SB3088 EnrolledLRB096 20288 KTG 35900 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5adding Section 4.01a as follows:
 
6    (20 ILCS 105/4.01a new)
7    Sec. 4.01a. Use of certain moneys deposited into the
8Department on Aging State Projects Fund. All moneys transferred
9into the Department on Aging State Projects Fund from the
10Long-Term Care Provider Fund shall, subject to appropriation,
11be used for older adult services, as described in subsection
12(f) of Section 20 of the Older Adult Services Act. All federal
13moneys received as a result of expenditures of such moneys
14shall be deposited into the Department of Human Services
15Community Services Fund.
 
16    Section 10. The Department of Human Services Act is amended
17by adding Section 1-50 as follows:
 
18    (20 ILCS 1305/1-50 new)
19    Sec. 1-50. Department of Human Services Community Services
20Fund.
21    (a) The Department of Human Services Community Services

 

 

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1Fund is created in the State treasury as a special fund.
2    (b) The Fund is created for the purpose of receiving and
3disbursing moneys in accordance with this Section.
4Disbursements from the Fund shall be made, subject to
5appropriation, for payment of expenses incurred by the
6Department of Human Services in support of the Department's
7rebalancing services.
8    (c) The Fund shall consist of the following:
9        (1) Moneys transferred from another State fund.
10        (2) All federal moneys received as a result of
11    expenditures that are attributable to moneys deposited in
12    the Fund.
13        (3) All other moneys received for the Fund from any
14    other source.
15        (4) Interest earned upon moneys in the Fund.
 
16    Section 15. The State Finance Act is amended by adding
17Section 5.786 as follows:
 
18    (30 ILCS 105/5.786 new)
19    Sec. 5.786. The Department of Human Services Community
20Services Fund.
 
21    Section 20. The State Prompt Payment Act is amended by
22changing Section 3-2 as follows:
 

 

 

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1    (30 ILCS 540/3-2)
2    Sec. 3-2. Beginning July 1, 1993, in any instance where a
3State official or agency is late in payment of a vendor's bill
4or invoice for goods or services furnished to the State, as
5defined in Section 1, properly approved in accordance with
6rules promulgated under Section 3-3, the State official or
7agency shall pay interest to the vendor in accordance with the
8following:
9        (1) Any bill, except a bill submitted under Article V
10    of the Illinois Public Aid Code, approved for payment under
11    this Section must be paid or the payment issued to the
12    payee within 60 days of receipt of a proper bill or
13    invoice. If payment is not issued to the payee within this
14    60 day period, an interest penalty of 1.0% of any amount
15    approved and unpaid shall be added for each month or
16    fraction thereof after the end of this 60 day period, until
17    final payment is made. Any bill, except a bill for pharmacy
18    or nursing facility services or goods, submitted under
19    Article V of the Illinois Public Aid Code approved for
20    payment under this Section must be paid or the payment
21    issued to the payee within 60 days after receipt of a
22    proper bill or invoice, and, if payment is not issued to
23    the payee within this 60-day period, an interest penalty of
24    2.0% of any amount approved and unpaid shall be added for
25    each month or fraction thereof after the end of this 60-day
26    period, until final payment is made. Any bill for pharmacy

 

 

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1    or nursing facility services or goods submitted under
2    Article V of the Illinois Public Aid Code, approved for
3    payment under this Section must be paid or the payment
4    issued to the payee within 60 days of receipt of a proper
5    bill or invoice. If payment is not issued to the payee
6    within this 60-day period, an interest penalty of 1.0% of
7    any amount approved and unpaid shall be added for each
8    month or fraction thereof after the end of this 60-day
9    period, until final payment is made.
10        (1.1) A State agency shall review in a timely manner
11    each bill or invoice after its receipt. If the State agency
12    determines that the bill or invoice contains a defect
13    making it unable to process the payment request, the agency
14    shall notify the vendor requesting payment as soon as
15    possible after discovering the defect pursuant to rules
16    promulgated under Section 3-3; provided, however, that the
17    notice for construction related bills or invoices must be
18    given not later than 30 days after the bill or invoice was
19    first submitted. The notice shall identify the defect and
20    any additional information necessary to correct the
21    defect. If one or more items on a construction related bill
22    or invoice are disapproved, but not the entire bill or
23    invoice, then the portion that is not disapproved shall be
24    paid.
25        (2) Where a State official or agency is late in payment
26    of a vendor's bill or invoice properly approved in

 

 

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1    accordance with this Act, and different late payment terms
2    are not reduced to writing as a contractual agreement, the
3    State official or agency shall automatically pay interest
4    penalties required by this Section amounting to $50 or more
5    to the appropriate vendor. Each agency shall be responsible
6    for determining whether an interest penalty is owed and for
7    paying the interest to the vendor. Interest due to a vendor
8    that amounts to less than $50 shall not be paid but shall
9    be accrued until all interest due the vendor for all
10    similar warrants exceeds $50, at which time the accrued
11    interest shall be payable and interest will begin accruing
12    again, except that interest accrued as of the end of the
13    fiscal year that does not exceed $50 shall be payable at
14    that time. In the event an individual has paid a vendor for
15    services in advance, the provisions of this Section shall
16    apply until payment is made to that individual.
17(Source: P.A. 96-555, eff. 8-18-09; 96-802, eff. 1-1-10;
1896-959, eff. 7-1-10; 96-1000, eff. 7-2-10.)
 
19    Section 25. The Nursing Home Care Act is amended by
20changing Section 3-103 as follows:
 
21    (210 ILCS 45/3-103)  (from Ch. 111 1/2, par. 4153-103)
22    Sec. 3-103. The procedure for obtaining a valid license
23shall be as follows:
24        (1) Application to operate a facility shall be made to

 

 

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1    the Department on forms furnished by the Department.
2        (2) All license applications shall be accompanied with
3    an application fee. The fee for an annual license shall be
4    $1,990. Facilities that pay a fee or assessment pursuant to
5    Article V-C of the Illinois Public Aid Code shall be exempt
6    from the license fee imposed under this item (2). The fee
7    for a 2-year license shall be double the fee for the annual
8    license set forth in the preceding sentence. The fees
9    collected shall be deposited with the State Treasurer into
10    the Long Term Care Monitor/Receiver Fund, which has been
11    created as a special fund in the State treasury. This
12    special fund is to be used by the Department for expenses
13    related to the appointment of monitors and receivers as
14    contained in Sections 3-501 through 3-517 of this Act, for
15    the enforcement of this Act, and for implementation of the
16    Abuse Prevention Review Team Act. All federal moneys
17    received as a result of expenditures from the Fund shall be
18    deposited into the Fund. The Department may reduce or waive
19    a penalty pursuant to Section 3-308 only if that action
20    will not threaten the ability of the Department to meet the
21    expenses required to be met by the Long Term Care
22    Monitor/Receiver Fund. At the end of each fiscal year, any
23    funds in excess of $1,000,000 held in the Long Term Care
24    Monitor/Receiver Fund shall be deposited in the State's
25    General Revenue Fund. The application shall be under oath
26    and the submission of false or misleading information shall

 

 

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1    be a Class A misdemeanor. The application shall contain the
2    following information:
3            (a) The name and address of the applicant if an
4        individual, and if a firm, partnership, or
5        association, of every member thereof, and in the case
6        of a corporation, the name and address thereof and of
7        its officers and its registered agent, and in the case
8        of a unit of local government, the name and address of
9        its chief executive officer;
10            (b) The name and location of the facility for which
11        a license is sought;
12            (c) The name of the person or persons under whose
13        management or supervision the facility will be
14        conducted;
15            (d) The number and type of residents for which
16        maintenance, personal care, or nursing is to be
17        provided; and
18            (e) Such information relating to the number,
19        experience, and training of the employees of the
20        facility, any management agreements for the operation
21        of the facility, and of the moral character of the
22        applicant and employees as the Department may deem
23        necessary.
24        (3) Each initial application shall be accompanied by a
25    financial statement setting forth the financial condition
26    of the applicant and by a statement from the unit of local

 

 

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1    government having zoning jurisdiction over the facility's
2    location stating that the location of the facility is not
3    in violation of a zoning ordinance. An initial application
4    for a new facility shall be accompanied by a permit as
5    required by the "Illinois Health Facilities Planning Act".
6    After the application is approved, the applicant shall
7    advise the Department every 6 months of any changes in the
8    information originally provided in the application.
9        (4) Other information necessary to determine the
10    identity and qualifications of an applicant to operate a
11    facility in accordance with this Act shall be included in
12    the application as required by the Department in
13    regulations.
14(Source: P.A. 96-758, eff. 8-25-09; 96-1372, eff. 7-29-10.)
 
15    Section 30. The Illinois Public Aid Code is amended by
16changing Sections 5-1.1, 5-5.2, 5-5.3, 5-5.4, 5-5.4a, 5-5.5,
175-5.5a, 5-5.6b, 5-5.7, 5-5.8b, 5-5.11, 5A-2, 5A-3, 5A-5, 5A-8,
185A-10, 5A-14, 5B-1, 5B-2, 5B-4, 5B-5, and 5B-8 as follows:
 
19    (305 ILCS 5/5-1.1)  (from Ch. 23, par. 5-1.1)
20    Sec. 5-1.1. Definitions. The terms defined in this Section
21shall have the meanings ascribed to them, except when the
22context otherwise requires.
23    (a) "Nursing Skilled nursing facility" means a nursing home
24eligible to participate as a skilled nursing facility, licensed

 

 

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1by the Department of Public Health under the Nursing Home Care
2Act, that provides nursing facility services within the meaning
3of under Title XIX of the federal Social Security Act.
4    (b) "Intermediate care facility for the developmentally
5disabled" or "ICF/DD" means a nursing home eligible to
6participate as an intermediate care facility, licensed by the
7Department of Public Health under the MR/DD Community Care Act,
8that is an intermediate care facility for the mentally retarded
9within the meaning of under Title XIX of the federal Social
10Security Act.
11    (c) "Standard services" means those services required for
12the care of all patients in the facility and shall, as a
13minimum, include the following: (1) administration; (2)
14dietary (standard); (3) housekeeping; (4) laundry and linen;
15(5) maintenance of property and equipment, including
16utilities; (6) medical records; (7) training of employees; (8)
17utilization review; (9) activities services; (10) social
18services; (11) disability services; and all other similar
19services required by either the laws of the State of Illinois
20or one of its political subdivisions or municipalities or by
21Title XIX of the Social Security Act.
22    (d) "Patient services" means those which vary with the
23number of personnel; professional and para-professional skills
24of the personnel; specialized equipment, and reflect the
25intensity of the medical and psycho-social needs of the
26patients. Patient services shall as a minimum include: (1)

