Rep. Sara Feigenholtz

Filed: 1/7/2011

 

 


 

 


 
09600SB3088ham002LRB096 20288 KTG 44846 a

1
AMENDMENT TO SENATE BILL 3088

2    AMENDMENT NO. ______. Amend Senate Bill 3088 by replacing
3everything after the enacting clause with the following:
 
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.
 

 

 

09600SB3088ham002- 2 -LRB096 20288 KTG 44846 a

1    Section 10. The Department of Human Services Act is amended
2by adding Section 1-50 as follows:
 
3    (20 ILCS 1305/1-50 new)
4    Sec. 1-50. Department of Human Services Community Services
5Fund.
6    (a) The Department of Human Services Community Services
7Fund is created in the State treasury as a special fund.
8    (b) The Fund is created for the purpose of receiving and
9disbursing moneys in accordance with this Section.
10Disbursements from the Fund shall be made, subject to
11appropriation, for payment of expenses incurred by the
12Department of Human Services in support of the Department's
13rebalancing services.
14    (c) The Fund shall consist of the following:
15        (1) Moneys transferred from another State fund.
16        (2) All federal moneys received as a result of
17    expenditures that are attributable to moneys deposited in
18    the Fund.
19        (3) All other moneys received for the Fund from any
20    other source.
21        (4) Interest earned upon moneys in the Fund.
 
22    Section 15. The State Finance Act is amended by adding
23Section 5.786 as follows:
 

 

 

09600SB3088ham002- 3 -LRB096 20288 KTG 44846 a

1    (30 ILCS 105/5.786 new)
2    Sec. 5.786. The Department of Human Services Community
3Services Fund.
 
4    Section 20. The State Prompt Payment Act is amended by
5changing Section 3-2 as follows:
 
6    (30 ILCS 540/3-2)
7    Sec. 3-2. Beginning July 1, 1993, in any instance where a
8State official or agency is late in payment of a vendor's bill
9or invoice for goods or services furnished to the State, as
10defined in Section 1, properly approved in accordance with
11rules promulgated under Section 3-3, the State official or
12agency shall pay interest to the vendor in accordance with the
13following:
14        (1) Any bill, except a bill submitted under Article V
15    of the Illinois Public Aid Code, approved for payment under
16    this Section must be paid or the payment issued to the
17    payee within 60 days of receipt of a proper bill or
18    invoice. If payment is not issued to the payee within this
19    60 day period, an interest penalty of 1.0% of any amount
20    approved and unpaid shall be added for each month or
21    fraction thereof after the end of this 60 day period, until
22    final payment is made. Any bill, except a bill for pharmacy
23    or nursing facility services or goods, submitted under
24    Article V of the Illinois Public Aid Code approved for

 

 

09600SB3088ham002- 4 -LRB096 20288 KTG 44846 a

1    payment under this Section must be paid or the payment
2    issued to the payee within 60 days after receipt of a
3    proper bill or invoice, and, if payment is not issued to
4    the payee within this 60-day period, an interest penalty of
5    2.0% of any amount approved and unpaid shall be added for
6    each month or fraction thereof after the end of this 60-day
7    period, until final payment is made. Any bill for pharmacy
8    or nursing facility services or goods submitted under
9    Article V of the Illinois Public Aid Code, approved for
10    payment under this Section must be paid or the payment
11    issued to the payee within 60 days of receipt of a proper
12    bill or invoice. If payment is not issued to the payee
13    within this 60 day period, an interest penalty of 1.0% of
14    any amount approved and unpaid shall be added for each
15    month or fraction thereof after the end of this 60 day
16    period, until final payment is made.
17        (1.1) A State agency shall review in a timely manner
18    each bill or invoice after its receipt. If the State agency
19    determines that the bill or invoice contains a defect
20    making it unable to process the payment request, the agency
21    shall notify the vendor requesting payment as soon as
22    possible after discovering the defect pursuant to rules
23    promulgated under Section 3-3; provided, however, that the
24    notice for construction related bills or invoices must be
25    given not later than 30 days after the bill or invoice was
26    first submitted. The notice shall identify the defect and

 

 

09600SB3088ham002- 5 -LRB096 20288 KTG 44846 a

1    any additional information necessary to correct the
2    defect. If one or more items on a construction related bill
3    or invoice are disapproved, but not the entire bill or
4    invoice, then the portion that is not disapproved shall be
5    paid.
6        (2) Where a State official or agency is late in payment
7    of a vendor's bill or invoice properly approved in
8    accordance with this Act, and different late payment terms
9    are not reduced to writing as a contractual agreement, the
10    State official or agency shall automatically pay interest
11    penalties required by this Section amounting to $50 or more
12    to the appropriate vendor. Each agency shall be responsible
13    for determining whether an interest penalty is owed and for
14    paying the interest to the vendor. Interest due to a vendor
15    that amounts to less than $50 shall not be paid but shall
16    be accrued until all interest due the vendor for all
17    similar warrants exceeds $50, at which time the accrued
18    interest shall be payable and interest will begin accruing
19    again, except that interest accrued as of the end of the
20    fiscal year that does not exceed $50 shall be payable at
21    that time. In the event an individual has paid a vendor for
22    services in advance, the provisions of this Section shall
23    apply until payment is made to that individual.
24(Source: P.A. 96-555, eff. 8-18-09; 96-802, eff. 1-1-10;
2596-959, eff. 7-1-10; 96-1000, eff. 7-2-10.)
 

 

 

09600SB3088ham002- 6 -LRB096 20288 KTG 44846 a

1    Section 25. The Nursing Home Care Act is amended by
2changing Section 3-103 as follows:
 
3    (210 ILCS 45/3-103)  (from Ch. 111 1/2, par. 4153-103)
4    Sec. 3-103. The procedure for obtaining a valid license
5shall be as follows:
6        (1) Application to operate a facility shall be made to
7    the Department on forms furnished by the Department.
8        (2) All license applications shall be accompanied with
9    an application fee. The fee for an annual license shall be
10    $1,990. Facilities that pay a fee or assessment pursuant to
11    Article V-C of the Illinois Public Aid Code shall be exempt
12    from the license fee imposed under this item (2). The fee
13    for a 2-year license shall be double the fee for the annual
14    license set forth in the preceding sentence. The fees
15    collected shall be deposited with the State Treasurer into
16    the Long Term Care Monitor/Receiver Fund, which has been
17    created as a special fund in the State treasury. This
18    special fund is to be used by the Department for expenses
19    related to the appointment of monitors and receivers as
20    contained in Sections 3-501 through 3-517 of this Act, for
21    the enforcement of this Act, and for implementation of the
22    Abuse Prevention Review Team Act. All federal moneys
23    received as a result of expenditures from the Fund shall be
24    deposited into the Fund. The Department may reduce or waive
25    a penalty pursuant to Section 3-308 only if that action

 

 

09600SB3088ham002- 7 -LRB096 20288 KTG 44846 a

1    will not threaten the ability of the Department to meet the
2    expenses required to be met by the Long Term Care
3    Monitor/Receiver Fund. At the end of each fiscal year, any
4    funds in excess of $1,000,000 held in the Long Term Care
5    Monitor/Receiver Fund shall be deposited in the State's
6    General Revenue Fund. The application shall be under oath
7    and the submission of false or misleading information shall
8    be a Class A misdemeanor. The application shall contain the
9    following information:
10            (a) The name and address of the applicant if an
11        individual, and if a firm, partnership, or
12        association, of every member thereof, and in the case
13        of a corporation, the name and address thereof and of
14        its officers and its registered agent, and in the case
15        of a unit of local government, the name and address of
16        its chief executive officer;
17            (b) The name and location of the facility for which
18        a license is sought;
19            (c) The name of the person or persons under whose
20        management or supervision the facility will be
21        conducted;
22            (d) The number and type of residents for which
23        maintenance, personal care, or nursing is to be
24        provided; and
25            (e) Such information relating to the number,
26        experience, and training of the employees of the

 

 

09600SB3088ham002- 8 -LRB096 20288 KTG 44846 a

1        facility, any management agreements for the operation
2        of the facility, and of the moral character of the
3        applicant and employees as the Department may deem
4        necessary.
5        (3) Each initial application shall be accompanied by a
6    financial statement setting forth the financial condition
7    of the applicant and by a statement from the unit of local
8    government having zoning jurisdiction over the facility's
9    location stating that the location of the facility is not
10    in violation of a zoning ordinance. An initial application
11    for a new facility shall be accompanied by a permit as
12    required by the "Illinois Health Facilities Planning Act".
13    After the application is approved, the applicant shall
14    advise the Department every 6 months of any changes in the
15    information originally provided in the application.
16        (4) Other information necessary to determine the
17    identity and qualifications of an applicant to operate a
18    facility in accordance with this Act shall be included in
19    the application as required by the Department in
20    regulations.
21(Source: P.A. 96-758, eff. 8-25-09; 96-1372, eff. 7-29-10.)
 
