centers for Medicare and Medicaid Services of the U.S.
13 Department of Health and Human Services; and (ii) the hospital
14 has received the payments required under Section 5A-12 or
15 Section 5A-12.1, whichever is applicable for that fiscal year.
16 Upon notification to the Department of approval of the payment
17 methodologies required under Section 5A-12 or Section 5A-12.1,
18 whichever is applicable for that fiscal year, and the waiver
19 granted under 42 CFR 433.68, all quarterly installments
20 otherwise due under Section 5A-2 prior to the date of
21 notification shall be due and payable to the Department upon
22 written direction from the Department and receipt of the
23 payments required under Section 5A-12.1.
24     (b) The Illinois Department is authorized to establish
25 delayed payment schedules for hospital providers that are
26 unable to make installment payments when due under this Section
27 due to financial difficulties, as determined by the Illinois
28 Department.
29     (c) If a hospital provider fails to pay the full amount of
30 an installment when due (including any extensions granted under
31 subsection (b)), there shall, unless waived by the Illinois
32 Department for reasonable cause, be added to the assessment
33 imposed by Section 5A-2 a penalty assessment equal to the
34 lesser of (i) 5% of the amount of the installment not paid on
35 or before the due date plus 5% of the portion thereof remaining
36 unpaid on the last day of each 30-day period thereafter or (ii)

 

 

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1 100% of the installment amount not paid on or before the due
2 date. For purposes of this subsection, payments will be
3 credited first to unpaid installment amounts (rather than to
4 penalty or interest), beginning with the most delinquent
5 installments.
6 (Source: P.A. 93-659, eff. 2-3-04; 93-841, eff. 7-30-04;
7 93-1066, eff. 1-15-05.)
 
8     (305 ILCS 5/5A-5)  (from Ch. 23, par. 5A-5)
9     Sec. 5A-5. Notice; penalty; maintenance of records.
10     (a) The Department of Public Aid shall send a notice of
11 assessment to every hospital provider subject to assessment
12 under this Article. The notice of assessment shall notify the
13 hospital of its assessment and shall be sent after within 14
14 days of receipt by the Department of notification from the
15 Centers for Medicare and Medicaid Services of the U.S.
16 Department of Health and Human Services that the payment
17 methodologies required under Section 5A-12 or Section 5A-12.1,
18 whichever is applicable for that fiscal year, and, if
19 necessary, the waiver granted under 42 CFR 433.68 have been
20 approved. The notice shall be on a form prepared by the
21 Illinois Department and shall state the following:
22         (1) The name of the hospital provider.
23         (2) The address of the hospital provider's principal
24     place of business from which the provider engages in the
25     occupation of hospital provider in this State, and the name
26     and address of each hospital operated, conducted, or
27     maintained by the provider in this State.
28         (3) The occupied bed days or adjusted gross hospital
29     revenue of the hospital provider (whichever is
30     applicable), the amount of assessment imposed under
31     Section 5A-2 for the State fiscal year for which the notice
32     is sent, and the amount of each quarterly installment to be
33     paid during the State fiscal year.
34         (4) (Blank).
35         (5) Other reasonable information as determined by the

 

 

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1     Illinois Department.
2     (b) If a hospital provider conducts, operates, or maintains
3 more than one hospital licensed by the Illinois Department of
4 Public Health, the provider shall pay the assessment for each
5 hospital separately.
6     (c) Notwithstanding any other provision in this Article, in
7 the case of a person who ceases to conduct, operate, or
8 maintain a hospital in respect of which the person is subject
9 to assessment under this Article as a hospital provider, the
10 assessment for the State fiscal year in which the cessation
11 occurs shall be adjusted by multiplying the assessment computed
12 under Section 5A-2 by a fraction, the numerator of which is the
13 number of days in the year during which the provider conducts,
14 operates, or maintains the hospital and the denominator of
15 which is 365. Immediately upon ceasing to conduct, operate, or
16 maintain a hospital, the person shall pay the assessment for
17 the year as so adjusted (to the extent not previously paid).
18     (d) Notwithstanding any other provision in this Article, a
19 provider who commences conducting, operating, or maintaining a
20 hospital, upon notice by the Illinois Department, shall pay the
21 assessment computed under Section 5A-2 and subsection (e) in
22 installments on the due dates stated in the notice and on the
23 regular installment due dates for the State fiscal year
24 occurring after the due dates of the initial notice.
25     (e) Notwithstanding any other provision in this Article,
26 for State fiscal years 2004 and 2005, in the case of a hospital
27 provider that did not conduct, operate, or maintain a hospital
28 throughout calendar year 2001, the assessment for that State
29 fiscal year shall be computed on the basis of hypothetical
30 occupied bed days for the full calendar year as determined by
31 the Illinois Department. Notwithstanding any other provision
32 in this Article, for State fiscal years after 2005, in the case
33 of a hospital provider that did not conduct, operate, or
34 maintain a hospital in 2003, the assessment for that State
35 fiscal year shall be computed on the basis of hypothetical
36 adjusted gross hospital revenue for the hospital's first full