 

 

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1physical services; (2) nursing services, including restorative
2nursing; (3) medical direction and patient care planning; (4)
3health related supportive and habilitative services and all
4similar services required by either the laws of the State of
5Illinois or one of its political subdivisions or municipalities
6or by Title XIX of the Social Security Act.
7    (e) "Ancillary services" means those services which
8require a specific physician's order and defined as under the
9medical assistance program as not being routine in nature for
10skilled nursing facilities and ICF/DDs intermediate care
11facilities. Such services generally must be authorized prior to
12delivery and payment as provided for under the rules of the
13Department of Healthcare and Family Services.
14    (f) "Capital" means the investment in a facility's assets
15for both debt and non-debt funds. Non-debt capital is the
16difference between an adjusted replacement value of the assets
17and the actual amount of debt capital.
18    (g) "Profit" means the amount which shall accrue to a
19facility as a result of its revenues exceeding its expenses as
20determined in accordance with generally accepted accounting
21principles.
22    (h) "Non-institutional services" means those services
23provided under paragraph (f) of Section 3 of the Disabled
24Persons Rehabilitation Act and those services provided under
25Section 4.02 of the Illinois Act on the Aging.
26    (i) "Exceptional medical care" means the level of medical

 

 

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1care required by persons who are medically stable for discharge
2from a hospital but who require acute intensity hospital level
3care for physician, nurse and ancillary specialist services,
4including persons with acquired immunodeficiency syndrome
5(AIDS) or a related condition. Such care shall consist of those
6services which the Department shall determine by rule.
7    (j) "Institutionalized person" means an individual who is
8an inpatient in an ICF/DD or intermediate care or skilled
9nursing facility, or who is an inpatient in a medical
10institution receiving a level of care equivalent to that of an
11ICF/DD or intermediate care or skilled nursing facility, or who
12is receiving services under Section 1915(c) of the Social
13Security Act.
14    (k) "Institutionalized spouse" means an institutionalized
15person who is expected to receive services at the same level of
16care for at least 30 days and is married to a spouse who is not
17an institutionalized person.
18    (l) "Community spouse" is the spouse of an
19institutionalized spouse.
20(Source: P.A. 95-331, eff. 8-21-07.)
 
21    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
22    Sec. 5-5.2. Payment.
23    (a) All nursing facilities Skilled Nursing Facilities that
24are grouped pursuant to Section 5-5.1 of this Act shall receive
25the same rate of payment for similar services. All Intermediate

 

 

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1Care Facilities that are grouped pursuant to Section 5-5.1 of
2this Act shall receive the same rate of payment for similar
3services.
4    (b) It shall be a matter of State policy that the Illinois
5Department shall utilize a uniform billing cycle throughout the
6State for the following long-term care providers: skilled
7nursing facilities, intermediate care facilities, and
8intermediate care facilities for persons with a developmental
9disability. The Illinois Department shall establish billing
10cycles on a calendar month basis for all long-term care
11providers no later than July 1, 1992.
12    (c) Notwithstanding any other provisions of this Code,
13beginning July 1, 2012 the methodologies for reimbursement of
14nursing facility services as provided under this Article shall
15no longer be applicable for bills payable for State fiscal
16years 2012 and thereafter. The Department of Healthcare and
17Family Services shall, effective July 1, 2012, implement an
18evidence-based payment methodology for the reimbursement of
19nursing facility services. The methodology shall continue to
20take into consideration the needs of individual residents, as
21assessed and reported by the most current version of the
22nursing facility Resident Assessment Instrument, adopted and
23in use by the federal government.
24(Source: P.A. 87-809; 88-380.)
 
25    (305 ILCS 5/5-5.3)  (from Ch. 23, par. 5-5.3)

 

 

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1    Sec. 5-5.3. Conditions of Payment - Prospective Rates -
2Accounting Principles. This amendatory Act establishes certain
3conditions for the Department of Public Aid (now Healthcare and
4Family Services) in instituting rates for the care of
5recipients of medical assistance in skilled nursing facilities
6and ICF/DDs intermediate care facilities. Such conditions
7shall assure a method under which the payment for skilled
8nursing facility and ICF/DD and intermediate care services,
9provided to recipients under the Medical Assistance Program
10shall be on a reasonable cost related basis, which is
11prospectively determined at least annually by the Department of
12Public Aid (now Healthcare and Family Services). The annually
13established payment rate shall take effect on July 1 in 1984
14and subsequent years. There shall be no rate increase during
15calendar year 1983 and the first six months of calendar year
161984.
17    The determination of the payment shall be made on the basis
18of generally accepted accounting principles that shall take
19into account the actual costs to the facility of providing
20skilled nursing facility and ICF/DD and intermediate care
21services to recipients under the medical assistance program.
22    The resultant total rate for a specified type of service
23shall be an amount which shall have been determined to be
24adequate to reimburse allowable costs of a facility that is
25economically and efficiently operated. The Department shall
26establish an effective date for each facility or group of

 

 

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1facilities after which rates shall be paid on a reasonable cost
2related basis which shall be no sooner than the effective date
3of this amendatory Act of 1977.
4(Source: P.A. 95-331, eff. 8-21-07.)
 
5    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
6    Sec. 5-5.4. Standards of Payment - Department of Healthcare
7and Family Services. The Department of Healthcare and Family
8Services shall develop standards of payment of skilled nursing
9facility and ICF/DD and intermediate care services in
10facilities providing such services under this Article which:
11    (1) Provide for the determination of a facility's payment
12for skilled nursing facility or ICF/DD and intermediate care
13services on a prospective basis. The amount of the payment rate
14for all nursing facilities certified by the Department of
15Public Health under the MR/DD Community Care Act or the Nursing
16Home Care Act as Intermediate Care for the Developmentally
17Disabled facilities, Long Term Care for Under Age 22
18facilities, Skilled Nursing facilities, or Intermediate Care
19facilities under the medical assistance program shall be
20prospectively established annually on the basis of historical,
21financial, and statistical data reflecting actual costs from
22prior years, which shall be applied to the current rate year
23and updated for inflation, except that the capital cost element
24for newly constructed facilities shall be based upon projected
25budgets. The annually established payment rate shall take

 

 

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1effect on July 1 in 1984 and subsequent years. No rate increase
2and no update for inflation shall be provided on or after July
31, 1994 and before July 1, 2012 2011, unless specifically
4provided for in this Section. The changes made by Public Act
593-841 extending the duration of the prohibition against a rate
6increase or update for inflation are effective retroactive to
7July 1, 2004.
8    For facilities licensed by the Department of Public Health
9under the Nursing Home Care Act as Intermediate Care for the
10Developmentally Disabled facilities or Long Term Care for Under
11Age 22 facilities, the rates taking effect on July 1, 1998
12shall include an increase of 3%. For facilities licensed by the
13Department of Public Health under the Nursing Home Care Act as
14Skilled Nursing facilities or Intermediate Care facilities,
15the rates taking effect on July 1, 1998 shall include an
16increase of 3% plus $1.10 per resident-day, as defined by the
17Department. For facilities licensed by the Department of Public
18Health under the Nursing Home Care Act as Intermediate Care
19Facilities for the Developmentally Disabled or Long Term Care
20for Under Age 22 facilities, the rates taking effect on January
211, 2006 shall include an increase of 3%. For facilities
22licensed by the Department of Public Health under the Nursing
23Home Care Act as Intermediate Care Facilities for the
24Developmentally Disabled or Long Term Care for Under Age 22
25facilities, the rates taking effect on January 1, 2009 shall
26include an increase sufficient to provide a $0.50 per hour wage

 

 

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1increase for non-executive staff.
2    For facilities licensed by the Department of Public Health
3under the Nursing Home Care Act as Intermediate Care for the
4Developmentally Disabled facilities or Long Term Care for Under
5Age 22 facilities, the rates taking effect on July 1, 1999
6shall include an increase of 1.6% plus $3.00 per resident-day,
7as defined by the Department. For facilities licensed by the
8Department of Public Health under the Nursing Home Care Act as
9Skilled Nursing facilities or Intermediate Care facilities,
10the rates taking effect on July 1, 1999 shall include an
11increase of 1.6% and, for services provided on or after October
121, 1999, shall be increased by $4.00 per resident-day, as
13defined by the Department.
14    For facilities licensed by the Department of Public Health
15under the Nursing Home Care Act as Intermediate Care for the
16Developmentally Disabled facilities or Long Term Care for Under
17Age 22 facilities, the rates taking effect on July 1, 2000
18shall include an increase of 2.5% per resident-day, as defined
19by the Department. For facilities licensed by the Department of
20Public Health under the Nursing Home Care Act as Skilled
21Nursing facilities or Intermediate Care facilities, the rates
22taking effect on July 1, 2000 shall include an increase of 2.5%
23per resident-day, as defined by the Department.
24    For facilities licensed by the Department of Public Health
25under the Nursing Home Care Act as skilled nursing facilities
26or intermediate care facilities, a new payment methodology must

 

 

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1be implemented for the nursing component of the rate effective
2July 1, 2003. The Department of Public Aid (now Healthcare and
3Family Services) shall develop the new payment methodology
4using the Minimum Data Set (MDS) as the instrument to collect
5information concerning nursing home resident condition
6necessary to compute the rate. The Department shall develop the
7new payment methodology to meet the unique needs of Illinois
8nursing home residents while remaining subject to the
9appropriations provided by the General Assembly. A transition
10period from the payment methodology in effect on June 30, 2003
11to the payment methodology in effect on July 1, 2003 shall be
12provided for a period not exceeding 3 years and 184 days after
13implementation of the new payment methodology as follows:
14        (A) For a facility that would receive a lower nursing
15    component rate per patient day under the new system than
16    the facility received effective on the date immediately
17    preceding the date that the Department implements the new
18    payment methodology, the nursing component rate per
19    patient day for the facility shall be held at the level in
20    effect on the date immediately preceding the date that the
21    Department implements the new payment methodology until a
22    higher nursing component rate of reimbursement is achieved
23    by that facility.
24        (B) For a facility that would receive a higher nursing
25    component rate per patient day under the payment
26    methodology in effect on July 1, 2003 than the facility