22    Section 30. The Illinois Public Aid Code is amended by
23changing Sections 5-1.1, 5-5.2, 5-5.3, 5-5.4, 5-5.4a, 5-5.5,
245-5.5a, 5-5.6b, 5-5.7, 5-5.8b, 5-5.11, 5A-2, 5A-3, 5A-5, 5A-8,
255A-10, 5A-14, 5B-1, 5B-2, 5B-4, 5B-5, and 5B-8 as follows:
 

 

 

09600SB3088ham002- 9 -LRB096 20288 KTG 44846 a

1    (305 ILCS 5/5-1.1)  (from Ch. 23, par. 5-1.1)
2    Sec. 5-1.1. Definitions. The terms defined in this Section
3shall have the meanings ascribed to them, except when the
4context otherwise requires.
5    (a) "Nursing Skilled nursing facility" means a nursing home
6eligible to participate as a skilled nursing facility, licensed
7by the Department of Public Health under the Nursing Home Care
8Act, that provides nursing facility services within the meaning
9of under Title XIX of the federal Social Security Act.
10    (b) "Intermediate care facility for the developmentally
11disabled" or "ICF/DD" means a nursing home eligible to
12participate as an intermediate care facility, licensed by the
13Department of Public Health under the MR/DD Community Care Act,
14that is an intermediate care facility for the mentally retarded
15within the meaning of under Title XIX of the federal Social
16Security Act.
17    (c) "Standard services" means those services required for
18the care of all patients in the facility and shall, as a
19minimum, include the following: (1) administration; (2)
20dietary (standard); (3) housekeeping; (4) laundry and linen;
21(5) maintenance of property and equipment, including
22utilities; (6) medical records; (7) training of employees; (8)
23utilization review; (9) activities services; (10) social
24services; (11) disability services; and all other similar
25services required by either the laws of the State of Illinois

 

 

09600SB3088ham002- 10 -LRB096 20288 KTG 44846 a

1or one of its political subdivisions or municipalities or by
2Title XIX of the Social Security Act.
3    (d) "Patient services" means those which vary with the
4number of personnel; professional and para-professional skills
5of the personnel; specialized equipment, and reflect the
6intensity of the medical and psycho-social needs of the
7patients. Patient services shall as a minimum include: (1)
8physical services; (2) nursing services, including restorative
9nursing; (3) medical direction and patient care planning; (4)
10health related supportive and habilitative services and all
11similar services required by either the laws of the State of
12Illinois or one of its political subdivisions or municipalities
13or by Title XIX of the Social Security Act.
14    (e) "Ancillary services" means those services which
15require a specific physician's order and defined as under the
16medical assistance program as not being routine in nature for
17skilled nursing facilities and ICF/DDs intermediate care
18facilities. Such services generally must be authorized prior to
19delivery and payment as provided for under the rules of the
20Department of Healthcare and Family Services.
21    (f) "Capital" means the investment in a facility's assets
22for both debt and non-debt funds. Non-debt capital is the
23difference between an adjusted replacement value of the assets
24and the actual amount of debt capital.
25    (g) "Profit" means the amount which shall accrue to a
26facility as a result of its revenues exceeding its expenses as

 

 

09600SB3088ham002- 11 -LRB096 20288 KTG 44846 a

1determined in accordance with generally accepted accounting
2principles.
3    (h) "Non-institutional services" means those services
4provided under paragraph (f) of Section 3 of the Disabled
5Persons Rehabilitation Act and those services provided under
6Section 4.02 of the Illinois Act on the Aging.
7    (i) "Exceptional medical care" means the level of medical
8care required by persons who are medically stable for discharge
9from a hospital but who require acute intensity hospital level
10care for physician, nurse and ancillary specialist services,
11including persons with acquired immunodeficiency syndrome
12(AIDS) or a related condition. Such care shall consist of those
13services which the Department shall determine by rule.
14    (j) "Institutionalized person" means an individual who is
15an inpatient in an ICF/DD or intermediate care or skilled
16nursing facility, or who is an inpatient in a medical
17institution receiving a level of care equivalent to that of an
18ICF/DD or intermediate care or skilled nursing facility, or who
19is receiving services under Section 1915(c) of the Social
20Security Act.
21    (k) "Institutionalized spouse" means an institutionalized
22person who is expected to receive services at the same level of
23care for at least 30 days and is married to a spouse who is not
24an institutionalized person.
25    (l) "Community spouse" is the spouse of an
26institutionalized spouse.

 

 

09600SB3088ham002- 12 -LRB096 20288 KTG 44846 a

1(Source: P.A. 95-331, eff. 8-21-07.)
 
2    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
3    Sec. 5-5.2. Payment.
4    (a) All nursing facilities Skilled Nursing Facilities that
5are grouped pursuant to Section 5-5.1 of this Act shall receive
6the same rate of payment for similar services. All Intermediate
7Care Facilities that are grouped pursuant to Section 5-5.1 of
8this Act shall receive the same rate of payment for similar
9services.
10    (b) It shall be a matter of State policy that the Illinois
11Department shall utilize a uniform billing cycle throughout the
12State for the following long-term care providers: skilled
13nursing facilities, intermediate care facilities, and
14intermediate care facilities for persons with a developmental
15disability. The Illinois Department shall establish billing
16cycles on a calendar month basis for all long-term care
17providers no later than July 1, 1992.
18    (c) Notwithstanding any other provisions of this Code,
19beginning July 1, 2012 the methodologies for reimbursement of
20nursing facility services as provided under this Article shall
21no longer be applicable for bills payable for State fiscal
22years 2012 and thereafter. The Department of Healthcare and
23Family Services shall, effective July 1, 2012, implement an
24evidence-based payment methodology for the reimbursement of
25nursing facility services. The methodology shall continue to

 

 

09600SB3088ham002- 13 -LRB096 20288 KTG 44846 a

1take into consideration the needs of individual residents, as
2assessed and reported by the most current version of the
3nursing facility Resident Assessment Instrument, adopted and
4in use by the federal government.
5(Source: P.A. 87-809; 88-380.)
 
6    (305 ILCS 5/5-5.3)  (from Ch. 23, par. 5-5.3)
7    Sec. 5-5.3. Conditions of Payment - Prospective Rates -
8Accounting Principles. This amendatory Act establishes certain
9conditions for the Department of Public Aid (now Healthcare and
10Family Services) in instituting rates for the care of
11recipients of medical assistance in skilled nursing facilities
12and ICF/DDs intermediate care facilities. Such conditions
13shall assure a method under which the payment for skilled
14nursing facility and ICF/DD and intermediate care services,
15provided to recipients under the Medical Assistance Program
16shall be on a reasonable cost related basis, which is
17prospectively determined at least annually by the Department of
18Public Aid (now Healthcare and Family Services). The annually
19established payment rate shall take effect on July 1 in 1984
20and subsequent years. There shall be no rate increase during
21calendar year 1983 and the first six months of calendar year
221984.
23    The determination of the payment shall be made on the basis
24of generally accepted accounting principles that shall take
25into account the actual costs to the facility of providing

 

 

09600SB3088ham002- 14 -LRB096 20288 KTG 44846 a

1skilled nursing facility and ICF/DD and intermediate care
2services to recipients under the medical assistance program.
3    The resultant total rate for a specified type of service
4shall be an amount which shall have been determined to be
5adequate to reimburse allowable costs of a facility that is
6economically and efficiently operated. The Department shall
7establish an effective date for each facility or group of
8facilities after which rates shall be paid on a reasonable cost
9related basis which shall be no sooner than the effective date
10of this amendatory Act of 1977.
11(Source: P.A. 95-331, eff. 8-21-07.)
 