 

 

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1 fiscal year as determined by the Illinois Department (which may
2 be based on annualization of the provider's actual revenues for
3 a portion of the year, or revenues of a comparable hospital for
4 the year, including revenues realized by a prior provider of
5 the same hospital during the year).
6     (f) Every hospital provider subject to assessment under
7 this Article shall keep sufficient records to permit the
8 determination of adjusted gross hospital revenue for the
9 hospital's fiscal year. All such records shall be kept in the
10 English language and shall, at all times during regular
11 business hours of the day, be subject to inspection by the
12 Illinois Department or its duly authorized agents and
13 employees. (Blank).
14     (g) The Illinois Department may, by rule, provide a
15 hospital provider a reasonable opportunity to request a
16 clarification or correction of any clerical or computational
17 errors contained in the calculation of its assessment, but such
18 corrections shall not extend to updating the cost report
19 information used to calculate the assessment. (Blank).
20     (h) (Blank).
21 (Source: P.A. 93-659, eff. 2-3-04; 93-841, eff. 7-30-04.)
 
22     (305 ILCS 5/5A-7)  (from Ch. 23, par. 5A-7)
23     Sec. 5A-7. Administration; enforcement provisions.
24     (a) The Illinois Department shall establish and maintain a
25 listing of all hospital providers appearing in the licensing
26 records of the Illinois Department of Public Health, which
27 shall show each provider's name and principal place of business
28 and the name and address of each hospital operated, conducted,
29 or maintained by the provider in this State. The Illinois
30 Department shall administer and enforce this Article and
31 collect the assessments and penalty assessments imposed under
32 this Article using procedures employed in its administration of
33 this Code generally. The Illinois Department, its Director, and
34 every hospital provider subject to assessment under this
35 Article measured by occupied bed days shall have the following

 

 

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1 powers, duties, and rights:
2         (1) The Illinois Department may initiate either
3     administrative or judicial proceedings, or both, to
4     enforce provisions of this Article. Administrative
5     enforcement proceedings initiated hereunder shall be
6     governed by the Illinois Department's administrative
7     rules. Judicial enforcement proceedings initiated
8     hereunder shall be governed by the rules of procedure
9     applicable in the courts of this State.
10         (2) No proceedings for collection, refund, credit, or
11     other adjustment of an assessment amount shall be issued
12     more than 3 years after the due date of the assessment,
13     except in the case of an extended period agreed to in
14     writing by the Illinois Department and the hospital
15     provider before the expiration of this limitation period.
16         (3) Any unpaid assessment under this Article shall
17     become a lien upon the assets of the hospital upon which it
18     was assessed. If any hospital provider, outside the usual
19     course of its business, sells or transfers the major part
20     of any one or more of (A) the real property and
21     improvements, (B) the machinery and equipment, or (C) the
22     furniture or fixtures, of any hospital that is subject to
23     the provisions of this Article, the seller or transferor
24     shall pay the Illinois Department the amount of any
25     assessment, assessment penalty, and interest (if any) due
26     from it under this Article up to the date of the sale or
27     transfer. If the seller or transferor fails to pay any
28     assessment, assessment penalty, and interest (if any) due,
29     the purchaser or transferee of such asset shall be liable
30     for the amount of the assessment, penalties, and interest
31     (if any) up to the amount of the reasonable value of the
32     property acquired by the purchaser or transferee. The
33     purchaser or transferee shall continue to be liable until
34     the purchaser or transferee pays the full amount of the
35     assessment, penalties, and interest (if any) up to the
36     amount of the reasonable value of the property acquired by

 

 

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1     the purchaser or transferee or until the purchaser or
2     transferee receives from the Illinois Department a
3     certificate showing that such assessment, penalty, and
4     interest have been paid or a certificate from the Illinois
5     Department showing that no assessment, penalty, or
6     interest is due from the seller or transferor under this
7     Article.
8         (4) Payments under this Article are not subject to the
9     Illinois Prompt Payment Act. Credits or refunds shall not
10     bear interest.
11     (b) In addition to any other remedy provided for and
12 without sending a notice of assessment liability, the Illinois
13 Department may collect an unpaid assessment by withholding, as
14 payment of the assessment, reimbursements or other amounts
15 otherwise payable by the Illinois Department to the hospital
16 provider.
17 (Source: P.A. 93-659, eff. 2-3-04; 93-841, eff. 7-30-04.)
 