 

 

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1    received effective on the date immediately preceding the
2    date that the Department implements the new payment
3    methodology, the nursing component rate per patient day for
4    the facility shall be adjusted.
5        (C) Notwithstanding paragraphs (A) and (B), the
6    nursing component rate per patient day for the facility
7    shall be adjusted subject to appropriations provided by the
8    General Assembly.
9    For facilities licensed by the Department of Public Health
10under the Nursing Home Care Act as Intermediate Care for the
11Developmentally Disabled facilities or Long Term Care for Under
12Age 22 facilities, the rates taking effect on March 1, 2001
13shall include a statewide increase of 7.85%, as defined by the
14Department.
15    Notwithstanding any other provision of this Section, for
16facilities licensed by the Department of Public Health under
17the Nursing Home Care Act as skilled nursing facilities or
18intermediate care facilities, except facilities participating
19in the Department's demonstration program pursuant to the
20provisions of Title 77, Part 300, Subpart T of the Illinois
21Administrative Code, the numerator of the ratio used by the
22Department of Healthcare and Family Services to compute the
23rate payable under this Section using the Minimum Data Set
24(MDS) methodology shall incorporate the following annual
25amounts as the additional funds appropriated to the Department
26specifically to pay for rates based on the MDS nursing

 

 

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1component methodology in excess of the funding in effect on
2December 31, 2006:
3        (i) For rates taking effect January 1, 2007,
4    $60,000,000.
5        (ii) For rates taking effect January 1, 2008,
6    $110,000,000.
7        (iii) For rates taking effect January 1, 2009,
8    $194,000,000.
9        (iv) For rates taking effect April 1, 2011, or the
10    first day of the month that begins at least 45 days after
11    the effective date of this amendatory Act of the 96th
12    General Assembly, $416,500,000 or an amount as may be
13    necessary to complete the transition to the MDS methodology
14    for the nursing component of the rate.
15    Notwithstanding any other provision of this Section, for
16facilities licensed by the Department of Public Health under
17the Nursing Home Care Act as skilled nursing facilities or
18intermediate care facilities, the support component of the
19rates taking effect on January 1, 2008 shall be computed using
20the most recent cost reports on file with the Department of
21Healthcare and Family Services no later than April 1, 2005,
22updated for inflation to January 1, 2006.
23    For facilities licensed by the Department of Public Health
24under the Nursing Home Care Act as Intermediate Care for the
25Developmentally Disabled facilities or Long Term Care for Under
26Age 22 facilities, the rates taking effect on April 1, 2002

 

 

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1shall include a statewide increase of 2.0%, as defined by the
2Department. This increase terminates on July 1, 2002; beginning
3July 1, 2002 these rates are reduced to the level of the rates
4in effect on March 31, 2002, as defined by the Department.
5    For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as skilled nursing facilities
7or intermediate care facilities, the rates taking effect on
8July 1, 2001 shall be computed using the most recent cost
9reports on file with the Department of Public Aid no later than
10April 1, 2000, updated for inflation to January 1, 2001. For
11rates effective July 1, 2001 only, rates shall be the greater
12of the rate computed for July 1, 2001 or the rate effective on
13June 30, 2001.
14    Notwithstanding any other provision of this Section, for
15facilities licensed by the Department of Public Health under
16the Nursing Home Care Act as skilled nursing facilities or
17intermediate care facilities, the Illinois Department shall
18determine by rule the rates taking effect on July 1, 2002,
19which shall be 5.9% less than the rates in effect on June 30,
202002.
21    Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, if the payment methodologies
25required under Section 5A-12 and the waiver granted under 42
26CFR 433.68 are approved by the United States Centers for

 

 

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1Medicare and Medicaid Services, the rates taking effect on July
21, 2004 shall be 3.0% greater than the rates in effect on June
330, 2004. These rates shall take effect only upon approval and
4implementation of the payment methodologies required under
5Section 5A-12.
6    Notwithstanding any other provisions of this Section, for
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as skilled nursing facilities or
9intermediate care facilities, the rates taking effect on
10January 1, 2005 shall be 3% more than the rates in effect on
11December 31, 2004.
12    Notwithstanding any other provision of this Section, for
13facilities licensed by the Department of Public Health under
14the Nursing Home Care Act as skilled nursing facilities or
15intermediate care facilities, effective January 1, 2009, the
16per diem support component of the rates effective on January 1,
172008, computed using the most recent cost reports on file with
18the Department of Healthcare and Family Services no later than
19April 1, 2005, updated for inflation to January 1, 2006, shall
20be increased to the amount that would have been derived using
21standard Department of Healthcare and Family Services methods,
22procedures, and inflators.
23    Notwithstanding any other provisions of this Section, for
24facilities licensed by the Department of Public Health under
25the Nursing Home Care Act as intermediate care facilities that
26are federally defined as Institutions for Mental Disease, a

 

 

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1socio-development component rate equal to 6.6% of the
2facility's nursing component rate as of January 1, 2006 shall
3be established and paid effective July 1, 2006. The
4socio-development component of the rate shall be increased by a
5factor of 2.53 on the first day of the month that begins at
6least 45 days after January 11, 2008 (the effective date of
7Public Act 95-707). As of August 1, 2008, the socio-development
8component rate shall be equal to 6.6% of the facility's nursing
9component rate as of January 1, 2006, multiplied by a factor of
103.53. For services provided on or after April 1, 2011, or the
11first day of the month that begins at least 45 days after the
12effective date of this amendatory Act of the 96th General
13Assembly, whichever is later, the The Illinois Department may
14by rule adjust these socio-development component rates, and may
15use different adjustment methodologies for those facilities
16participating, and those not participating, in the Illinois
17Department's demonstration program pursuant to the provisions
18of Title 77, Part 300, Subpart T of the Illinois Administrative
19Code, but in no case may such rates be diminished below those
20in effect on August 1, 2008.
21    For facilities licensed by the Department of Public Health
22under the Nursing Home Care Act as Intermediate Care for the
23Developmentally Disabled facilities or as long-term care
24facilities for residents under 22 years of age, the rates
25taking effect on July 1, 2003 shall include a statewide
26increase of 4%, as defined by the Department.

 

 

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1    For facilities licensed by the Department of Public Health
2under the Nursing Home Care Act as Intermediate Care for the
3Developmentally Disabled facilities or Long Term Care for Under
4Age 22 facilities, the rates taking effect on the first day of
5the month that begins at least 45 days after the effective date
6of this amendatory Act of the 95th General Assembly shall
7include a statewide increase of 2.5%, as defined by the
8Department.
9    Notwithstanding any other provision of this Section, for
10facilities licensed by the Department of Public Health under
11the Nursing Home Care Act as skilled nursing facilities or
12intermediate care facilities, effective January 1, 2005,
13facility rates shall be increased by the difference between (i)
14a facility's per diem property, liability, and malpractice
15insurance costs as reported in the cost report filed with the
16Department of Public Aid and used to establish rates effective
17July 1, 2001 and (ii) those same costs as reported in the
18facility's 2002 cost report. These costs shall be passed
19through to the facility without caps or limitations, except for
20adjustments required under normal auditing procedures.
21    Rates established effective each July 1 shall govern
22payment for services rendered throughout that fiscal year,
23except that rates established on July 1, 1996 shall be
24increased by 6.8% for services provided on or after January 1,
251997. Such rates will be based upon the rates calculated for
26the year beginning July 1, 1990, and for subsequent years

 

 

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1thereafter until June 30, 2001 shall be based on the facility
2cost reports for the facility fiscal year ending at any point
3in time during the previous calendar year, updated to the
4midpoint of the rate year. The cost report shall be on file
5with the Department no later than April 1 of the current rate
6year. Should the cost report not be on file by April 1, the
7Department shall base the rate on the latest cost report filed
8by each skilled care facility and intermediate care facility,
9updated to the midpoint of the current rate year. In
10determining rates for services rendered on and after July 1,
111985, fixed time shall not be computed at less than zero. The
12Department shall not make any alterations of regulations which
13would reduce any component of the Medicaid rate to a level
14below what that component would have been utilizing in the rate
15effective on July 1, 1984.
16    (2) Shall take into account the actual costs incurred by
17facilities in providing services for recipients of skilled
18nursing and intermediate care services under the medical
19assistance program.
20    (3) Shall take into account the medical and psycho-social
21characteristics and needs of the patients.
22    (4) Shall take into account the actual costs incurred by
23facilities in meeting licensing and certification standards
24imposed and prescribed by the State of Illinois, any of its
25political subdivisions or municipalities and by the U.S.
26Department of Health and Human Services pursuant to Title XIX

 

 

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1of the Social Security Act.
2    The Department of Healthcare and Family Services shall
3develop precise standards for payments to reimburse nursing
4facilities for any utilization of appropriate rehabilitative
5personnel for the provision of rehabilitative services which is
6authorized by federal regulations, including reimbursement for
7services provided by qualified therapists or qualified
8assistants, and which is in accordance with accepted
9professional practices. Reimbursement also may be made for
10utilization of other supportive personnel under appropriate
11supervision.
12    The Department shall develop enhanced payments to offset
13the additional costs incurred by a facility serving exceptional
14need residents and shall allocate at least $8,000,000 of the
15funds collected from the assessment established by Section 5B-2
16of this Code for such payments. For the purpose of this
17Section, "exceptional needs" means, but need not be limited to,
18ventilator care, tracheotomy care, bariatric care, complex
19wound care, and traumatic brain injury care.
20    (5) Beginning July 1, 2012 the methodologies for
21reimbursement of nursing facility services as provided under
22this Section 5-5.4 shall no longer be applicable for bills
23payable for State fiscal years 2012 and thereafter.
24(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
25eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09;
2696-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff.

 

 

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17-2-10.)
 