12    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
13    Sec. 5-5.4. Standards of Payment - Department of Healthcare
14and Family Services. The Department of Healthcare and Family
15Services shall develop standards of payment of skilled nursing
16facility and ICF/DD and intermediate care services in
17facilities providing such services under this Article which:
18    (1) Provide for the determination of a facility's payment
19for skilled nursing facility or ICF/DD and intermediate care
20services on a prospective basis. The amount of the payment rate
21for all nursing facilities certified by the Department of
22Public Health under the MR/DD Community Care Act or the Nursing
23Home Care Act as Intermediate Care for the Developmentally
24Disabled facilities, Long Term Care for Under Age 22
25facilities, Skilled Nursing facilities, or Intermediate Care

 

 

09600SB3088ham002- 15 -LRB096 20288 KTG 44846 a

1facilities under the medical assistance program shall be
2prospectively established annually on the basis of historical,
3financial, and statistical data reflecting actual costs from
4prior years, which shall be applied to the current rate year
5and updated for inflation, except that the capital cost element
6for newly constructed facilities shall be based upon projected
7budgets. The annually established payment rate shall take
8effect on July 1 in 1984 and subsequent years. No rate increase
9and no update for inflation shall be provided on or after July
101, 1994 and before July 1, 2012 2011, unless specifically
11provided for in this Section. The changes made by Public Act
1293-841 extending the duration of the prohibition against a rate
13increase or update for inflation are effective retroactive to
14July 1, 2004.
15    For facilities licensed by the Department of Public Health
16under the Nursing Home Care Act as Intermediate Care for the
17Developmentally Disabled facilities or Long Term Care for Under
18Age 22 facilities, the rates taking effect on July 1, 1998
19shall include an increase of 3%. For facilities licensed by the
20Department of Public Health under the Nursing Home Care Act as
21Skilled Nursing facilities or Intermediate Care facilities,
22the rates taking effect on July 1, 1998 shall include an
23increase of 3% plus $1.10 per resident-day, as defined by the
24Department. For facilities licensed by the Department of Public
25Health under the Nursing Home Care Act as Intermediate Care
26Facilities for the Developmentally Disabled or Long Term Care

 

 

09600SB3088ham002- 16 -LRB096 20288 KTG 44846 a

1for Under Age 22 facilities, the rates taking effect on January
21, 2006 shall include an increase of 3%. For facilities
3licensed by the Department of Public Health under the Nursing
4Home Care Act as Intermediate Care Facilities for the
5Developmentally Disabled or Long Term Care for Under Age 22
6facilities, the rates taking effect on January 1, 2009 shall
7include an increase sufficient to provide a $0.50 per hour wage
8increase for non-executive staff.
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 July 1, 1999
13shall include an increase of 1.6% plus $3.00 per resident-day,
14as defined by the Department. For facilities licensed by the
15Department of Public Health under the Nursing Home Care Act as
16Skilled Nursing facilities or Intermediate Care facilities,
17the rates taking effect on July 1, 1999 shall include an
18increase of 1.6% and, for services provided on or after October
191, 1999, shall be increased by $4.00 per resident-day, as
20defined by the Department.
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 Long Term Care for Under
24Age 22 facilities, the rates taking effect on July 1, 2000
25shall include an increase of 2.5% per resident-day, as defined
26by the Department. For facilities licensed by the Department of

 

 

09600SB3088ham002- 17 -LRB096 20288 KTG 44846 a

1Public Health under the Nursing Home Care Act as Skilled
2Nursing facilities or Intermediate Care facilities, the rates
3taking effect on July 1, 2000 shall include an increase of 2.5%
4per resident-day, 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, a new payment methodology must
8be implemented for the nursing component of the rate effective
9July 1, 2003. The Department of Public Aid (now Healthcare and
10Family Services) shall develop the new payment methodology
11using the Minimum Data Set (MDS) as the instrument to collect
12information concerning nursing home resident condition
13necessary to compute the rate. The Department shall develop the
14new payment methodology to meet the unique needs of Illinois
15nursing home residents while remaining subject to the
16appropriations provided by the General Assembly. A transition
17period from the payment methodology in effect on June 30, 2003
18to the payment methodology in effect on July 1, 2003 shall be
19provided for a period not exceeding 3 years and 184 days after
20implementation of the new payment methodology as follows:
21        (A) For a facility that would receive a lower nursing
22    component rate per patient day under the new system than
23    the facility received effective on the date immediately
24    preceding the date that the Department implements the new
25    payment methodology, the nursing component rate per
26    patient day for the facility shall be held at the level in

 

 

09600SB3088ham002- 18 -LRB096 20288 KTG 44846 a

1    effect on the date immediately preceding the date that the
2    Department implements the new payment methodology until a
3    higher nursing component rate of reimbursement is achieved
4    by that facility.
5        (B) For a facility that would receive a higher nursing
6    component rate per patient day under the payment
7    methodology in effect on July 1, 2003 than the facility
8    received effective on the date immediately preceding the
9    date that the Department implements the new payment
10    methodology, the nursing component rate per patient day for
11    the facility shall be adjusted.
12        (C) Notwithstanding paragraphs (A) and (B), the
13    nursing component rate per patient day for the facility
14    shall be adjusted subject to appropriations provided by the
15    General Assembly.
16    For facilities licensed by the Department of Public Health
17under the Nursing Home Care Act as Intermediate Care for the
18Developmentally Disabled facilities or Long Term Care for Under
19Age 22 facilities, the rates taking effect on March 1, 2001
20shall include a statewide increase of 7.85%, as defined by the
21Department.
22    Notwithstanding any other provision of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as skilled nursing facilities or
25intermediate care facilities, except facilities participating
26in the Department's demonstration program pursuant to the

 

 

09600SB3088ham002- 19 -LRB096 20288 KTG 44846 a

1provisions of Title 77, Part 300, Subpart T of the Illinois
2Administrative Code, the numerator of the ratio used by the
3Department of Healthcare and Family Services to compute the
4rate payable under this Section using the Minimum Data Set
5(MDS) methodology shall incorporate the following annual
6amounts as the additional funds appropriated to the Department
7specifically to pay for rates based on the MDS nursing
8component methodology in excess of the funding in effect on
9December 31, 2006:
10        (i) For rates taking effect January 1, 2007,
11    $60,000,000.
12        (ii) For rates taking effect January 1, 2008,
13    $110,000,000.
14        (iii) For rates taking effect January 1, 2009,
15    $194,000,000.
16        (iv) For rates taking effect April 1, 2011, or the
17    first day of the month that begins at least 45 days after
18    the effective date of this amendatory Act of the 96th
19    General Assembly, $416,500,000 or an amount as may be
20    necessary to complete the transition to the MDS methodology
21    for the nursing component of the rate.
22    Notwithstanding any other provision of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as skilled nursing facilities or
25intermediate care facilities, the support component of the
26rates taking effect on January 1, 2008 shall be computed using

 

 

09600SB3088ham002- 20 -LRB096 20288 KTG 44846 a

1the most recent cost reports on file with the Department of
2Healthcare and Family Services no later than April 1, 2005,
3updated for inflation to January 1, 2006.
4    For facilities licensed by the Department of Public Health
5under the Nursing Home Care Act as Intermediate Care for the
6Developmentally Disabled facilities or Long Term Care for Under
7Age 22 facilities, the rates taking effect on April 1, 2002
8shall include a statewide increase of 2.0%, as defined by the
9Department. This increase terminates on July 1, 2002; beginning
10July 1, 2002 these rates are reduced to the level of the rates
11in effect on March 31, 2002, as defined by the Department.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as skilled nursing facilities
14or intermediate care facilities, the rates taking effect on
15July 1, 2001 shall be computed using the most recent cost
16reports on file with the Department of Public Aid no later than
17April 1, 2000, updated for inflation to January 1, 2001. For
18rates effective July 1, 2001 only, rates shall be the greater
19of the rate computed for July 1, 2001 or the rate effective on
20June 30, 2001.
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, the Illinois Department shall
25determine by rule the rates taking effect on July 1, 2002,
26which shall be 5.9% less than the rates in effect on June 30,

 

 