18     (305 ILCS 5/5A-8)  (from Ch. 23, par. 5A-8)
19     Sec. 5A-8. Hospital Provider Fund.
20     (a) There is created in the State Treasury the Hospital
21 Provider Fund. Interest earned by the Fund shall be credited to
22 the Fund. The Fund shall not be used to replace any moneys
23 appropriated to the Medicaid program by the General Assembly.
24     (b) The Fund is created for the purpose of receiving moneys
25 in accordance with Section 5A-6 and disbursing moneys only for
26 the following purposes, notwithstanding any other provision of
27 law:
28         (1) For making payments to hospitals as required under
29     Articles V, VI, and XIV of this Code and under the
30     Children's Health Insurance Program Act.
31         (2) For the reimbursement of moneys collected by the
32     Illinois Department from hospitals or hospital providers
33     through error or mistake in performing the activities
34     authorized under this Article and Article V of this Code.
35         (3) For payment of administrative expenses incurred by

 

 

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1     the Illinois Department or its agent in performing the
2     activities authorized by this Article.
3         (4) For payments of any amounts which are reimbursable
4     to the federal government for payments from this Fund which
5     are required to be paid by State warrant.
6         (5) For making transfers, as those transfers are
7     authorized in the proceedings authorizing debt under the
8     Short Term Borrowing Act, but transfers made under this
9     paragraph (5) shall not exceed the principal amount of debt
10     issued in anticipation of the receipt by the State of
11     moneys to be deposited into the Fund.
12         (6) For making transfers to any other fund in the State
13     treasury, but transfers made under this paragraph (6) shall
14     not exceed the amount transferred previously from that
15     other fund into the Hospital Provider Fund.
16         (7) For State fiscal years 2004 and 2005 for making
17     transfers to the Health and Human Services Medicaid Trust
18     Fund, including 20% of the moneys received from hospital
19     providers under Section 5A-4 and transferred into the
20     Hospital Provider Fund under Section 5A-6. For State fiscal
21     years 2006, 2007 and 2008 for making transfers to the
22     Health and Human Services Medicaid Trust Fund of up to
23     $130,000,000 per year of the moneys received from hospital
24     providers under Section 5A-4 and transferred into the
25     Hospital Provider Fund under Section 5A-6. Transfers under
26     this paragraph shall be made within 7 days after the
27     payments have been received pursuant to the schedule of
28     payments provided in subsection (a) of Section 5A-4.
29         (8) For making refunds to hospital providers pursuant
30     to Section 5A-10.
31     Disbursements from the Fund, other than transfers
32 authorized under paragraphs (5) and (6) of this subsection,
33 shall be by warrants drawn by the State Comptroller upon
34 receipt of vouchers duly executed and certified by the Illinois
35 Department.
36     (c) The Fund shall consist of the following:

 

 

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1         (1) All moneys collected or received by the Illinois
2     Department from the hospital provider assessment imposed
3     by this Article.
4         (2) All federal matching funds received by the Illinois
5     Department as a result of expenditures made by the Illinois
6     Department that are attributable to moneys deposited in the
7     Fund.
8         (3) Any interest or penalty levied in conjunction with
9     the administration of this Article.
10         (4) Moneys transferred from another fund in the State
11     treasury.
12         (5) All other moneys received for the Fund from any
13     other source, including interest earned thereon.
14     (d) (Blank).
15 (Source: P.A. 93-659, eff. 2-3-04.)
 
16     (305 ILCS 5/5A-10)  (from Ch. 23, par. 5A-10)
17     Sec. 5A-10. Applicability.
18     (a) The assessment imposed by Section 5A-2 shall not take
19 effect or shall cease to be imposed, and any moneys remaining
20 in the Fund shall be refunded to hospital providers in
21 proportion to the amounts paid by them, if:
22         (1) the sum of the appropriations for State fiscal
23     years 2004 and 2005 from the General Revenue Fund for
24     hospital payments under the medical assistance program is
25     less than $4,500,000,000 or the appropriation for each of
26     State fiscal years 2006, 2007 and 2008 from the General
27     Revenue Fund for hospital payments under the medical
28     assistance program is less than $2,500,000,000 increased
29     annually to reflect any increase in the number of
30     recipients; or
31         (2) the Department of Public Aid makes changes in its
32     rules that reduce the hospital inpatient or outpatient
33     payment rates, including adjustment payment rates, in
34     effect on October 1, 2004 2003, except for hospitals
35     described in subsection (b) of Section 5A-3 and except for

 

 

SB0157 Enrolled - 29 - LRB094 07276 DRJ 37433 b

1     changes in the methodology for calculating outlier
2     payments to hospitals for exceptionally costly stays and
3     except for changes in outpatient payment rates made to
4     comply with the federal Health Insurance Portability and
5     Accountability Act, so long as those changes do not reduce
6     aggregate expenditures below the amount expended in State
7     fiscal year 2005 2003 for such services; or
8         (3) the payments to hospitals required under Section
9     5A-12 are changed or are not eligible for federal matching
10     funds under Title XIX or XXI of the Social Security Act.
11     (b) The assessment imposed by Section 5A-2 shall not take
12 effect or shall cease to be imposed if the assessment is
13 determined to be an impermissible tax under Title XIX of the
14 Social Security Act. Moneys in the Hospital Provider Fund
15 derived from assessments imposed prior thereto shall be
16 disbursed in accordance with Section 5A-8 to the extent federal
17 matching is not reduced due to the impermissibility of the
18 assessments, and any remaining moneys shall be refunded to
19 hospital providers in proportion to the amounts paid by them.
20 (Source: P.A. 93-659, eff. 2-3-04.)
 