2    (305 ILCS 5/5-5.4a)
3    Sec. 5-5.4a. Intermediate Care Facility for the
4Developmentally Disabled; bed reserve payments.
5    The Department of Public Aid shall promulgate rules that by
6October 1, 1993 which establish a policy of bed reserve
7payments to ICF/DDs Intermediate Care Facilities for the
8Developmentally Disabled which addresses the needs of
9residents of ICF/DDs Intermediate Care Facilities for the
10Developmentally Disabled (ICF/DD) and their families.
11    (a) When a resident of an ICF/DD Intermediate Care Facility
12for the Developmentally Disabled (ICF/DD) is absent from the
13facility ICF/DD in which he or she is a resident for purposes
14of physician authorized in-patient admission to a hospital, the
15Department's rules shall, at a minimum, provide (1) bed reserve
16payments at a daily rate which is 100% of the client's current
17per diem rate, for a period not exceeding 10 consecutive days;
18(2) bed reserve payments at a daily rate which is 75% of a
19client's current per diem rate, for a period which exceeds 10
20consecutive days but does not exceed 30 consecutive days; and
21(3) bed reserve payments at a daily rate which is 50% of a
22client's current per diem rate for a period which exceeds
23thirty consecutive days but does not exceed 45 consecutive
24days.
25    (b) When a resident of an ICF/DD Intermediate Care Facility

 

 

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1for the Developmentally Disabled (ICF/DD) is absent from the
2facility ICF/DD in which he or she is a resident for purposes
3of a home visit with a family member the Department's rules
4shall, at a minimum, provide (1) bed reserve payments at a rate
5which is 100% of a client's current per diem rate, for a period
6not exceeding 10 days per State fiscal year; and (2) bed
7reserve payments at a rate which is 75% of a client's current
8per diem rate, for a period which exceeds 10 days per State
9fiscal year but does not exceed 30 days per State fiscal year.
10    (c) No Department rule regarding bed reserve payments shall
11require an ICF/DD to have a specified percentage of total
12facility occupancy as a requirement for receiving bed reserve
13payments.
14    This Section 5-5.4a shall not apply to any State operated
15facilities.
16(Source: P.A. 91-357, eff. 7-29-99.)
 
17    (305 ILCS 5/5-5.5)  (from Ch. 23, par. 5-5.5)
18    Sec. 5-5.5. Elements of Payment Rate.
19    (a) The Department of Healthcare and Family Services shall
20develop a prospective method for determining payment rates for
21skilled nursing facility and ICF/DD and intermediate care
22services in nursing facilities composed of the following cost
23elements:
24        (1) Standard Services, with the cost of this component
25    being determined by taking into account the actual costs to

 

 

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1    the facilities of these services subject to cost ceilings
2    to be defined in the Department's rules.
3        (2) Resident Services, with the cost of this component
4    being determined by taking into account the actual costs,
5    needs and utilization of these services, as derived from an
6    assessment of the resident needs in the nursing facilities.
7        (3) Ancillary Services, with the payment rate being
8    developed for each individual type of service. Payment
9    shall be made only when authorized under procedures
10    developed by the Department of Healthcare and Family
11    Services.
12        (4) Nurse's Aide Training, with the cost of this
13    component being determined by taking into account the
14    actual cost to the facilities of such training.
15        (5) Real Estate Taxes, with the cost of this component
16    being determined by taking into account the figures
17    contained in the most currently available cost reports
18    (with no imposition of maximums) updated to the midpoint of
19    the current rate year for long term care services rendered
20    between July 1, 1984 and June 30, 1985, and with the cost
21    of this component being determined by taking into account
22    the actual 1983 taxes for which the nursing homes were
23    assessed (with no imposition of maximums) updated to the
24    midpoint of the current rate year for long term care
25    services rendered between July 1, 1985 and June 30, 1986.
26    (b) In developing a prospective method for determining

 

 

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1payment rates for skilled nursing facility and ICF/DD and
2intermediate care services in nursing facilities and ICF/DDs,
3the Department of Healthcare and Family Services shall consider
4the following cost elements:
5        (1) Reasonable capital cost determined by utilizing
6    incurred interest rate and the current value of the
7    investment, including land, utilizing composite rates, or
8    by utilizing such other reasonable cost related methods
9    determined by the Department. However, beginning with the
10    rate reimbursement period effective July 1, 1987, the
11    Department shall be prohibited from establishing,
12    including, and implementing any depreciation factor in
13    calculating the capital cost element.
14        (2) Profit, with the actual amount being produced and
15    accruing to the providers in the form of a return on their
16    total investment, on the basis of their ability to
17    economically and efficiently deliver a type of service. The
18    method of payment may assure the opportunity for a profit,
19    but shall not guarantee or establish a specific amount as a
20    cost.
21    (c) The Illinois Department may implement the amendatory
22changes to this Section made by this amendatory Act of 1991
23through the use of emergency rules in accordance with the
24provisions of Section 5.02 of the Illinois Administrative
25Procedure Act. For purposes of the Illinois Administrative
26Procedure Act, the adoption of rules to implement the

 

 

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1amendatory changes to this Section made by this amendatory Act
2of 1991 shall be deemed an emergency and necessary for the
3public interest, safety and welfare.
4    (d) No later than January 1, 2001, the Department of Public
5Aid shall file with the Joint Committee on Administrative
6Rules, pursuant to the Illinois Administrative Procedure Act, a
7proposed rule, or a proposed amendment to an existing rule,
8regarding payment for appropriate services, including
9assessment, care planning, discharge planning, and treatment
10provided by nursing facilities to residents who have a serious
11mental illness.
12(Source: P.A. 95-331, eff. 8-21-07; 96-1123, eff. 1-1-11.)
 
13    (305 ILCS 5/5-5.5a)  (from Ch. 23, par. 5-5.5a)
14    Sec. 5-5.5a. Kosher kitchen and food service.
15    (a) The Department of Healthcare and Family Services may
16develop in its rate structure for skilled nursing facilities
17and intermediate care facilities an accommodation for fully
18kosher kitchen and food service operations, rabbinically
19approved or certified on an annual basis for a facility in
20which the only kitchen or all kitchens are fully kosher (a
21fully kosher facility). Beginning in the fiscal year after the
22fiscal year when this amendatory Act of 1990 becomes effective,
23the rate structure may provide for an additional payment to
24such facility not to exceed 50 cents per resident per day if
2560% or more of the residents in the facility request kosher

 

 

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1foods or food products prepared in accordance with Jewish
2religious dietary requirements for religious purposes in a
3fully kosher facility. Based upon food cost reports of the
4Illinois Department of Agriculture regarding kosher and
5non-kosher food available in the various regions of the State,
6this rate structure may be periodically adjusted by the
7Department but may not exceed the maximum authorized under this
8subsection (a).
9    (b) The Department shall by rule determine how a facility
10with a fully kosher kitchen and food service may be determined
11to be eligible and apply for the rate accommodation specified
12in subsection (a).
13(Source: P.A. 95-331, eff. 8-21-07.)
 
14    (305 ILCS 5/5-5.6b)  (from Ch. 23, par. 5-5.6b)
15    Sec. 5-5.6b. Prohibition against double payment. If any
16resident of a skilled nursing facility or ICF/DD intermediate
17care facility is admitted to such facility on the basis that
18the charges for such resident's care will be paid from private
19funds, and the source of payment for such care thereafter
20changes from private funds to payments under this Article, the
21facility shall, upon receiving the first such payment under
22this Article, notify the Illinois Department of such source of
23private funds for such recipient and repay to the source of
24private funds any amounts received from such source as payment
25for care for which payment also was made under this Article.

 

 

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1Private funds shall not include third party resources such as
2insurance or Medicare benefits or payments made by responsible
3relatives.
4(Source: P.A. 85-824.)
 
5    (305 ILCS 5/5-5.7)  (from Ch. 23, par. 5-5.7)
6    Sec. 5-5.7. Cost Reports - Audits. The Department of
7Healthcare and Family Services shall work with the Department
8of Public Health to use cost report information currently being
9collected under provisions of the Nursing Home Care Act and the
10MR/DD Community Care Act. The Department of Healthcare and
11Family Services may, in conjunction with the Department of
12Public Health, develop in accordance with generally accepted
13accounting principles a uniform chart of accounts which each
14facility providing services under the medical assistance
15program shall adopt, after a reasonable period.
16    Nursing homes licensed under the Nursing Home Care Act or
17the MR/DD Community Care Act and providers of adult
18developmental training services certified by the Department of
19Human Services pursuant to Section 15.2 of the Mental Health
20and Developmental Disabilities Administrative Act which
21provide services to clients eligible for medical assistance
22under this Article are responsible for submitting the required
23annual cost report to the Department of Healthcare and Family
24Services.
25    The Department of Healthcare and Family Services shall

 

 

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1audit the financial and statistical records of each provider
2participating in the medical assistance program as a skilled
3nursing facility or ICF/DD or intermediate care facility over a
43 year period, beginning with the close of the first cost
5reporting year. Following the end of this 3-year term, audits
6of the financial and statistical records will be performed each
7year in at least 20% of the facilities participating in the
8medical assistance program with at least 10% being selected on
9a random sample basis, and the remainder selected on the basis
10of exceptional profiles. All audits shall be conducted in
11accordance with generally accepted auditing standards.
12    The Department of Healthcare and Family Services shall
13establish prospective payment rates for categories of service
14needed within the skilled nursing facility or ICF/DD and
15intermediate care levels of services, in order to more
16appropriately recognize the individual needs of patients in
17nursing facilities.
18    The Department of Healthcare and Family Services shall
19provide, during the process of establishing the payment rate
20for skilled nursing facility or ICF/DD and intermediate care
21services, or when a substantial change in rates is proposed, an
22opportunity for public review and comment on the proposed rates
23prior to their becoming effective.
24(Source: P.A. 95-331, eff. 8-21-07; 96-339, eff. 7-1-10.)
 