09600SB3088ham002- 21 -LRB096 20288 KTG 44846 a

12002.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, if the payment methodologies
6required under Section 5A-12 and the waiver granted under 42
7CFR 433.68 are approved by the United States Centers for
8Medicare and Medicaid Services, the rates taking effect on July
91, 2004 shall be 3.0% greater than the rates in effect on June
1030, 2004. These rates shall take effect only upon approval and
11implementation of the payment methodologies required under
12Section 5A-12.
13    Notwithstanding any other provisions of this Section, for
14facilities licensed by the Department of Public Health under
15the Nursing Home Care Act as skilled nursing facilities or
16intermediate care facilities, the rates taking effect on
17January 1, 2005 shall be 3% more than the rates in effect on
18December 31, 2004.
19    Notwithstanding any other provision of this Section, for
20facilities licensed by the Department of Public Health under
21the Nursing Home Care Act as skilled nursing facilities or
22intermediate care facilities, effective January 1, 2009, the
23per diem support component of the rates effective on January 1,
242008, computed using the most recent cost reports on file with
25the Department of Healthcare and Family Services no later than
26April 1, 2005, updated for inflation to January 1, 2006, shall

 

 

09600SB3088ham002- 22 -LRB096 20288 KTG 44846 a

1be increased to the amount that would have been derived using
2standard Department of Healthcare and Family Services methods,
3procedures, and inflators.
4    Notwithstanding any other provisions of this Section, for
5facilities licensed by the Department of Public Health under
6the Nursing Home Care Act as intermediate care facilities that
7are federally defined as Institutions for Mental Disease, a
8socio-development component rate equal to 6.6% of the
9facility's nursing component rate as of January 1, 2006 shall
10be established and paid effective July 1, 2006. The
11socio-development component of the rate shall be increased by a
12factor of 2.53 on the first day of the month that begins at
13least 45 days after January 11, 2008 (the effective date of
14Public Act 95-707). As of August 1, 2008, the socio-development
15component rate shall be equal to 6.6% of the facility's nursing
16component rate as of January 1, 2006, multiplied by a factor of
173.53. For services provided on or after April 1, 2011, or the
18first day of the month that begins at least 45 days after the
19effective date of this amendatory Act of the 96th General
20Assembly, whichever is later, the The Illinois Department may
21by rule adjust these socio-development component rates, and may
22use different adjustment methodologies for those facilities
23participating, and those not participating, in the Illinois
24Department's demonstration program pursuant to the provisions
25of Title 77, Part 300, Subpart T of the Illinois Administrative
26Code, but in no case may such rates be diminished below those

 

 

09600SB3088ham002- 23 -LRB096 20288 KTG 44846 a

1in effect on August 1, 2008.
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 as long-term care
5facilities for residents under 22 years of age, the rates
6taking effect on July 1, 2003 shall include a statewide
7increase of 4%, as defined by the Department.
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 the first day of
12the month that begins at least 45 days after the effective date
13of this amendatory Act of the 95th General Assembly shall
14include a statewide increase of 2.5%, as defined by the
15Department.
16    Notwithstanding any other provision of this Section, for
17facilities licensed by the Department of Public Health under
18the Nursing Home Care Act as skilled nursing facilities or
19intermediate care facilities, effective January 1, 2005,
20facility rates shall be increased by the difference between (i)
21a facility's per diem property, liability, and malpractice
22insurance costs as reported in the cost report filed with the
23Department of Public Aid and used to establish rates effective
24July 1, 2001 and (ii) those same costs as reported in the
25facility's 2002 cost report. These costs shall be passed
26through to the facility without caps or limitations, except for

 

 

09600SB3088ham002- 24 -LRB096 20288 KTG 44846 a

1adjustments required under normal auditing procedures.
2    Rates established effective each July 1 shall govern
3payment for services rendered throughout that fiscal year,
4except that rates established on July 1, 1996 shall be
5increased by 6.8% for services provided on or after January 1,
61997. Such rates will be based upon the rates calculated for
7the year beginning July 1, 1990, and for subsequent years
8thereafter until June 30, 2001 shall be based on the facility
9cost reports for the facility fiscal year ending at any point
10in time during the previous calendar year, updated to the
11midpoint of the rate year. The cost report shall be on file
12with the Department no later than April 1 of the current rate
13year. Should the cost report not be on file by April 1, the
14Department shall base the rate on the latest cost report filed
15by each skilled care facility and intermediate care facility,
16updated to the midpoint of the current rate year. In
17determining rates for services rendered on and after July 1,
181985, fixed time shall not be computed at less than zero. The
19Department shall not make any alterations of regulations which
20would reduce any component of the Medicaid rate to a level
21below what that component would have been utilizing in the rate
22effective on July 1, 1984.
23    (2) Shall take into account the actual costs incurred by
24facilities in providing services for recipients of skilled
25nursing and intermediate care services under the medical
26assistance program.

 

 

09600SB3088ham002- 25 -LRB096 20288 KTG 44846 a

1    (3) Shall take into account the medical and psycho-social
2characteristics and needs of the patients.
3    (4) Shall take into account the actual costs incurred by
4facilities in meeting licensing and certification standards
5imposed and prescribed by the State of Illinois, any of its
6political subdivisions or municipalities and by the U.S.
7Department of Health and Human Services pursuant to Title XIX
8of the Social Security Act.
9    The Department of Healthcare and Family Services shall
10develop precise standards for payments to reimburse nursing
11facilities for any utilization of appropriate rehabilitative
12personnel for the provision of rehabilitative services which is
13authorized by federal regulations, including reimbursement for
14services provided by qualified therapists or qualified
15assistants, and which is in accordance with accepted
16professional practices. Reimbursement also may be made for
17utilization of other supportive personnel under appropriate
18supervision.
19    The Department shall develop enhanced payments to offset
20the additional costs incurred by a facility serving exceptional
21need residents and shall allocate at least $8,000,000 of the
22funds collected from the assessment established by Section 5B-2
23of this Code for such payments. For the purpose of this
24Section, "exceptional needs" means, but need not be limited to,
25ventilator care, tracheotomy care, bariatric care, complex
26wound care, and traumatic brain injury care.

 

 

09600SB3088ham002- 26 -LRB096 20288 KTG 44846 a

1    (5) Beginning July 1, 2012 the methodologies for
2reimbursement of nursing facility services as provided under
3this Section 5-5.4 shall no longer be applicable for bills
4payable for State fiscal years 2012 and thereafter.
5(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
6eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09;
796-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff.
87-2-10.)
 
9    (305 ILCS 5/5-5.4a)
10    Sec. 5-5.4a. Intermediate Care Facility for the
11Developmentally Disabled; bed reserve payments.
12    The Department of Public Aid shall promulgate rules that by
13October 1, 1993 which establish a policy of bed reserve
14payments to ICF/DDs Intermediate Care Facilities for the
15Developmentally Disabled which addresses the needs of
16residents of ICF/DDs Intermediate Care Facilities for the
17Developmentally Disabled (ICF/DD) and their families.
18    (a) When a resident of an ICF/DD Intermediate Care Facility
19for the Developmentally Disabled (ICF/DD) is absent from the
20facility ICF/DD in which he or she is a resident for purposes
21of physician authorized in-patient admission to a hospital, the
22Department's rules shall, at a minimum, provide (1) bed reserve
23payments at a daily rate which is 100% of the client's current
24per diem rate, for a period not exceeding 10 consecutive days;
25(2) bed reserve payments at a daily rate which is 75% of a

 

 

09600SB3088ham002- 27 -LRB096 20288 KTG 44846 a

1client's current per diem rate, for a period which exceeds 10
2consecutive days but does not exceed 30 consecutive days; and
3(3) bed reserve payments at a daily rate which is 50% of a
4client's current per diem rate for a period which exceeds
5thirty consecutive days but does not exceed 45 consecutive
6days.
7    (b) When a resident of an ICF/DD Intermediate Care Facility
8for the Developmentally Disabled (ICF/DD) is absent from the
9facility ICF/DD in which he or she is a resident for purposes
10of a home visit with a family member the Department's rules
11shall, at a minimum, provide (1) bed reserve payments at a rate
12which is 100% of a client's current per diem rate, for a period
13not exceeding 10 days per State fiscal year; and (2) bed
14reserve payments at a rate which is 75% of a client's current
15per diem rate, for a period which exceeds 10 days per State
16fiscal year but does not exceed 30 days per State fiscal year.
17    (c) No Department rule regarding bed reserve payments shall
18require an ICF/DD to have a specified percentage of total
19facility occupancy as a requirement for receiving bed reserve
20payments.
21    This Section 5-5.4a shall not apply to any State operated
22facilities.
23(Source: P.A. 91-357, eff. 7-29-99.)
 