21     (305 ILCS 5/5A-12.1 new)
22     Sec. 5A-12.1. Hospital access improvement payments.
23     (a) To preserve and improve access to hospital services,
24 for hospital services rendered on or after August 1, 2005, the
25 Department of Public Aid shall make payments to hospitals as
26 set forth in this Section, except for hospitals described in
27 subsection (b) of Section 5A-3. These payments shall be paid on
28 a quarterly basis. For State fiscal year 2006, once the
29 approval of the payment methodology required under this Section
30 and any waiver required under 42 CFR 433.68 by the Centers for
31 Medicare and Medicaid Services of the U.S. Department of Health
32 and Human Services is received, the Department shall pay the
33 total amounts required for fiscal year 2006 under this Section
34 within 100 days of the latest notification. In State fiscal
35 years 2007 and 2008, the total amounts required under this

 

 

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1 Section shall be paid in 4 equal installments on or before the
2 seventh State business day of September, December, March, and
3 May, except that if the date of notification of the approval of
4 the payment methodologies required under this Section and any
5 waiver required under 42 CFR 433.68 is on or after July 1,
6 2006, the sum of amounts required under this Section prior to
7 the date of notification shall be paid within 100 days of the
8 date of the last notification. Payments under this Section are
9 not due and payable, however, until (i) the methodologies
10 described in this Section are approved by the federal
11 government in an appropriate State Plan amendment, (ii) the
12 assessment imposed under this Article is determined to be a
13 permissible tax under Title XIX of the Social Security Act, and
14 (iii) the assessment is in effect.
15     (b) Medicaid eligibility payment. In addition to amounts
16 paid for inpatient hospital services, the Department shall pay
17 each Illinois hospital (except for hospitals described in
18 Section 5A-3) for each inpatient Medicaid admission in State
19 fiscal year 2003, $430 multiplied by the percentage by which
20 the number of Medicaid recipients in the county in which the
21 hospital is located increased from State fiscal year 1998 to
22 State fiscal year 2003.
23     (c) Medicaid high volume adjustment.
24         (1) In addition to rates paid for inpatient hospital
25     services, the Department shall pay to each Illinois
26     hospital (except for hospitals that qualify for Medicaid
27     Percentage Adjustment payments under 89 Ill. Adm. Code
28     148.122 for the 12-month period beginning on October 1,
29     2004) that provided more than 10,000 Medicaid inpatient
30     days of care (determined using the hospital's fiscal year
31     2002 Medicaid cost report on file with the Department on
32     July 1, 2004) amounts as follows:
33             (i) for hospitals that provided more than 10,000
34         Medicaid inpatient days of care but less than or equal
35         to 14,500 Medicaid inpatient days of care, $90 for each
36         Medicaid inpatient day of care provided during that

 

 

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1         period; and
2             (ii) for hospitals that provided more than 14,500
3         Medicaid inpatient days of care but less than or equal
4         to 18,500 Medicaid inpatient days of care, $135 for
5         each Medicaid inpatient day of care provided during
6         that period; and
7             (iii) for hospitals that provided more than 18,500
8         Medicaid inpatient days of care but less than or equal
9         to 20,000 Medicaid inpatient days of care, $225 for
10         each Medicaid inpatient day of care provided during
11         that period; and
12             (iv) for hospitals that provided more than 20,000
13         Medicaid inpatient days of care, $900 for each Medicaid
14         inpatient day of care provided during that period.
15         Provided, however, that no hospital shall receive more
16     than $19,000,000 per year in such payments under
17     subparagraphs (i), (ii), (iii), and (iv).
18         (2) In addition to rates paid for inpatient hospital
19     services, the Department shall pay to each Illinois general
20     acute care hospital that as of October 1, 2004, qualified
21     for Medicaid percentage adjustment payments under 89 Ill.
22     Adm. Code 148.122 and provided more than 21,000 Medicaid
23     inpatient days of care (determined using the hospital's
24     fiscal year 2002 Medicaid cost report on file with the
25     Department on July 1, 2004) $35 for each Medicaid inpatient
26     day of care provided during that period. Provided, however,
27     that no hospital shall receive more than $1,200,000 per
28     year in such payments.
29     (d) Intensive care adjustment. In addition to rates paid
30 for inpatient services, the Department shall pay an adjustment
31 payment to each Illinois general acute care hospital located in
32 a large urban area that, based on the hospital's fiscal year
33 2002 Medicaid cost report, had a ratio of Medicaid intensive
34 care unit days to total Medicaid days greater than 19%. If such
35 ratio for the hospital is less than 30%, the hospital shall be
36 paid an adjustment payment for each Medicaid inpatient day of

 

 