25    (305 ILCS 5/5-5.8b)  (from Ch. 23, par. 5-5.8b)

 

 

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1    Sec. 5-5.8b. Payment to Campus Facilities. There is hereby
2established a separate payment category for campus facilities.
3A "campus facility" is defined as an entity which consists of a
4long term care facility (or group of facilities if the
5facilities are on the same contiguous parcel of real estate)
6which meets all of the following criteria as of May 1, 1987:
7the entity provides care for both children and adults;
8residents of the entity reside in three or more separate
9buildings with congregate and small group living arrangements
10on a single campus; the entity provides three or more separate
11licensed levels of care; the entity (or a part of the entity)
12is enrolled with the Department of Public Aid (now Department
13of Healthcare and Family Services) as a provider of long term
14care services and receives payments from that Department; the
15entity (or a part of the entity) receives funding from the
16Department of Mental Health and Developmental Disabilities
17(now the Department of Human Services); and the entity (or a
18part of the entity) holds a current license as a child care
19institution issued by the Department of Children and Family
20Services.
21    The Department of Healthcare and Family Services, the
22Department of Human Services, and the Department of Children
23and Family Services shall develop jointly a rate methodology or
24methodologies for campus facilities. Such methodology or
25methodologies may establish a single rate to be paid by all the
26agencies, or a separate rate to be paid by each agency, or

 

 

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1separate components to be paid to different parts of the campus
2facility. All campus facilities shall receive the same rate of
3payment for similar services. Any methodology developed
4pursuant to this section shall take into account the actual
5costs to the facility of providing services to residents, and
6shall be adequate to reimburse the allowable costs of a campus
7facility which is economically and efficiently operated. Any
8methodology shall be established on the basis of historical,
9financial, and statistical data submitted by campus
10facilities, and shall take into account the actual costs
11incurred by campus facilities in providing services, and in
12meeting licensing and certification standards imposed and
13prescribed by the State of Illinois, any of its political
14subdivisions or municipalities and by the United States
15Department of Health and Human Services. Rates may be
16established on a prospective or retrospective basis. Any
17methodology shall provide reimbursement for appropriate
18payment elements, including the following: standard services,
19patient services, real estate taxes, and capital costs.
20(Source: P.A. 95-331, eff. 8-21-07.)
 
21    (305 ILCS 5/5A-2)  (from Ch. 23, par. 5A-2)
22    (Section scheduled to be repealed on July 1, 2013)
23    Sec. 5A-2. Assessment.
24    (a) Subject to Sections 5A-3 and 5A-10, an annual
25assessment on inpatient services is imposed on each hospital

 

 

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1provider in an amount equal to the hospital's occupied bed days
2multiplied by $84.19 multiplied by the proration factor for
3State fiscal year 2004 and the hospital's occupied bed days
4multiplied by $84.19 for State fiscal year 2005.
5    For State fiscal years 2004 and 2005, the Department of
6Healthcare and Family Services shall use the number of occupied
7bed days as reported by each hospital on the Annual Survey of
8Hospitals conducted by the Department of Public Health to
9calculate the hospital's annual assessment. If the sum of a
10hospital's occupied bed days is not reported on the Annual
11Survey of Hospitals or if there are data errors in the reported
12sum of a hospital's occupied bed days as determined by the
13Department of Healthcare and Family Services (formerly
14Department of Public Aid), then the Department of Healthcare
15and Family Services may obtain the sum of occupied bed days
16from any source available, including, but not limited to,
17records maintained by the hospital provider, which may be
18inspected at all times during business hours of the day by the
19Department of Healthcare and Family Services or its duly
20authorized agents and employees.
21    Subject to Sections 5A-3 and 5A-10, for the privilege of
22engaging in the occupation of hospital provider, beginning
23August 1, 2005, an annual assessment is imposed on each
24hospital provider for State fiscal years 2006, 2007, and 2008,
25in an amount equal to 2.5835% of the hospital provider's
26adjusted gross hospital revenue for inpatient services and

 

 

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12.5835% of the hospital provider's adjusted gross hospital
2revenue for outpatient services. If the hospital provider's
3adjusted gross hospital revenue is not available, then the
4Illinois Department may obtain the hospital provider's
5adjusted gross hospital revenue from any source available,
6including, but not limited to, records maintained by the
7hospital provider, which may be inspected at all times during
8business hours of the day by the Illinois Department or its
9duly authorized agents and employees.
10    Subject to Sections 5A-3 and 5A-10, for State fiscal years
112009 through 2014 2013, an annual assessment on inpatient
12services is imposed on each hospital provider in an amount
13equal to $218.38 multiplied by the difference of the hospital's
14occupied bed days less the hospital's Medicare bed days.
15    For State fiscal years 2009 through 2014 2013, a hospital's
16occupied bed days and Medicare bed days shall be determined
17using the most recent data available from each hospital's 2005
18Medicare cost report as contained in the Healthcare Cost Report
19Information System file, for the quarter ending on December 31,
202006, without regard to any subsequent adjustments or changes
21to such data. If a hospital's 2005 Medicare cost report is not
22contained in the Healthcare Cost Report Information System,
23then the Illinois Department may obtain the hospital provider's
24occupied bed days and Medicare bed days from any source
25available, including, but not limited to, records maintained by
26the hospital provider, which may be inspected at all times

 

 

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1during business hours of the day by the Illinois Department or
2its duly authorized agents and employees.
3    (b) (Blank).
4    (c) (Blank).
5    (d) Notwithstanding any of the other provisions of this
6Section, the Department is authorized, during this 94th General
7Assembly, to adopt rules to reduce the rate of any annual
8assessment imposed under this Section, as authorized by Section
95-46.2 of the Illinois Administrative Procedure Act.
10    (e) Notwithstanding any other provision of this Section,
11any plan providing for an assessment on a hospital provider as
12a permissible tax under Title XIX of the federal Social
13Security Act and Medicaid-eligible payments to hospital
14providers from the revenues derived from that assessment shall
15be reviewed by the Illinois Department of Healthcare and Family
16Services, as the Single State Medicaid Agency required by
17federal law, to determine whether those assessments and
18hospital provider payments meet federal Medicaid standards. If
19the Department determines that the elements of the plan may
20meet federal Medicaid standards and a related State Medicaid
21Plan Amendment is prepared in a manner and form suitable for
22submission, that State Plan Amendment shall be submitted in a
23timely manner for review by the Centers for Medicare and
24Medicaid Services of the United States Department of Health and
25Human Services and subject to approval by the Centers for
26Medicare and Medicaid Services of the United States Department

 

 

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1of Health and Human Services. No such plan shall become
2effective without approval by the Illinois General Assembly by
3the enactment into law of related legislation. Notwithstanding
4any other provision of this Section, the Department is
5authorized to adopt rules to reduce the rate of any annual
6assessment imposed under this Section. Any such rules may be
7adopted by the Department under Section 5-50 of the Illinois
8Administrative Procedure Act.
9(Source: P.A. 94-242, eff. 7-18-05; 94-838, eff. 6-6-06;
1095-859, eff. 8-19-08.)
 
11    (305 ILCS 5/5A-3)  (from Ch. 23, par. 5A-3)
12    Sec. 5A-3. Exemptions.
13    (a) (Blank).
14    (b) A hospital provider that is a State agency, a State
15university, or a county with a population of 3,000,000 or more
16is exempt from the assessment imposed by Section 5A-2.
17    (b-2) A hospital provider that is a county with a
18population of less than 3,000,000 or a township, municipality,
19hospital district, or any other local governmental unit is
20exempt from the assessment imposed by Section 5A-2.
21    (b-5) (Blank).
22    (b-10) For State fiscal years 2004 through 2014 2013, a
23hospital provider, described in Section 1903(w)(3)(F) of the
24Social Security Act, whose hospital does not charge for its
25services is exempt from the assessment imposed by Section 5A-2,

 

 

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1unless the exemption is adjudged to be unconstitutional or
2otherwise invalid, in which case the hospital provider shall
3pay the assessment imposed by Section 5A-2.
4    (b-15) For State fiscal years 2004 and 2005, a hospital
5provider whose hospital is licensed by the Department of Public
6Health as a psychiatric hospital is exempt from the assessment
7imposed by Section 5A-2, unless the exemption is adjudged to be
8unconstitutional or otherwise invalid, in which case the
9hospital provider shall pay the assessment imposed by Section
105A-2.
11    (b-20) For State fiscal years 2004 and 2005, a hospital
12provider whose hospital is licensed by the Department of Public
13Health as a rehabilitation hospital is exempt from the
14assessment imposed by Section 5A-2, unless the exemption is
15adjudged to be unconstitutional or otherwise invalid, in which
16case the hospital provider shall pay the assessment imposed by
17Section 5A-2.
18    (b-25) For State fiscal years 2004 and 2005, a hospital
19provider whose hospital (i) is not a psychiatric hospital,
20rehabilitation hospital, or children's hospital and (ii) has an
21average length of inpatient stay greater than 25 days is exempt
22from the assessment imposed by Section 5A-2, unless the
23exemption is adjudged to be unconstitutional or otherwise
24invalid, in which case the hospital provider shall pay the
25assessment imposed by Section 5A-2.
26    (c) (Blank).

 

 

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1(Source: P.A. 94-242, eff. 7-18-05; 95-859, eff. 8-19-08.)
 