24    (305 ILCS 5/5-5.5)  (from Ch. 23, par. 5-5.5)
25    Sec. 5-5.5. Elements of Payment Rate.

 

 

09600SB3088ham002- 28 -LRB096 20288 KTG 44846 a

1    (a) The Department of Healthcare and Family Services shall
2develop a prospective method for determining payment rates for
3skilled nursing facility and ICF/DD and intermediate care
4services in nursing facilities composed of the following cost
5elements:
6        (1) Standard Services, with the cost of this component
7    being determined by taking into account the actual costs to
8    the facilities of these services subject to cost ceilings
9    to be defined in the Department's rules.
10        (2) Resident Services, with the cost of this component
11    being determined by taking into account the actual costs,
12    needs and utilization of these services, as derived from an
13    assessment of the resident needs in the nursing facilities.
14        (3) Ancillary Services, with the payment rate being
15    developed for each individual type of service. Payment
16    shall be made only when authorized under procedures
17    developed by the Department of Healthcare and Family
18    Services.
19        (4) Nurse's Aide Training, with the cost of this
20    component being determined by taking into account the
21    actual cost to the facilities of such training.
22        (5) Real Estate Taxes, with the cost of this component
23    being determined by taking into account the figures
24    contained in the most currently available cost reports
25    (with no imposition of maximums) updated to the midpoint of
26    the current rate year for long term care services rendered

 

 

09600SB3088ham002- 29 -LRB096 20288 KTG 44846 a

1    between July 1, 1984 and June 30, 1985, and with the cost
2    of this component being determined by taking into account
3    the actual 1983 taxes for which the nursing homes were
4    assessed (with no imposition of maximums) updated to the
5    midpoint of the current rate year for long term care
6    services rendered between July 1, 1985 and June 30, 1986.
7    (b) In developing a prospective method for determining
8payment rates for skilled nursing facility and ICF/DD and
9intermediate care services in nursing facilities and ICF/DDs,
10the Department of Healthcare and Family Services shall consider
11the following cost elements:
12        (1) Reasonable capital cost determined by utilizing
13    incurred interest rate and the current value of the
14    investment, including land, utilizing composite rates, or
15    by utilizing such other reasonable cost related methods
16    determined by the Department. However, beginning with the
17    rate reimbursement period effective July 1, 1987, the
18    Department shall be prohibited from establishing,
19    including, and implementing any depreciation factor in
20    calculating the capital cost element.
21        (2) Profit, with the actual amount being produced and
22    accruing to the providers in the form of a return on their
23    total investment, on the basis of their ability to
24    economically and efficiently deliver a type of service. The
25    method of payment may assure the opportunity for a profit,
26    but shall not guarantee or establish a specific amount as a

 

 

09600SB3088ham002- 30 -LRB096 20288 KTG 44846 a

1    cost.
2    (c) The Illinois Department may implement the amendatory
3changes to this Section made by this amendatory Act of 1991
4through the use of emergency rules in accordance with the
5provisions of Section 5.02 of the Illinois Administrative
6Procedure Act. For purposes of the Illinois Administrative
7Procedure Act, the adoption of rules to implement the
8amendatory changes to this Section made by this amendatory Act
9of 1991 shall be deemed an emergency and necessary for the
10public interest, safety and welfare.
11    (d) No later than January 1, 2001, the Department of Public
12Aid shall file with the Joint Committee on Administrative
13Rules, pursuant to the Illinois Administrative Procedure Act, a
14proposed rule, or a proposed amendment to an existing rule,
15regarding payment for appropriate services, including
16assessment, care planning, discharge planning, and treatment
17provided by nursing facilities to residents who have a serious
18mental illness.
19(Source: P.A. 95-331, eff. 8-21-07; 96-1123, eff. 1-1-11.)
 
20    (305 ILCS 5/5-5.5a)  (from Ch. 23, par. 5-5.5a)
21    Sec. 5-5.5a. Kosher kitchen and food service.
22    (a) The Department of Healthcare and Family Services may
23develop in its rate structure for skilled nursing facilities
24and intermediate care facilities an accommodation for fully
25kosher kitchen and food service operations, rabbinically

 

 

09600SB3088ham002- 31 -LRB096 20288 KTG 44846 a

1approved or certified on an annual basis for a facility in
2which the only kitchen or all kitchens are fully kosher (a
3fully kosher facility). Beginning in the fiscal year after the
4fiscal year when this amendatory Act of 1990 becomes effective,
5the rate structure may provide for an additional payment to
6such facility not to exceed 50 cents per resident per day if
760% or more of the residents in the facility request kosher
8foods or food products prepared in accordance with Jewish
9religious dietary requirements for religious purposes in a
10fully kosher facility. Based upon food cost reports of the
11Illinois Department of Agriculture regarding kosher and
12non-kosher food available in the various regions of the State,
13this rate structure may be periodically adjusted by the
14Department but may not exceed the maximum authorized under this
15subsection (a).
16    (b) The Department shall by rule determine how a facility
17with a fully kosher kitchen and food service may be determined
18to be eligible and apply for the rate accommodation specified
19in subsection (a).
20(Source: P.A. 95-331, eff. 8-21-07.)
 
21    (305 ILCS 5/5-5.6b)  (from Ch. 23, par. 5-5.6b)
22    Sec. 5-5.6b. Prohibition against double payment. If any
23resident of a skilled nursing facility or ICF/DD intermediate
24care facility is admitted to such facility on the basis that
25the charges for such resident's care will be paid from private

 

 

09600SB3088ham002- 32 -LRB096 20288 KTG 44846 a

1funds, and the source of payment for such care thereafter
2changes from private funds to payments under this Article, the
3facility shall, upon receiving the first such payment under
4this Article, notify the Illinois Department of such source of
5private funds for such recipient and repay to the source of
6private funds any amounts received from such source as payment
7for care for which payment also was made under this Article.
8Private funds shall not include third party resources such as
9insurance or Medicare benefits or payments made by responsible
10relatives.
11(Source: P.A. 85-824.)
 
12    (305 ILCS 5/5-5.7)  (from Ch. 23, par. 5-5.7)
13    Sec. 5-5.7. Cost Reports - Audits. The Department of
14Healthcare and Family Services shall work with the Department
15of Public Health to use cost report information currently being
16collected under provisions of the Nursing Home Care Act and the
17MR/DD Community Care Act. The Department of Healthcare and
18Family Services may, in conjunction with the Department of
19Public Health, develop in accordance with generally accepted
20accounting principles a uniform chart of accounts which each
21facility providing services under the medical assistance
22program shall adopt, after a reasonable period.
23    Nursing homes licensed under the Nursing Home Care Act or
24the MR/DD Community Care Act and providers of adult
25developmental training services certified by the Department of

 

 

09600SB3088ham002- 33 -LRB096 20288 KTG 44846 a

1Human Services pursuant to Section 15.2 of the Mental Health
2and Developmental Disabilities Administrative Act which
3provide services to clients eligible for medical assistance
4under this Article are responsible for submitting the required
5annual cost report to the Department of Healthcare and Family
6Services.
7    The Department of Healthcare and Family Services shall
8audit the financial and statistical records of each provider
9participating in the medical assistance program as a skilled
10nursing facility or ICF/DD or intermediate care facility over a
113 year period, beginning with the close of the first cost
12reporting year. Following the end of this 3-year term, audits
13of the financial and statistical records will be performed each
14year in at least 20% of the facilities participating in the
15medical assistance program with at least 10% being selected on
16a random sample basis, and the remainder selected on the basis
17of exceptional profiles. All audits shall be conducted in
18accordance with generally accepted auditing standards.
19    The Department of Healthcare and Family Services shall
20establish prospective payment rates for categories of service
21needed within the skilled nursing facility or ICF/DD and
22intermediate care levels of services, in order to more
23appropriately recognize the individual needs of patients in
24nursing facilities.
25    The Department of Healthcare and Family Services shall
26provide, during the process of establishing the payment rate

 

 

09600SB3088ham002- 34 -LRB096 20288 KTG 44846 a

1for skilled nursing facility or ICF/DD and intermediate care
2services, or when a substantial change in rates is proposed, an
3opportunity for public review and comment on the proposed rates
4prior to their becoming effective.
5(Source: P.A. 95-331, eff. 8-21-07; 96-339, eff. 7-1-10.)
 