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1 care provided equal to $1,000 multiplied by the hospital's
2 ratio of Medicaid intensive care days to total Medicaid days.
3 If such ratio for the hospital is equal to or greater than 30%,
4 the hospital shall be paid an adjustment payment for each
5 Medicaid inpatient day of care provided equal to $2,800
6 multiplied by the hospital's ratio of Medicaid intensive care
7 days to total Medicaid days.
8     (e) Trauma center adjustments.
9         (1) In addition to rates paid for inpatient hospital
10     services, the Department shall pay to each Illinois general
11     acute care hospital that as of January 1, 2005, was
12     designated as a Level I trauma center and is either located
13     in a large urban area or is located in an other urban area
14     and as of October 1, 2004 qualified for Medicaid percentage
15     adjustment payments under 89 Ill. Adm. Code 148.122, a
16     payment equal to $800 multiplied by the hospital's Medicaid
17     intensive care unit days (excluding Medicare crossover
18     days). This payment shall be calculated based on data from
19     the hospital's 2002 cost report on file with the Department
20     on July 1, 2004. For hospitals located in large urban areas
21     outside of a city with a population in excess of 1,000,000
22     people, the payment required under this subsection shall be
23     multiplied by 4.5. For hospitals located in other urban
24     areas, the payment required under this subsection shall be
25     multiplied by 8.5.
26         (2) In addition to rates paid for inpatient hospital
27     services, the Department shall pay an additional payment to
28     each Illinois general acute care hospital that as of
29     January 1, 2005, was designated as a Level II trauma center
30     and is located in a county with a population in excess of
31     3,000,000 people. The payment shall equal $4,000 per day
32     for the first 500 Medicaid inpatient days, $2,000 per day
33     for the Medicaid inpatient days between 501 and 1,500, and
34     $100 per day for any Medicaid inpatient day in excess of
35     1,500. This payment shall be calculated based on data from
36     the hospital's 2002 cost report on file with the Department

 

 

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1     on July 1, 2004.
2         (3) In addition to rates paid for inpatient hospital
3     services, the Department shall pay an additional payment to
4     each Illinois general acute care hospital that as of
5     January 1, 2005, was designated as a Level II trauma
6     center, is located in a large urban area outside of a
7     county with a population in excess of 3,000,000 people, and
8     as of January 1, 2005, was designated a Level III perinatal
9     center or designated a Level II or II+ prenatal center that
10     has a ratio of Medicaid intensive care unit days to total
11     Medicaid days greater than 5%. The payment shall equal
12     $4,000 per day for the first 500 Medicaid inpatient days,
13     $2,000 per day for the Medicaid inpatient days between 501
14     and 1,500, and $100 per day for any Medicaid inpatient day
15     in excess of 1,500. This payment shall be calculated based
16     on data from the hospital's 2002 cost report on file with
17     the Department on July 1, 2004.
18         (4) In addition to rates paid for inpatient hospital
19     services, the Department shall pay an additional payment to
20     each Illinois children's hospital that as of January 1,
21     2005, was designated a Level I pediatric trauma center that
22     had more than 30,000 Medicaid days in State fiscal year
23     2003 and to each Level I pediatric trauma center located
24     outside of Illinois and that had more than 700 Illinois
25     Medicaid cases in State fiscal year 2003. The amount of
26     such payment shall equal $325 multiplied by the hospital's
27     Medicaid intensive care unit days, and this payment shall
28     be multiplied by 2.25 for hospitals located outside of
29     Illinois. This payment shall be calculated based on data
30     from the hospital's 2002 cost report on file with the
31     Department on July 1, 2004.
32         (5) Notwithstanding any other provision of this
33     subsection, a children's hospital, as defined in 89 Ill.
34     Adm. Code 149.50(c)(3)(B), is not eligible for the payments
35     described in paragraphs (1), (2), and (3) of this
36     subsection.

 

 

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1     (f) Psychiatric rate adjustment.
2         (1) In addition to rates paid for inpatient psychiatric
3     services, the Department shall pay each Illinois
4     psychiatric hospital and general acute care hospital with a
5     distinct part psychiatric unit, for each Medicaid
6     inpatient psychiatric day of care provided in State fiscal
7     year 2003, an amount equal to $420 less the hospital's per
8     diem rate for Medicaid inpatient psychiatric services as in
9     effect on July 1, 2002. In no event, however, shall that
10     amount be less than zero.
11         (2) For Illinois psychiatric hospitals and distinct
12     part psychiatric units of Illinois general acute care
13     hospitals whose inpatient per diem rate as in effect on
14     July 1, 2002 is greater than $420, the Department shall
15     pay, in addition to any other amounts authorized under this
16     Code, $40 for each Medicaid inpatient psychiatric day of
17     care provided in State fiscal year 2003.
18         (3) In addition to rates paid for inpatient psychiatric
19     services, for Illinois psychiatric hospitals located in a
20     county with a population in excess of 3,000,000 people that
21     did not qualify for Medicaid percentage adjustment
22     payments under 89 Ill. Adm. Code 148.122 for the 12-month
23     period beginning on October 1, 2004, the Illinois
24     Department shall make an adjustment payment of $150 for
25     each Medicaid inpatient psychiatric day of care provided by
26     the hospital in State fiscal year 2003. In addition to
27     rates paid for inpatient psychiatric services, for
28     Illinois psychiatric hospitals located in a county with a
29     population in excess of 3,000,000 people, but outside of a
30     city with a population in excess of 1,000,000 people, that
31     did qualify for Medicaid percentage adjustment payments
32     under 89 Ill. Adm. Code 148.122 for the 12-month period
33     beginning on October 1, 2004, the Illinois Department shall
34     make an adjustment payment of $20 for each Medicaid
35     inpatient psychiatric day of care provided by the hospital
36     in State fiscal year 2003.