2    (305 ILCS 5/5A-5)  (from Ch. 23, par. 5A-5)
3    Sec. 5A-5. Notice; penalty; maintenance of records.
4    (a) The Department of Healthcare and Family Services shall
5send a notice of assessment to every hospital provider subject
6to assessment under this Article. The notice of assessment
7shall notify the hospital of its assessment and shall be sent
8after receipt by the Department of notification from the
9Centers for Medicare and Medicaid Services of the U.S.
10Department of Health and Human Services that the payment
11methodologies required under Section 5A-12, Section 5A-12.1,
12or Section 5A-12.2, whichever is applicable for that fiscal
13year, and, if necessary, the waiver granted under 42 CFR 433.68
14have been approved. The notice shall be on a form prepared by
15the Illinois Department and shall state the following:
16        (1) The name of the hospital provider.
17        (2) The address of the hospital provider's principal
18    place of business from which the provider engages in the
19    occupation of hospital provider in this State, and the name
20    and address of each hospital operated, conducted, or
21    maintained by the provider in this State.
22        (3) The occupied bed days, occupied bed days less
23    Medicare days, or adjusted gross hospital revenue of the
24    hospital provider (whichever is applicable), the amount of
25    assessment imposed under Section 5A-2 for the State fiscal

 

 

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1    year for which the notice is sent, and the amount of each
2    installment to be paid during the State fiscal year.
3        (4) (Blank).
4        (5) Other reasonable information as determined by the
5    Illinois Department.
6    (b) If a hospital provider conducts, operates, or maintains
7more than one hospital licensed by the Illinois Department of
8Public Health, the provider shall pay the assessment for each
9hospital separately.
10    (c) Notwithstanding any other provision in this Article, in
11the case of a person who ceases to conduct, operate, or
12maintain a hospital in respect of which the person is subject
13to assessment under this Article as a hospital provider, the
14assessment for the State fiscal year in which the cessation
15occurs shall be adjusted by multiplying the assessment computed
16under Section 5A-2 by a fraction, the numerator of which is the
17number of days in the year during which the provider conducts,
18operates, or maintains the hospital and the denominator of
19which is 365. Immediately upon ceasing to conduct, operate, or
20maintain a hospital, the person shall pay the assessment for
21the year as so adjusted (to the extent not previously paid).
22    (d) Notwithstanding any other provision in this Article, a
23provider who commences conducting, operating, or maintaining a
24hospital, upon notice by the Illinois Department, shall pay the
25assessment computed under Section 5A-2 and subsection (e) in
26installments on the due dates stated in the notice and on the

 

 

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1regular installment due dates for the State fiscal year
2occurring after the due dates of the initial notice.
3    (e) Notwithstanding any other provision in this Article,
4for State fiscal years 2004 and 2005, in the case of a hospital
5provider that did not conduct, operate, or maintain a hospital
6throughout calendar year 2001, the assessment for that State
7fiscal year shall be computed on the basis of hypothetical
8occupied bed days for the full calendar year as determined by
9the Illinois Department. Notwithstanding any other provision
10in this Article, for State fiscal years 2006 through 2008, in
11the case of a hospital provider that did not conduct, operate,
12or maintain a hospital in 2003, the assessment for that State
13fiscal year shall be computed on the basis of hypothetical
14adjusted gross hospital revenue for the hospital's first full
15fiscal year as determined by the Illinois Department (which may
16be based on annualization of the provider's actual revenues for
17a portion of the year, or revenues of a comparable hospital for
18the year, including revenues realized by a prior provider of
19the same hospital during the year). Notwithstanding any other
20provision in this Article, for State fiscal years 2009 through
212014 2013, in the case of a hospital provider that did not
22conduct, operate, or maintain a hospital in 2005, the
23assessment for that State fiscal year shall be computed on the
24basis of hypothetical occupied bed days for the full calendar
25year as determined by the Illinois Department.
26    (f) Every hospital provider subject to assessment under

 

 

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1this Article shall keep sufficient records to permit the
2determination of adjusted gross hospital revenue for the
3hospital's fiscal year. All such records shall be kept in the
4English language and shall, at all times during regular
5business hours of the day, be subject to inspection by the
6Illinois Department or its duly authorized agents and
7employees.
8    (g) The Illinois Department may, by rule, provide a
9hospital provider a reasonable opportunity to request a
10clarification or correction of any clerical or computational
11errors contained in the calculation of its assessment, but such
12corrections shall not extend to updating the cost report
13information used to calculate the assessment.
14    (h) (Blank).
15(Source: P.A. 94-242, eff. 7-18-05; 95-331, eff. 8-21-07;
1695-859, eff. 8-19-08.)
 
17    (305 ILCS 5/5A-8)  (from Ch. 23, par. 5A-8)
18    Sec. 5A-8. Hospital Provider Fund.
19    (a) There is created in the State Treasury the Hospital
20Provider Fund. Interest earned by the Fund shall be credited to
21the Fund. The Fund shall not be used to replace any moneys
22appropriated to the Medicaid program by the General Assembly.
23    (b) The Fund is created for the purpose of receiving moneys
24in accordance with Section 5A-6 and disbursing moneys only for
25the following purposes, notwithstanding any other provision of

 

 

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1law:
2        (1) For making payments to hospitals as required under
3    Articles V, V-A, VI, and XIV of this Code, under the
4    Children's Health Insurance Program Act, under the
5    Covering ALL KIDS Health Insurance Act, and under the
6    Senior Citizens and Disabled Persons Property Tax Relief
7    and Pharmaceutical Assistance Act.
8        (2) For the reimbursement of moneys collected by the
9    Illinois Department from hospitals or hospital providers
10    through error or mistake in performing the activities
11    authorized under this Article and Article V of this Code.
12        (3) For payment of administrative expenses incurred by
13    the Illinois Department or its agent in performing the
14    activities authorized by this Article.
15        (4) For payments of any amounts which are reimbursable
16    to the federal government for payments from this Fund which
17    are required to be paid by State warrant.
18        (5) For making transfers, as those transfers are
19    authorized in the proceedings authorizing debt under the
20    Short Term Borrowing Act, but transfers made under this
21    paragraph (5) shall not exceed the principal amount of debt
22    issued in anticipation of the receipt by the State of
23    moneys to be deposited into the Fund.
24        (6) For making transfers to any other fund in the State
25    treasury, but transfers made under this paragraph (6) shall
26    not exceed the amount transferred previously from that

 

 

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1    other fund into the Hospital Provider Fund.
2        (6.5) For making transfers to the Healthcare Provider
3    Relief Fund, except that transfers made under this
4    paragraph (6.5) shall not exceed $60,000,000 in the
5    aggregate.
6        (7) For State fiscal years 2004 and 2005 for making
7    transfers to the Health and Human Services Medicaid Trust
8    Fund, including 20% of the moneys received from hospital
9    providers under Section 5A-4 and transferred into the
10    Hospital Provider Fund under Section 5A-6. For State fiscal
11    year 2006 for making transfers to the Health and Human
12    Services Medicaid Trust Fund of up to $130,000,000 per year
13    of the moneys received from hospital providers under
14    Section 5A-4 and transferred into the Hospital Provider
15    Fund under Section 5A-6. Transfers under this paragraph
16    shall be made within 7 days after the payments have been
17    received pursuant to the schedule of payments provided in
18    subsection (a) of Section 5A-4.
19        (7.5) For State fiscal year 2007 for making transfers
20    of the moneys received from hospital providers under
21    Section 5A-4 and transferred into the Hospital Provider
22    Fund under Section 5A-6 to the designated funds not
23    exceeding the following amounts in that State fiscal year:
24        Health and Human Services
25            Medicaid Trust Fund................. $20,000,000
26        Long-Term Care Provider Fund............ $30,000,000

 

 

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1        General Revenue Fund................... $80,000,000.
2        Transfers under this paragraph shall be made within 7
3    days after the payments have been received pursuant to the
4    schedule of payments provided in subsection (a) of Section
5    5A-4.
6        (7.8) For State fiscal year 2008, for making transfers
7    of the moneys received from hospital providers under
8    Section 5A-4 and transferred into the Hospital Provider
9    Fund under Section 5A-6 to the designated funds not
10    exceeding the following amounts in that State fiscal year:
11        Health and Human Services
12            Medicaid Trust Fund..................$40,000,000
13        Long-Term Care Provider Fund..............$60,000,000
14        General Revenue Fund...................$160,000,000.
15        Transfers under this paragraph shall be made within 7
16    days after the payments have been received pursuant to the
17    schedule of payments provided in subsection (a) of Section
18    5A-4.
19        (7.9) For State fiscal years 2009 through 2014 2013,
20    for making transfers of the moneys received from hospital
21    providers under Section 5A-4 and transferred into the
22    Hospital Provider Fund under Section 5A-6 to the designated
23    funds not exceeding the following amounts in that State
24    fiscal year:
25        Health and Human Services
26            Medicaid Trust Fund...................$20,000,000

 

 

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1        Long Term Care Provider Fund..............$30,000,000
2        General Revenue Fund.....................$80,000,000.
3        Except as provided under this paragraph, transfers
4    under this paragraph shall be made within 7 business days
5    after the payments have been received pursuant to the
6    schedule of payments provided in subsection (a) of Section
7    5A-4. For State fiscal year 2009, transfers to the General
8    Revenue Fund under this paragraph shall be made on or
9    before June 30, 2009, as sufficient funds become available
10    in the Hospital Provider Fund to both make the transfers
11    and continue hospital payments.
12        (8) For making refunds to hospital providers pursuant
13    to Section 5A-10.
14    Disbursements from the Fund, other than transfers
15authorized under paragraphs (5) and (6) of this subsection,
16shall be by warrants drawn by the State Comptroller upon
17receipt of vouchers duly executed and certified by the Illinois
18Department.
19    (c) The Fund shall consist of the following:
20        (1) All moneys collected or received by the Illinois
21    Department from the hospital provider assessment imposed
22    by this Article.
23        (2) All federal matching funds received by the Illinois
24    Department as a result of expenditures made by the Illinois
25    Department that are attributable to moneys deposited in the
26    Fund.

 

 

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1        (3) Any interest or penalty levied in conjunction with
2    the administration of this Article.
3        (4) Moneys transferred from another fund in the State
4    treasury.
5        (5) All other moneys received for the Fund from any
6    other source, including interest earned thereon.
7    (d) (Blank).
8(Source: P.A. 95-707, eff. 1-11-08; 95-859, eff. 8-19-08; 96-3,
9eff. 2-27-09; 96-45, eff. 7-15-09; 96-821, eff. 11-20-09.)
 