6    (305 ILCS 5/5-5.8b)  (from Ch. 23, par. 5-5.8b)
7    Sec. 5-5.8b. Payment to Campus Facilities. There is hereby
8established a separate payment category for campus facilities.
9A "campus facility" is defined as an entity which consists of a
10long term care facility (or group of facilities if the
11facilities are on the same contiguous parcel of real estate)
12which meets all of the following criteria as of May 1, 1987:
13the entity provides care for both children and adults;
14residents of the entity reside in three or more separate
15buildings with congregate and small group living arrangements
16on a single campus; the entity provides three or more separate
17licensed levels of care; the entity (or a part of the entity)
18is enrolled with the Department of Public Aid (now Department
19of Healthcare and Family Services) as a provider of long term
20care services and receives payments from that Department; the
21entity (or a part of the entity) receives funding from the
22Department of Mental Health and Developmental Disabilities
23(now the Department of Human Services); and the entity (or a
24part of the entity) holds a current license as a child care
25institution issued by the Department of Children and Family

 

 

09600SB3088ham002- 35 -LRB096 20288 KTG 44846 a

1Services.
2    The Department of Healthcare and Family Services, the
3Department of Human Services, and the Department of Children
4and Family Services shall develop jointly a rate methodology or
5methodologies for campus facilities. Such methodology or
6methodologies may establish a single rate to be paid by all the
7agencies, or a separate rate to be paid by each agency, or
8separate components to be paid to different parts of the campus
9facility. All campus facilities shall receive the same rate of
10payment for similar services. Any methodology developed
11pursuant to this section shall take into account the actual
12costs to the facility of providing services to residents, and
13shall be adequate to reimburse the allowable costs of a campus
14facility which is economically and efficiently operated. Any
15methodology shall be established on the basis of historical,
16financial, and statistical data submitted by campus
17facilities, and shall take into account the actual costs
18incurred by campus facilities in providing services, and in
19meeting licensing and certification standards imposed and
20prescribed by the State of Illinois, any of its political
21subdivisions or municipalities and by the United States
22Department of Health and Human Services. Rates may be
23established on a prospective or retrospective basis. Any
24methodology shall provide reimbursement for appropriate
25payment elements, including the following: standard services,
26patient services, real estate taxes, and capital costs.

 

 

09600SB3088ham002- 36 -LRB096 20288 KTG 44846 a

1(Source: P.A. 95-331, eff. 8-21-07.)
 
2    (305 ILCS 5/5A-2)  (from Ch. 23, par. 5A-2)
3    (Section scheduled to be repealed on July 1, 2013)
4    Sec. 5A-2. Assessment.
5    (a) Subject to Sections 5A-3 and 5A-10, an annual
6assessment on inpatient services is imposed on each hospital
7provider in an amount equal to the hospital's occupied bed days
8multiplied by $84.19 multiplied by the proration factor for
9State fiscal year 2004 and the hospital's occupied bed days
10multiplied by $84.19 for State fiscal year 2005.
11    For State fiscal years 2004 and 2005, the Department of
12Healthcare and Family Services shall use the number of occupied
13bed days as reported by each hospital on the Annual Survey of
14Hospitals conducted by the Department of Public Health to
15calculate the hospital's annual assessment. If the sum of a
16hospital's occupied bed days is not reported on the Annual
17Survey of Hospitals or if there are data errors in the reported
18sum of a hospital's occupied bed days as determined by the
19Department of Healthcare and Family Services (formerly
20Department of Public Aid), then the Department of Healthcare
21and Family Services may obtain the sum of occupied bed days
22from any source available, including, but not limited to,
23records maintained by the hospital provider, which may be
24inspected at all times during business hours of the day by the
25Department of Healthcare and Family Services or its duly

 

 

09600SB3088ham002- 37 -LRB096 20288 KTG 44846 a

1authorized agents and employees.
2    Subject to Sections 5A-3 and 5A-10, for the privilege of
3engaging in the occupation of hospital provider, beginning
4August 1, 2005, an annual assessment is imposed on each
5hospital provider for State fiscal years 2006, 2007, and 2008,
6in an amount equal to 2.5835% of the hospital provider's
7adjusted gross hospital revenue for inpatient services and
82.5835% of the hospital provider's adjusted gross hospital
9revenue for outpatient services. If the hospital provider's
10adjusted gross hospital revenue is not available, then the
11Illinois Department may obtain the hospital provider's
12adjusted gross hospital revenue from any source available,
13including, but not limited to, records maintained by the
14hospital provider, which may be inspected at all times during
15business hours of the day by the Illinois Department or its
16duly authorized agents and employees.
17    Subject to Sections 5A-3 and 5A-10, for State fiscal years
182009 through 2014 2013, an annual assessment on inpatient
19services is imposed on each hospital provider in an amount
20equal to $218.38 multiplied by the difference of the hospital's
21occupied bed days less the hospital's Medicare bed days.
22    For State fiscal years 2009 through 2014 2013, a hospital's
23occupied bed days and Medicare bed days shall be determined
24using the most recent data available from each hospital's 2005
25Medicare cost report as contained in the Healthcare Cost Report
26Information System file, for the quarter ending on December 31,

 

 

09600SB3088ham002- 38 -LRB096 20288 KTG 44846 a

12006, without regard to any subsequent adjustments or changes
2to such data. If a hospital's 2005 Medicare cost report is not
3contained in the Healthcare Cost Report Information System,
4then the Illinois Department may obtain the hospital provider's
5occupied bed days and Medicare bed days from any source
6available, including, but not limited to, records maintained by
7the hospital provider, which may be inspected at all times
8during business hours of the day by the Illinois Department or
9its duly authorized agents and employees.
10    (b) (Blank).
11    (c) (Blank).
12    (d) Notwithstanding any of the other provisions of this
13Section, the Department is authorized, during this 94th General
14Assembly, to adopt rules to reduce the rate of any annual
15assessment imposed under this Section, as authorized by Section
165-46.2 of the Illinois Administrative Procedure Act.
17    (e) Notwithstanding any other provision of this Section,
18any plan providing for an assessment on a hospital provider as
19a permissible tax under Title XIX of the federal Social
20Security Act and Medicaid-eligible payments to hospital
21providers from the revenues derived from that assessment shall
22be reviewed by the Illinois Department of Healthcare and Family
23Services, as the Single State Medicaid Agency required by
24federal law, to determine whether those assessments and
25hospital provider payments meet federal Medicaid standards. If
26the Department determines that the elements of the plan may

 

 

09600SB3088ham002- 39 -LRB096 20288 KTG 44846 a

1meet federal Medicaid standards and a related State Medicaid
2Plan Amendment is prepared in a manner and form suitable for
3submission, that State Plan Amendment shall be submitted in a
4timely manner for review by the Centers for Medicare and
5Medicaid Services of the United States Department of Health and
6Human Services and subject to approval by the Centers for
7Medicare and Medicaid Services of the United States Department
8of Health and Human Services. No such plan shall become
9effective without approval by the Illinois General Assembly by
10the enactment into law of related legislation. Notwithstanding
11any other provision of this Section, the Department is
12authorized to adopt rules to reduce the rate of any annual
13assessment imposed under this Section. Any such rules may be
14adopted by the Department under Section 5-50 of the Illinois
15Administrative Procedure Act.
16(Source: P.A. 94-242, eff. 7-18-05; 94-838, eff. 6-6-06;
1795-859, eff. 8-19-08.)
 