 

 

SB0157 Enrolled - 35 - LRB094 07276 DRJ 37433 b

1     (g) Rehabilitation adjustment.
2         (1) In addition to rates paid for inpatient
3     rehabilitation services, the Department shall pay each
4     Illinois general acute care hospital with a distinct part
5     rehabilitation unit that had at least 40 beds as reported
6     on the hospital's 2003 Medicaid cost report on file with
7     the Department as of March 31, 2005, for each Medicaid
8     inpatient day of care provided during State fiscal year
9     2003, an amount equal to $230.
10         (2) In addition to rates paid for inpatient
11     rehabilitation services, for Illinois rehabilitation
12     hospitals that did not qualify for Medicaid percentage
13     adjustment payments under 89 Ill. Adm. Code 148.122 for the
14     12-month period beginning on October 1, 2004, the Illinois
15     Department shall make an adjustment payment of $200 for
16     each Medicaid inpatient day of care provided during State
17     fiscal year 2003.
18     (h) Supplemental tertiary care adjustment. In addition to
19 rates paid for inpatient services, the Department shall pay to
20 each Illinois hospital eligible for tertiary care adjustment
21 payments under 89 Ill. Adm. Code 148.296, as in effect for
22 State fiscal year 2005, a supplemental tertiary care adjustment
23 payment equal to 2.5 multiplied by the tertiary care adjustment
24 payment required under 89 Ill. Adm. Code 148.296, as in effect
25 for State fiscal year 2005.
26     (i) Crossover percentage adjustment. In addition to rates
27 paid for inpatient services, the Department shall pay each
28 Illinois general acute care hospital, excluding any hospital
29 defined as a cancer center hospital in rules by the Department,
30 located in an urban area that provided over 500 days of
31 inpatient care to Medicaid recipients, that had a ratio of
32 crossover days to total Medicaid days, utilizing information
33 used for the Medicaid percentage adjustment determination
34 described in 84 Ill. Adm. Code 148.122, effective October 1,
35 2004, of greater than 40%, and that does not qualify for
36 Medicaid percentage adjustment payments under 89 Ill. Adm. Code

 

 

SB0157 Enrolled - 36 - LRB094 07276 DRJ 37433 b

1 148.122, on October 1, 2004, an amount as follows:
2         (1) for hospitals located in an other urban area, $140
3     per Medicaid inpatient day (including crossover days);
4         (2) for hospitals located in a large urban area whose
5     ratio of crossover days to total Medicaid days is less than
6     55%, $350 per Medicaid inpatient day (including crossover
7     days);
8         (3) for hospitals located in a large urban area whose
9     ratio of crossover days to total Medicaid days is equal to
10     or greater than 55%, $1,400 per Medicaid inpatient day
11     (including crossover days).
12     The term "Medicaid days" in paragraphs (1), (2), and (3) of
13 this subsection (i) means the Medicaid days utilized for the
14 Medicaid percentage adjustment determination described in 89
15 Ill. Adm. Code 148.122 for the October 1, 2004 determination.
16     (j) Long term acute care hospital adjustment. In addition
17 to rates paid for inpatient services, the Department shall pay
18 each Illinois long term acute care hospital that, as of October
19 1, 2004, qualified for a Medicaid percentage adjustment under
20 89 Ill. Adm. Code 148.122, $125 for each Medicaid inpatient day
21 of care provided in State fiscal year 2003. In addition to
22 rates paid for inpatient services, the Department shall pay
23 each long term acute care hospital that, as of October 1, 2004,
24 did not qualify for a Medicaid percentage adjustment under 89
25 Ill. Adm. Code 148.122, $1,250 for each Medicaid inpatient day
26 of care provided in State fiscal year 2003. For purposes of
27 this subsection, "long term acute care hospital" means a
28 hospital that (i) is not a psychiatric hospital, rehabilitation
29 hospital, or children's hospital and (ii) has an average length
30 of inpatient stay greater than 25 days.
31     (k) Obstetrical care adjustments.
32         (1) In addition to rates paid for inpatient services,
33     the Department shall pay each Illinois hospital an amount
34     equal to $550 multiplied by each Medicaid obstetrical day
35     of care provided by the hospital in State fiscal year 2003.
36         (2) In addition to rates paid for inpatient services,

 

 