10    (305 ILCS 5/5A-10)  (from Ch. 23, par. 5A-10)
11    Sec. 5A-10. Applicability.
12    (a) The assessment imposed by Section 5A-2 shall not take
13effect or shall cease to be imposed, and any moneys remaining
14in the Fund shall be refunded to hospital providers in
15proportion to the amounts paid by them, if:
16        (1) The sum of the appropriations for State fiscal
17    years 2004 and 2005 from the General Revenue Fund for
18    hospital payments under the medical assistance program is
19    less than $4,500,000,000 or the appropriation for each of
20    State fiscal years 2006, 2007 and 2008 from the General
21    Revenue Fund for hospital payments under the medical
22    assistance program is less than $2,500,000,000 increased
23    annually to reflect any increase in the number of
24    recipients, or the annual appropriation for State fiscal
25    years 2009 through 2014 2013, from the General Revenue Fund

 

 

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1    combined with the Hospital Provider Fund as authorized in
2    Section 5A-8 for hospital payments under the medical
3    assistance program, is less than the amount appropriated
4    for State fiscal year 2009, adjusted annually to reflect
5    any change in the number of recipients, excluding State
6    fiscal year 2009 supplemental appropriations made
7    necessary by the enactment of the American Recovery and
8    Reinvestment Act of 2009; or
9        (2) For State fiscal years prior to State fiscal year
10    2009, the Department of Healthcare and Family Services
11    (formerly Department of Public Aid) makes changes in its
12    rules that reduce the hospital inpatient or outpatient
13    payment rates, including adjustment payment rates, in
14    effect on October 1, 2004, except for hospitals described
15    in subsection (b) of Section 5A-3 and except for changes in
16    the methodology for calculating outlier payments to
17    hospitals for exceptionally costly stays, so long as those
18    changes do not reduce aggregate expenditures below the
19    amount expended in State fiscal year 2005 for such
20    services; or
21        (2.1) For State fiscal years 2009 through 2014 2013,
22    the Department of Healthcare and Family Services adopts any
23    administrative rule change to reduce payment rates or
24    alters any payment methodology that reduces any payment
25    rates made to operating hospitals under the approved Title
26    XIX or Title XXI State plan in effect January 1, 2008

 

 

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1    except for:
2            (A) any changes for hospitals described in
3        subsection (b) of Section 5A-3; or
4            (B) any rates for payments made under this Article
5        V-A; or
6            (C) any changes proposed in State plan amendment
7        transmittal numbers 08-01, 08-02, 08-04, 08-06, and
8        08-07; or
9            (D) in relation to any admissions on or after
10        January 1, 2011, a modification in the methodology for
11        calculating outlier payments to hospitals for
12        exceptionally costly stays, for hospitals reimbursed
13        under the diagnosis-related grouping methodology;
14        provided that the Department shall be limited to one
15        such modification during the 36-month period after the
16        effective date of this amendatory Act of the 96th
17        General Assembly; or
18        (3) The payments to hospitals required under Section
19    5A-12 or Section 5A-12.2 are changed or are not eligible
20    for federal matching funds under Title XIX or XXI of the
21    Social Security Act.
22    (b) The assessment imposed by Section 5A-2 shall not take
23effect or shall cease to be imposed if the assessment is
24determined to be an impermissible tax under Title XIX of the
25Social Security Act. Moneys in the Hospital Provider Fund
26derived from assessments imposed prior thereto shall be

 

 

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1disbursed in accordance with Section 5A-8 to the extent federal
2financial participation is not reduced due to the
3impermissibility of the assessments, and any remaining moneys
4shall be refunded to hospital providers in proportion to the
5amounts paid by them.
6(Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08; 96-8,
7eff. 4-28-09.)
 
8    (305 ILCS 5/5A-14)
9    Sec. 5A-14. Repeal of assessments and disbursements.
10    (a) Section 5A-2 is repealed on July 1, 2014 2013.
11    (b) Section 5A-12 is repealed on July 1, 2005.
12    (c) Section 5A-12.1 is repealed on July 1, 2008.
13    (d) Section 5A-12.2 is repealed on July 1, 2014 2013.
14    (e) Section 5A-12.3 is repealed on July 1, 2011.
15(Source: P.A. 95-859, eff. 8-19-08; 96-821, eff. 11-20-09.)
 
16    (305 ILCS 5/5B-1)  (from Ch. 23, par. 5B-1)
17    Sec. 5B-1. Definitions. As used in this Article, unless the
18context requires otherwise:
19    "Fund" means the Long-Term Care Provider Fund.
20    "Long-term care facility" means (i) a skilled nursing or
21intermediate long term care facility, whether public or private
22and whether organized for profit or not-for-profit, that is
23subject to licensure by the Illinois Department of Public
24Health under the Nursing Home Care Act or the MR/DD Community

 

 

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1Care Act, including a county nursing home directed and
2maintained under Section 5-1005 of the Counties Code, and (ii)
3a part of a hospital in which skilled or intermediate long-term
4care services within the meaning of Title XVIII or XIX of the
5Social Security Act are provided; except that the term
6"long-term care facility" does not include a facility operated
7by a State agency, a facility participating in the Illinois
8Department's demonstration program pursuant to the provisions
9of Title 77, Part 300, Subpart T of the Illinois Administrative
10Code, or operated solely as an intermediate care facility for
11the mentally retarded within the meaning of Title XIX of the
12Social Security Act.
13    "Long-term care provider" means (i) a person licensed by
14the Department of Public Health to operate and maintain a
15skilled nursing or intermediate long-term care facility or (ii)
16a hospital provider that provides skilled or intermediate
17long-term care services within the meaning of Title XVIII or
18XIX of the Social Security Act. For purposes of this paragraph,
19"person" means any political subdivision of the State,
20municipal corporation, individual, firm, partnership,
21corporation, company, limited liability company, association,
22joint stock association, or trust, or a receiver, executor,
23trustee, guardian, or other representative appointed by order
24of any court. "Hospital provider" means a person licensed by
25the Department of Public Health to conduct, operate, or
26maintain a hospital.

 

 

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1    "Occupied bed days" shall be computed separately for each
2long-term care facility operated or maintained by a long-term
3care provider, and means the sum for all beds of the number of
4days during the month year on which each bed was is occupied by
5a resident, other than a resident for whom Medicare Part A is
6the primary payer (other than a resident receiving care at an
7intermediate care facility for the mentally retarded within the
8meaning of Title XIX of the Social Security Act).
9    "Intergovernmental transfer payment" means the payments
10established under Section 15-3 of this Code, and includes
11without limitation payments payable under that Section for
12July, August, and September of 1992.
13(Source: P.A. 96-339, eff. 7-1-10.)
 
14    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
15    Sec. 5B-2. Assessment; no local authorization to tax.
16    (a) For the privilege of engaging in the occupation of
17long-term care provider, beginning July 1, 2011 an assessment
18is imposed upon each long-term care provider in an amount equal
19to $6.07 times the number of occupied bed days due and payable
20each month for the State fiscal year beginning on July 1, 1992
21and ending on June 30, 1993, in an amount equal to $6.30 times
22the number of occupied bed days for the most recent calendar
23year ending before the beginning of that State fiscal year.
24Notwithstanding any provision of any other Act to the contrary,
25this assessment shall be construed as a tax, but may not be

 

 

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1added to the charges of an individual's nursing home care that
2is paid for in whole, or in part, by a federal, State, or
3combined federal-state medical care program, except those
4individuals receiving Medicare Part B benefits solely.
5    (b) Nothing in this amendatory Act of 1992 shall be
6construed to authorize any home rule unit or other unit of
7local government to license for revenue or impose a tax or
8assessment upon long-term care providers or the occupation of
9long-term care provider, or a tax or assessment measured by the
10income or earnings or occupied bed days of a long-term care
11provider.
12(Source: P.A. 87-861.)
 
13    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)
14    Sec. 5B-4. Payment of assessment; penalty.
15    (a) The assessment imposed by Section 5B-2 for a State
16fiscal year shall be due and payable monthly, on the last State
17business day of the month for occupied bed days reported for
18the preceding third month prior to the month in which the tax
19is payable and due. A facility that has delayed payment due to
20the State's failure to reimburse for services rendered may
21request an extension on the due date for payment pursuant to
22subsection (b) and shall pay the assessment within 30 days of
23reimbursement by the Department in quarterly installments,
24each equalling one-fourth of the assessment for the year, on
25September 30, December 31, March 31, and June 30 of the year.

 

 

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1The Illinois Department may provide that county nursing homes
2directed and maintained pursuant to Section 5-1005 of the
3Counties Code may meet their assessment obligation by
4certifying to the Illinois Department that county expenditures
5have been obligated for the operation of the county nursing
6home in an amount at least equal to the amount of the
7assessment.
8    (a-5) Each assessment payment shall be accompanied by an
9assessment report to be completed by the long-term care
10provider. A separate report shall be completed for each
11long-term care facility in this State operated by a long-term
12care provider. The report shall be in a form and manner
13prescribed by the Illinois Department and shall at a minimum
14provide for the reporting of the number of occupied bed days of
15the long-term care facility for the reporting period and other
16reasonable information the Illinois Department requires for
17the administration of its responsibilities under this Code. To
18the extent practicable, the Department shall coordinate the
19assessment reporting requirements with other reporting
20required of long-term care facilities.
21    (b) The Illinois Department is authorized to establish
22delayed payment schedules for long-term care providers that are
23unable to make assessment installment payments when due under
24this Section due to financial difficulties, as determined by
25the Illinois Department. The Illinois Department may not deny a
26request for delay of payment of the assessment imposed under

 

 

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1this Article if the long-term care provider has not been paid
2for services provided during the month on which the assessment
3is levied.
4    (c) If a long-term care provider fails to pay the full
5amount of an assessment payment installment when due (including
6any extensions granted under subsection (b)), there shall,
7unless waived by the Illinois Department for reasonable cause,
8be added to the assessment imposed by Section 5B-2 for the
9State fiscal year a penalty assessment equal to the lesser of
10(i) 5% of the amount of the assessment payment installment not
11paid on or before the due date plus 5% of the portion thereof
12remaining unpaid on the last day of each month thereafter or
13(ii) 100% of the assessment payment installment amount not paid
14on or before the due date. For purposes of this subsection,
15payments will be credited first to unpaid assessment payment
16installment amounts (rather than to penalty or interest),
17beginning with the most delinquent assessment payments
18installments. Payment cycles of longer than 60 days shall be
19one factor the Director takes into account in granting a waiver
20under this Section.
21    (c-5) If a long-term care provider fails to file its report
22with payment, there shall, unless waived by the Illinois
23Department for reasonable cause, be added to the assessment due
24a penalty assessment equal to 25% of the assessment due.
25    (d) Nothing in this amendatory Act of 1993 shall be
26construed to prevent the Illinois Department from collecting

 

 

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1all amounts due under this Article pursuant to an assessment
2imposed before the effective date of this amendatory Act of
31993.
4    (e) Nothing in this amendatory Act of the 96th General
5Assembly shall be construed to prevent the Illinois Department
6from collecting all amounts due under this Code pursuant to an
7assessment, tax, fee, or penalty imposed before the effective
8date of this amendatory Act of the 96th General Assembly.
9(Source: P.A. 96-444, eff. 8-14-09.)
 