18    (305 ILCS 5/5A-3)  (from Ch. 23, par. 5A-3)
19    Sec. 5A-3. Exemptions.
20    (a) (Blank).
21    (b) A hospital provider that is a State agency, a State
22university, or a county with a population of 3,000,000 or more
23is exempt from the assessment imposed by Section 5A-2.
24    (b-2) A hospital provider that is a county with a
25population of less than 3,000,000 or a township, municipality,

 

 

09600SB3088ham002- 40 -LRB096 20288 KTG 44846 a

1hospital district, or any other local governmental unit is
2exempt from the assessment imposed by Section 5A-2.
3    (b-5) (Blank).
4    (b-10) For State fiscal years 2004 through 2014 2013, a
5hospital provider, described in Section 1903(w)(3)(F) of the
6Social Security Act, whose hospital does not charge for its
7services is exempt from the assessment imposed by Section 5A-2,
8unless the exemption is adjudged to be unconstitutional or
9otherwise invalid, in which case the hospital provider shall
10pay the assessment imposed by Section 5A-2.
11    (b-15) For State fiscal years 2004 and 2005, a hospital
12provider whose hospital is licensed by the Department of Public
13Health as a psychiatric hospital is exempt from the assessment
14imposed by Section 5A-2, unless the exemption is adjudged to be
15unconstitutional or otherwise invalid, in which case the
16hospital provider shall pay the assessment imposed by Section
175A-2.
18    (b-20) For State fiscal years 2004 and 2005, a hospital
19provider whose hospital is licensed by the Department of Public
20Health as a rehabilitation hospital is exempt from the
21assessment imposed by Section 5A-2, unless the exemption is
22adjudged to be unconstitutional or otherwise invalid, in which
23case the hospital provider shall pay the assessment imposed by
24Section 5A-2.
25    (b-25) For State fiscal years 2004 and 2005, a hospital
26provider whose hospital (i) is not a psychiatric hospital,

 

 

09600SB3088ham002- 41 -LRB096 20288 KTG 44846 a

1rehabilitation hospital, or children's hospital and (ii) has an
2average length of inpatient stay greater than 25 days is exempt
3from the assessment imposed by Section 5A-2, unless the
4exemption is adjudged to be unconstitutional or otherwise
5invalid, in which case the hospital provider shall pay the
6assessment imposed by Section 5A-2.
7    (c) (Blank).
8(Source: P.A. 94-242, eff. 7-18-05; 95-859, eff. 8-19-08.)
 
9    (305 ILCS 5/5A-5)  (from Ch. 23, par. 5A-5)
10    Sec. 5A-5. Notice; penalty; maintenance of records.
11    (a) The Department of Healthcare and Family Services shall
12send a notice of assessment to every hospital provider subject
13to assessment under this Article. The notice of assessment
14shall notify the hospital of its assessment and shall be sent
15after receipt by the Department of notification from the
16Centers for Medicare and Medicaid Services of the U.S.
17Department of Health and Human Services that the payment
18methodologies required under Section 5A-12, Section 5A-12.1,
19or Section 5A-12.2, whichever is applicable for that fiscal
20year, and, if necessary, the waiver granted under 42 CFR 433.68
21have been approved. The notice shall be on a form prepared by
22the Illinois Department and shall state the following:
23        (1) The name of the hospital provider.
24        (2) The address of the hospital provider's principal
25    place of business from which the provider engages in the

 

 

09600SB3088ham002- 42 -LRB096 20288 KTG 44846 a

1    occupation of hospital provider in this State, and the name
2    and address of each hospital operated, conducted, or
3    maintained by the provider in this State.
4        (3) The occupied bed days, occupied bed days less
5    Medicare days, or adjusted gross hospital revenue of the
6    hospital provider (whichever is applicable), the amount of
7    assessment imposed under Section 5A-2 for the State fiscal
8    year for which the notice is sent, and the amount of each
9    installment to be paid during the State fiscal year.
10        (4) (Blank).
11        (5) Other reasonable information as determined by the
12    Illinois Department.
13    (b) If a hospital provider conducts, operates, or maintains
14more than one hospital licensed by the Illinois Department of
15Public Health, the provider shall pay the assessment for each
16hospital separately.
17    (c) Notwithstanding any other provision in this Article, in
18the case of a person who ceases to conduct, operate, or
19maintain a hospital in respect of which the person is subject
20to assessment under this Article as a hospital provider, the
21assessment for the State fiscal year in which the cessation
22occurs shall be adjusted by multiplying the assessment computed
23under Section 5A-2 by a fraction, the numerator of which is the
24number of days in the year during which the provider conducts,
25operates, or maintains the hospital and the denominator of
26which is 365. Immediately upon ceasing to conduct, operate, or

 

 

09600SB3088ham002- 43 -LRB096 20288 KTG 44846 a

1maintain a hospital, the person shall pay the assessment for
2the year as so adjusted (to the extent not previously paid).
3    (d) Notwithstanding any other provision in this Article, a
4provider who commences conducting, operating, or maintaining a
5hospital, upon notice by the Illinois Department, shall pay the
6assessment computed under Section 5A-2 and subsection (e) in
7installments on the due dates stated in the notice and on the
8regular installment due dates for the State fiscal year
9occurring after the due dates of the initial notice.
10    (e) Notwithstanding any other provision in this Article,
11for State fiscal years 2004 and 2005, in the case of a hospital
12provider that did not conduct, operate, or maintain a hospital
13throughout calendar year 2001, the assessment for that State
14fiscal year shall be computed on the basis of hypothetical
15occupied bed days for the full calendar year as determined by
16the Illinois Department. Notwithstanding any other provision
17in this Article, for State fiscal years 2006 through 2008, in
18the case of a hospital provider that did not conduct, operate,
19or maintain a hospital in 2003, the assessment for that State
20fiscal year shall be computed on the basis of hypothetical
21adjusted gross hospital revenue for the hospital's first full
22fiscal year as determined by the Illinois Department (which may
23be based on annualization of the provider's actual revenues for
24a portion of the year, or revenues of a comparable hospital for
25the year, including revenues realized by a prior provider of
26the same hospital during the year). Notwithstanding any other

 

 

09600SB3088ham002- 44 -LRB096 20288 KTG 44846 a

1provision in this Article, for State fiscal years 2009 through
22014 2013, in the case of a hospital provider that did not
3conduct, operate, or maintain a hospital in 2005, the
4assessment for that State fiscal year shall be computed on the
5basis of hypothetical occupied bed days for the full calendar
6year as determined by the Illinois Department.
7    (f) Every hospital provider subject to assessment under
8this Article shall keep sufficient records to permit the
9determination of adjusted gross hospital revenue for the
10hospital's fiscal year. All such records shall be kept in the
11English language and shall, at all times during regular
12business hours of the day, be subject to inspection by the
13Illinois Department or its duly authorized agents and
14employees.
15    (g) The Illinois Department may, by rule, provide a
16hospital provider a reasonable opportunity to request a
17clarification or correction of any clerical or computational
18errors contained in the calculation of its assessment, but such
19corrections shall not extend to updating the cost report
20information used to calculate the assessment.
21    (h) (Blank).
22(Source: P.A. 94-242, eff. 7-18-05; 95-331, eff. 8-21-07;
2395-859, eff. 8-19-08.)
 
24    (305 ILCS 5/5A-8)  (from Ch. 23, par. 5A-8)
25    Sec. 5A-8. Hospital Provider Fund.

 

 

09600SB3088ham002- 45 -LRB096 20288 KTG 44846 a

1    (a) There is created in the State Treasury the Hospital
2Provider Fund. Interest earned by the Fund shall be credited to
3the Fund. The Fund shall not be used to replace any moneys
4appropriated to the Medicaid program by the General Assembly.
5    (b) The Fund is created for the purpose of receiving moneys
6in accordance with Section 5A-6 and disbursing moneys only for
7the following purposes, notwithstanding any other provision of
8law:
9        (1) For making payments to hospitals as required under
10    Articles V, V-A, VI, and XIV of this Code, under the
11    Children's Health Insurance Program Act, under the
12    Covering ALL KIDS Health Insurance Act, and under the
13    Senior Citizens and Disabled Persons Property Tax Relief
14    and Pharmaceutical Assistance Act.
15        (2) For the reimbursement of moneys collected by the
16    Illinois Department from hospitals or hospital providers
17    through error or mistake in performing the activities
18    authorized under this Article and Article V of this Code.
19        (3) For payment of administrative expenses incurred by
20    the Illinois Department or its agent in performing the
21    activities authorized by this Article.
22        (4) For payments of any amounts which are reimbursable
23    to the federal government for payments from this Fund which
24    are required to be paid by State warrant.
25        (5) For making transfers, as those transfers are
26    authorized in the proceedings authorizing debt under the

 

 