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1     the Department shall pay each Illinois hospital that
2     qualified as a Medicaid disproportionate share hospital
3     under 89 Ill. Adm. Code 148.120 as of October 1, 2004, and
4     that had a Medicaid obstetrical percentage greater than 10%
5     and a Medicaid emergency care percentage greater than 40%,
6     an amount equal to $650 multiplied by each Medicaid
7     obstetrical day of care provided by the hospital in State
8     fiscal year 2003.
9         (3) In addition to rates paid for inpatient services,
10     the Department shall pay each Illinois hospital that is
11     located in the St. Louis metropolitan statistical area and
12     that provided more than 500 Medicaid obstetrical days of
13     care in State fiscal year 2003, an amount equal to $1,800
14     multiplied by each Medicaid obstetrical day of care
15     provided by the hospital in State fiscal year 2003.
16         (4) In addition to rates paid for inpatient services,
17     the Department shall pay $600 for each Medicaid obstetrical
18     day of care provided in State fiscal year 2003 by each
19     Illinois hospital that (i) is located in a large urban
20     area, (ii) is located in a county whose number of Medicaid
21     recipients increased from State fiscal year 1998 to State
22     fiscal year 2003 by more than 60%, and (iii) that had a
23     Medicaid obstetrical percentage used for the October 1,
24     2004, Medicaid percentage adjustment determination
25     described in 89 Ill. Adm. Code 148.122 greater than 25%.
26         (5) In addition to rates paid for inpatient services,
27     the Department shall pay $400 for each Medicaid obstetrical
28     day of care provided in State fiscal year 2003 by each
29     Illinois rural hospital that (i) was designated a Level II
30     perinatal center as of January 1, 2005, (ii) had a Medicaid
31     inpatient utilization rate greater than 34% in State fiscal
32     year 2002, and (iii) had a Medicaid obstetrical percentage
33     used for the October 1, 2004, Medicaid percentage
34     adjustment determination described in 89 Ill. Adm. Code
35     148.122 greater than 15%.
36     (l) Outpatient access payments. In addition to the rates

 

 

SB0157 Enrolled - 38 - LRB094 07276 DRJ 37433 b

1 paid for outpatient hospital services, the Department shall pay
2 each Illinois hospital (except for hospitals described in
3 Section 5A-3), an amount equal to 2.38 multiplied by the
4 hospital's outpatient ambulatory procedure listing payments
5 for services provided during State fiscal year 2003 multiplied
6 by the percentage by which the number of Medicaid recipients in
7 the county in which the hospital is located increased from
8 State fiscal year 1998 to State fiscal year 2003.
9     (m) Outpatient utilization payment.
10         (1) In addition to the rates paid for outpatient
11     hospital services, the Department shall pay each Illinois
12     rural hospital, an amount equal to 1.7 multiplied by the
13     hospital's outpatient ambulatory procedure listing
14     payments for services provided during State fiscal year
15     2003.
16         (2) In addition to the rates paid for outpatient
17     hospital services, the Department shall pay each Illinois
18     hospital located in an urban area, an amount equal to 0.45
19     multiplied by the hospital's outpatient ambulatory
20     procedure listing payments received for services provided
21     during State fiscal year 2003.
22     (n) Outpatient complexity of care adjustment. In addition
23 to the rates paid for outpatient hospital services, the
24 Department shall pay each Illinois hospital located in an urban
25 area an amount equal to 2.55 multiplied by the hospital's
26 emergency care percentage multiplied by the hospital's
27 outpatient ambulatory procedure listing payments received for
28 services provided during State fiscal year 2003. For children's
29 hospitals with an inpatient utilization rate used for the
30 October 1, 2004, Medicaid percentage adjustment determination
31 described in 89 Ill. Adm. Code 148.122 greater than 90%, this
32 adjustment shall be multiplied by 2. For cancer center
33 hospitals, this adjustment shall be multiplied by 3.
34     (o) Rehabilitation hospital adjustment. In addition to the
35 rates paid for outpatient hospital services, the Department
36 shall pay each Illinois freestanding rehabilitation hospital

 

 

SB0157 Enrolled - 39 - LRB094 07276 DRJ 37433 b

1 that does not qualify for a Medicaid percentage adjustment
2 under 89 Ill. Adm. Code 148.122 as of October 1, 2004, an
3 amount equal to 3 multiplied by the hospital's outpatient
4 ambulatory procedure listing payments for Group 6A services
5 provided during State fiscal year 2003.
6     (p) Perinatal outpatient adjustment. In addition to the
7 rates paid for outpatient hospital services, the Department
8 shall pay an adjustment payment to each large urban general
9 acute care hospital that is designated as a perinatal center as
10 of January 1, 2005, has a Medicaid obstetrical percentage of at
11 least 10% used for the October 1, 2004, Medicaid percentage
12 adjustment determination described in 89 Ill. Adm. Code
13 148.122, has a Medicaid intensive care unit percentage of at
14 least 3%, and has a ratio of ambulatory procedure listing Level
15 3 services to total ambulatory procedure listing services of at
16 least 50%. The amount of the adjustment payment under this
17 subsection shall be $550 multiplied by the hospital's
18 outpatient ambulatory procedure listing Level 3A services
19 provided in State fiscal year 2003. If the hospital, as of
20 January 1, 2005, was designated a Level III or II+ perinatal
21 center, the adjustment payments required by this subsection
22 shall be multiplied by 4.
23     (q) Supplemental psychiatric adjustment payments. In
24 addition to rates paid for inpatient services, the Department
25 shall pay to each Illinois hospital that does not qualify for
26 Medicaid percentage adjustments described in 89 Ill. Adm. Code
27 148.122 but is eligible for psychiatric adjustment payments
28 under 89 Ill. Adm. Code 148.105 for State fiscal year 2005, a
29 supplemental psychiatric adjustment payment equal to 0.7
30 multiplied by the psychiatric adjustment payment required
31 under 89 Ill. Adm. Code 148.105, as in effect for State fiscal
32 year 2005.
33     (r) Outpatient community access adjustment. In addition to
34 the rates paid for outpatient hospital services, the Department
35 shall pay an adjustment payment to each general acute care
36 hospital that is designated as a perinatal center as of January