10    (305 ILCS 5/5B-5)  (from Ch. 23, par. 5B-5)
11    Sec. 5B-5. Annual reporting Reporting; penalty;
12maintenance of records.
13    (a) After December 31 of each year, and on or before March
1431 of the succeeding year, every long-term care provider
15subject to assessment under this Article shall file a report
16return with the Illinois Department. The return shall report
17the occupied bed days for the calendar year just ended and
18shall be utilized by the Illinois Department to calculate the
19assessment for the State fiscal year commencing on the next
20July 1, except that the return for the State fiscal year
21commencing July 1, 1992 and the report of occupied bed days for
22calendar year 1991 shall be filed on or before September 30,
231992. The report return shall be in a form and manner
24prescribed on a form prepared by the Illinois Department and
25shall state the revenue received by the long-term care

 

 

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1provider, reported in such categories as may be required by the
2Illinois Department, and other the following:
3        (1) The name of the long-term care provider.
4        (2) The address of the long-term care provider's
5    principal place of business from which the provider engages
6    in the occupation of long-term care provider in this State,
7    and the name and address of each long-term care facility
8    operated or maintained by the provider in this State.
9        (3) The number of occupied bed days of the long-term
10    care provider for the calendar year just ended, the amount
11    of assessment imposed under Section 5B-2 for the State
12    fiscal year for which the return is filed, and the amount
13    of each quarterly installment to be paid during the State
14    fiscal year.
15        (4) The amount of penalty due, if any.
16        (5) Other reasonable information the Illinois
17    Department requires for the administration of its
18    responsibilities under this Code.
19    (b) If a long-term care provider operates or maintains more
20than one long-term care facility in this State, the provider
21may not file a single return covering all those long-term care
22facilities, but shall file a separate return for each long-term
23care facility and shall compute and pay the assessment for each
24long-term care facility separately.
25    (c) Notwithstanding any other provision in this Article, in
26the case of a person who ceases to operate or maintain a

 

 

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1long-term care facility in respect of which the person is
2subject to assessment under this Article as a long-term care
3provider, the assessment for the State fiscal year in which the
4cessation occurs shall be adjusted by multiplying the
5assessment computed under Section 5B-2 by a fraction, the
6numerator of which is the number of months in the year during
7which the provider operates or maintains the long-term care
8facility and the denominator of which is 12. The person shall
9file a final, amended return with the Illinois Department not
10more than 90 days after the cessation reflecting the adjustment
11and shall pay with the final return the assessment for the year
12as so adjusted (to the extent not previously paid). If a person
13fails to file a final amended return on a timely basis, there
14shall, unless waived by the Illinois Department for reasonable
15cause, be added to the assessment due a penalty assessment
16equal to 25% of the assessment due.
17    (d) Notwithstanding any other provision of this Article, a
18provider who commences operating or maintaining a long-term
19care facility that was under a prior ownership and remained
20licensed by the Department of Public Health shall notify the
21Illinois Department of the change in ownership and shall be
22responsible to immediately pay any prior amounts owed by the
23facility. shall file an initial return for the State fiscal
24year in which the commencement occurs within 90 days thereafter
25and shall pay the assessment computed under Section 5B-2 and
26subsection (e) in equal installments on the due date of the

 

 

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1return and on the regular installment due dates for the State
2fiscal year occurring after the due date of the initial return.
3    (e) The Department shall develop a procedure for sharing
4with a potential buyer of a facility information regarding
5outstanding assessments and penalties owed by that facility.
6Notwithstanding any other provision of this Article, in the
7case of a long-term care provider that did not operate or
8maintain a long-term care facility throughout the calendar year
9preceding a State fiscal year, the assessment for that State
10fiscal year shall be computed on the basis of hypothetical
11occupied bed days for the full calendar year as determined by
12rules adopted by the Illinois Department (which may be based on
13annualization of the provider's actual occupied bed days for a
14portion of the calendar year, or the occupied bed days of a
15comparable facility for the year, including the same facility
16while operated by a prior provider).
17    (f) In the case of a long-term care provider existing as a
18corporation or legal entity other than an individual, the
19return filed by it shall be signed by its president,
20vice-president, secretary, or treasurer or by its properly
21authorized agent.
22    (g) If a long-term care provider fails to file its return
23for a State fiscal year on or before the due date of the
24return, there shall, unless waived by the Illinois Department
25for reasonable cause, be added to the assessment imposed by
26Section 5B-2 for the State fiscal year a penalty assessment

 

 

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1equal to 25% of the assessment imposed for the year.
2    (h) Every long-term care provider subject to assessment
3under this Article shall keep records and books that will
4permit the determination of occupied bed days on a calendar
5year basis. All such books and records shall be kept in the
6English language and shall, at all times during business hours
7of the day, be subject to inspection by the Illinois Department
8or its duly authorized agents and employees.
9(Source: P.A. 87-861.)
 
10    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
11    Sec. 5B-8. Long-Term Care Provider Fund.
12    (a) There is created in the State Treasury the Long-Term
13Care Provider Fund. Interest earned by the Fund shall be
14credited to the Fund. The Fund shall not be used to replace any
15moneys appropriated to the Medicaid program by the General
16Assembly.
17    (b) The Fund is created for the purpose of receiving and
18disbursing moneys in accordance with this Article.
19Disbursements from the Fund shall be made only as follows:
20        (1) For payments to skilled or intermediate nursing
21    facilities, including county nursing facilities but
22    excluding State-operated facilities, under Title XIX of
23    the Social Security Act and Article V of this Code.
24        (2) For the reimbursement of moneys collected by the
25    Illinois Department through error or mistake, and for

 

 

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1    making required payments under Section 5-4.38(a)(1) if
2    there are no moneys available for such payments in the
3    Medicaid Long Term Care Provider Participation Fee Trust
4    Fund.
5        (3) For payment of administrative expenses incurred by
6    the Illinois Department or its agent in performing the
7    activities authorized by this Article.
8        (3.5) For reimbursement of expenses incurred by
9    long-term care facilities, and payment of administrative
10    expenses incurred by the Department of Public Health, in
11    relation to the conduct and analysis of background checks
12    for identified offenders under the Nursing Home Care Act.
13        (4) For payments of any amounts that are reimbursable
14    to the federal government for payments from this Fund that
15    are required to be paid by State warrant.
16        (5) For making transfers to the General Obligation Bond
17    Retirement and Interest Fund, as those transfers are
18    authorized in the proceedings authorizing debt under the
19    Short Term Borrowing Act, but transfers made under this
20    paragraph (5) shall not exceed the principal amount of debt
21    issued in anticipation of the receipt by the State of
22    moneys to be deposited into the Fund.
23        (6) For making transfers, at the direction of the
24    Director of the Governor's Office of Management and Budget
25    during each fiscal year beginning on or after July 1, 2011,
26    to other State funds in an annual amount of $20,000,000 of

 

 

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1    the tax collected pursuant to this Article for the purpose
2    of enforcement of nursing home standards, support of the
3    ombudsman program, and efforts to expand home and
4    community-based services.
5    Disbursements from the Fund, other than transfers made
6pursuant to paragraphs (5) and (6) of this subsection to the
7General Obligation Bond Retirement and Interest Fund, shall be
8by warrants drawn by the State Comptroller upon receipt of
9vouchers duly executed and certified by the Illinois
10Department.
11    (c) The Fund shall consist of the following:
12        (1) All moneys collected or received by the Illinois
13    Department from the long-term care provider assessment
14    imposed by this Article.
15        (2) All federal matching funds received by the Illinois
16    Department as a result of expenditures made by the Illinois
17    Department that are attributable to moneys deposited in the
18    Fund.
19        (3) Any interest or penalty levied in conjunction with
20    the administration of this Article.
21        (4) (Blank). Any balance in the Medicaid Long Term Care
22    Provider Participation Fee Fund in the State Treasury. The
23    balance shall be transferred to the Fund upon certification
24    by the Illinois Department to the State Comptroller that
25    all of the disbursements required by Section 5-4.31(b) of
26    this Code have been made.

 

 

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1        (5) All other monies received for the Fund from any
2    other source, including interest earned thereon.
3(Source: P.A. 95-707, eff. 1-11-08.)
 
4    (305 ILCS 5/5-4.20 rep.)
5    (305 ILCS 5/5-4.21 rep.)
6    (305 ILCS 5/5-4.22 rep.)
7    (305 ILCS 5/5-4.23 rep.)
8    (305 ILCS 5/5-4.24 rep.)
9    (305 ILCS 5/5-4.25 rep.)
10    (305 ILCS 5/5-4.26 rep.)
11    (305 ILCS 5/5-4.27 rep.)
12    (305 ILCS 5/5-4.28 rep.)
13    (305 ILCS 5/5-4.29 rep.)
14    (305 ILCS 5/5-4.30 rep.)
15    (305 ILCS 5/5-4.31 rep.)
16    (305 ILCS 5/5-4.32 rep.)
17    (305 ILCS 5/5-4.33 rep.)
18    (305 ILCS 5/5-4.34 rep.)
19    (305 ILCS 5/5-4.35 rep.)
20    (305 ILCS 5/5-4.36 rep.)
21    (305 ILCS 5/5-4.37 rep.)
22    (305 ILCS 5/5-4.38 rep.)
23    (305 ILCS 5/5-4.39 rep.)
24    (305 ILCS 5/5-5.6a rep.)
25    (305 ILCS 5/5-5.11 rep.)

 

 

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1    (305 ILCS 5/5-5.21 rep.)
2    Section 35. The Illinois Public Aid Code is amended by
3repealing Sections 5-4.20, 5-4.21, 5-4.22, 5-4.23, 5-4.24,
45-4.25, 5-4.26, 5-4.27, 5-4.28, 5-4.29, 5-4.30, 5-4.31,
55-4.32, 5-4.33, 5-4.34, 5-4.35, 5-4.36, 5-4.37, 5-4.38,
65-4.39, 5-5.6a, 5-5.11, and 5-5.21.
 
7    Section 99. Effective date. This Act takes effect upon
8becoming law.