 

 

SB0157 Enrolled - 40 - LRB094 07276 DRJ 37433 b

1 1, 2005, that had a Medicaid obstetrical percentage used for
2 the October 1, 2004, Medicaid percentage adjustment
3 determination described in 89 Ill. Adm. Code 148.122 of at
4 least 12.5%, that had a ratio of crossover days to total
5 Medicaid days utilizing information used for the Medicaid
6 percentage adjustment described in 89 Ill. Adm. Code 148.122
7 determination effective October 1, 2004, of greater than or
8 equal to 25%, and that qualified for the Medicaid percentage
9 adjustment payments under 89 Ill. Adm. Code 148.122 on October
10 1, 2004, an amount equal to $100 multiplied by the hospital's
11 outpatient ambulatory procedure listing services provided
12 during State fiscal year 2003.
13     (s) Definitions. Unless the context requires otherwise or
14 unless provided otherwise in this Section, the terms used in
15 this Section for qualifying criteria and payment calculations
16 shall have the same meanings as those terms have been given in
17 the Illinois Department's administrative rules as in effect on
18 May 1, 2005. Other terms shall be defined by the Illinois
19 Department by rule.
20     As used in this Section, unless the context requires
21 otherwise:
22     "Emergency care percentage" means a fraction, the
23 numerator of which is the total Group 3 ambulatory procedure
24 listing services provided by the hospital in State fiscal year
25 2003, and the denominator of which is the total ambulatory
26 procedure listing services provided by the hospital in State
27 fiscal year 2003.
28     "Large urban area" means an area located within a
29 metropolitan statistical area, as defined by the U.S. Office of
30 Management and Budget in OMB Bulletin 04-03, dated February 18,
31 2004, with a population in excess of 1,000,000.
32     "Medicaid intensive care unit days" means the number of
33 hospital inpatient days during which Medicaid recipients
34 received intensive care services from the hospital, as
35 determined from the hospital's 2002 Medicaid cost report that
36 was on file with the Department as of July 1, 2004.

 

 

SB0157 Enrolled - 41 - LRB094 07276 DRJ 37433 b

1     "Other urban area" means an area located within a
2 metropolitan statistical area, as defined by the U.S. Office of
3 Management and Budget in OMB Bulletin 04-03, dated February 18,
4 2004, with a city with a population in excess of 50,000 or a
5 total population in excess of 100,000.
6     (t) For purposes of this Section, a hospital that enrolled
7 to provide Medicaid services during State fiscal year 2003
8 shall have its utilization and associated reimbursements
9 annualized prior to the payment calculations being performed
10 under this Section.
11     (u) For purposes of this Section, the terms "Medicaid
12 days", "ambulatory procedure listing services", and
13 "ambulatory procedure listing payments" do not include any
14 days, charges, or services for which Medicare was liable for
15 payment, except where explicitly stated otherwise in this
16 Section.
17     (v) As provided in Section 5A-14, this Section is repealed
18 on July 1, 2008.
 
19     (305 ILCS 5/5A-13)
20     Sec. 5A-13. Emergency rulemaking. The Department of Public
21 Aid may adopt rules necessary to implement this amendatory Act
22 of the 94th 93rd General Assembly through the use of emergency
23 rulemaking in accordance with Section 5-45 of the Illinois
24 Administrative Procedure Act. For purposes of that Act, the
25 General Assembly finds that the adoption of rules to implement
26 this amendatory Act of the 94th 93rd General Assembly is deemed
27 an emergency and necessary for the public interest, safety, and
28 welfare.
29 (Source: P.A. 93-659, eff. 2-3-04.)
 
30     (305 ILCS 5/5A-14)
31     Sec. 5A-14. Repeal of assessments and disbursements.
32     (a) Section 5A-2 is repealed on July 1, 2008 2005.
33     (b) Section 5A-12 is repealed on July 1, 2005.
34     (c) Section 5A-12.1 is repealed on July 1, 2008.

 

 

SB0157 Enrolled - 42 - LRB094 07276 DRJ 37433 b

1 (Source: P.A. 93-659, eff. 2-3-04.)
 
2     Section 90-97. Severability. The provisions of this Act are
3 severable under Section 1.31 of the Statute on Statutes.
 
4     Section 90-99. Effective date. This Act takes effect upon
5 becoming law.