09600SB3088ham002- 46 -LRB096 20288 KTG 44846 a

1    Short Term Borrowing Act, but transfers made under this
2    paragraph (5) shall not exceed the principal amount of debt
3    issued in anticipation of the receipt by the State of
4    moneys to be deposited into the Fund.
5        (6) For making transfers to any other fund in the State
6    treasury, but transfers made under this paragraph (6) shall
7    not exceed the amount transferred previously from that
8    other fund into the Hospital Provider Fund.
9        (6.5) For making transfers to the Healthcare Provider
10    Relief Fund, except that transfers made under this
11    paragraph (6.5) shall not exceed $60,000,000 in the
12    aggregate.
13        (7) For State fiscal years 2004 and 2005 for making
14    transfers to the Health and Human Services Medicaid Trust
15    Fund, including 20% of the moneys received from hospital
16    providers under Section 5A-4 and transferred into the
17    Hospital Provider Fund under Section 5A-6. For State fiscal
18    year 2006 for making transfers to the Health and Human
19    Services Medicaid Trust Fund of up to $130,000,000 per year
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. Transfers under this paragraph
23    shall be made within 7 days after the payments have been
24    received pursuant to the schedule of payments provided in
25    subsection (a) of Section 5A-4.
26        (7.5) For State fiscal year 2007 for making transfers

 

 

09600SB3088ham002- 47 -LRB096 20288 KTG 44846 a

1    of the moneys received from hospital providers under
2    Section 5A-4 and transferred into the Hospital Provider
3    Fund under Section 5A-6 to the designated funds not
4    exceeding the following amounts in that State fiscal year:
5        Health and Human Services
6            Medicaid Trust Fund................. $20,000,000
7        Long-Term Care Provider Fund............ $30,000,000
8        General Revenue Fund................... $80,000,000.
9        Transfers under this paragraph shall be made within 7
10    days after the payments have been received pursuant to the
11    schedule of payments provided in subsection (a) of Section
12    5A-4.
13        (7.8) For State fiscal year 2008, for making transfers
14    of the moneys received from hospital providers under
15    Section 5A-4 and transferred into the Hospital Provider
16    Fund under Section 5A-6 to the designated funds not
17    exceeding the following amounts in that State fiscal year:
18        Health and Human Services
19            Medicaid Trust Fund..................$40,000,000
20        Long-Term Care Provider Fund..............$60,000,000
21        General Revenue Fund...................$160,000,000.
22        Transfers under this paragraph shall be made within 7
23    days after the payments have been received pursuant to the
24    schedule of payments provided in subsection (a) of Section
25    5A-4.
26        (7.9) For State fiscal years 2009 through 2014 2013,

 

 

09600SB3088ham002- 48 -LRB096 20288 KTG 44846 a

1    for making transfers of the moneys received from hospital
2    providers under Section 5A-4 and transferred into the
3    Hospital Provider Fund under Section 5A-6 to the designated
4    funds not exceeding the following amounts in that State
5    fiscal year:
6        Health and Human Services
7            Medicaid Trust Fund...................$20,000,000
8        Long Term Care Provider Fund..............$30,000,000
9        General Revenue Fund.....................$80,000,000.
10        Except as provided under this paragraph, transfers
11    under this paragraph shall be made within 7 business days
12    after the payments have been received pursuant to the
13    schedule of payments provided in subsection (a) of Section
14    5A-4. For State fiscal year 2009, transfers to the General
15    Revenue Fund under this paragraph shall be made on or
16    before June 30, 2009, as sufficient funds become available
17    in the Hospital Provider Fund to both make the transfers
18    and continue hospital payments.
19        (8) For making refunds to hospital providers pursuant
20    to Section 5A-10.
21    Disbursements from the Fund, other than transfers
22authorized under paragraphs (5) and (6) of this subsection,
23shall be by warrants drawn by the State Comptroller upon
24receipt of vouchers duly executed and certified by the Illinois
25Department.
26    (c) The Fund shall consist of the following:

 

 

09600SB3088ham002- 49 -LRB096 20288 KTG 44846 a

1        (1) All moneys collected or received by the Illinois
2    Department from the hospital provider assessment imposed
3    by this Article.
4        (2) All federal matching funds received by the Illinois
5    Department as a result of expenditures made by the Illinois
6    Department that are attributable to moneys deposited in the
7    Fund.
8        (3) Any interest or penalty levied in conjunction with
9    the administration of this Article.
10        (4) Moneys transferred from another fund in the State
11    treasury.
12        (5) All other moneys received for the Fund from any
13    other source, including interest earned thereon.
14    (d) (Blank).
15(Source: P.A. 95-707, eff. 1-11-08; 95-859, eff. 8-19-08; 96-3,
16eff. 2-27-09; 96-45, eff. 7-15-09; 96-821, eff. 11-20-09.)
 
17    (305 ILCS 5/5A-10)  (from Ch. 23, par. 5A-10)
18    Sec. 5A-10. Applicability.
19    (a) The assessment imposed by Section 5A-2 shall not take
20effect or shall cease to be imposed, and any moneys remaining
21in the Fund shall be refunded to hospital providers in
22proportion to the amounts paid by them, if:
23        (1) The sum of the appropriations for State fiscal
24    years 2004 and 2005 from the General Revenue Fund for
25    hospital payments under the medical assistance program is

 

 

09600SB3088ham002- 50 -LRB096 20288 KTG 44846 a

1    less than $4,500,000,000 or the appropriation for each of
2    State fiscal years 2006, 2007 and 2008 from the General
3    Revenue Fund for hospital payments under the medical
4    assistance program is less than $2,500,000,000 increased
5    annually to reflect any increase in the number of
6    recipients, or the annual appropriation for State fiscal
7    years 2009 through 2014 2013, from the General Revenue Fund
8    combined with the Hospital Provider Fund as authorized in
9    Section 5A-8 for hospital payments under the medical
10    assistance program, is less than the amount appropriated
11    for State fiscal year 2009, adjusted annually to reflect
12    any change in the number of recipients, excluding State
13    fiscal year 2009 supplemental appropriations made
14    necessary by the enactment of the American Recovery and
15    Reinvestment Act of 2009; or
16        (2) For State fiscal years prior to State fiscal year
17    2009, the Department of Healthcare and Family Services
18    (formerly Department of Public Aid) makes changes in its
19    rules that reduce the hospital inpatient or outpatient
20    payment rates, including adjustment payment rates, in
21    effect on October 1, 2004, except for hospitals described
22    in subsection (b) of Section 5A-3 and except for changes in
23    the methodology for calculating outlier payments to
24    hospitals for exceptionally costly stays, so long as those
25    changes do not reduce aggregate expenditures below the
26    amount expended in State fiscal year 2005 for such

 

 

09600SB3088ham002- 51 -LRB096 20288 KTG 44846 a

1    services; or
2        (2.1) For State fiscal years 2009 through 2014 2013,
3    the Department of Healthcare and Family Services adopts any
4    administrative rule change to reduce payment rates or
5    alters any payment methodology that reduces any payment
6    rates made to operating hospitals under the approved Title
7    XIX or Title XXI State plan in effect January 1, 2008
8    except for:
9            (A) any changes for hospitals described in
10        subsection (b) of Section 5A-3; or
11            (B) any rates for payments made under this Article
12        V-A; or
13            (C) any changes proposed in State plan amendment
14        transmittal numbers 08-01, 08-02, 08-04, 08-06, and
15        08-07; or
16            (D) in relation to any admissions on or after
17        January 1, 2011, a modification in the methodology for
18        calculating outlier payments to hospitals for
19        exceptionally costly stays, for hospitals reimbursed
20        under the diagnosis-related grouping methodology;
21        provided that the Department shall be limited to one
22        such modification during the 36-month period after the
23        effective date of this amendatory Act of the 96th
24        General Assembly; or
25        (3) The payments to hospitals required under Section
26    5A-12 or Section 5A-12.2 are changed or are not eligible

 

 

09600SB3088ham002- 52 -LRB096 20288 KTG 44846 a

1    for federal matching funds under Title XIX or XXI of the
2    Social Security Act.
3    (b) The assessment imposed by Section 5A-2 shall not take
4effect or shall cease to be imposed if the assessment is
5determined to be an impermissible tax under Title XIX of the
6Social Security Act. Moneys in the Hospital Provider Fund
7derived from assessments imposed prior thereto shall be
8disbursed in accordance with Section 5A-8 to the extent federal
9financial participation is not reduced due to the
10impermissibility of the assessments, and any remaining moneys
11shall be refunded to hospital providers in proportion to the
12amounts paid by them.
13(Source: P.A. 95-331, eff. 8-21-07; 95-859, eff. 8-19-08; 96-8,
14eff. 4-28-09.)
 
15    (305 ILCS 5/5A-14)
16    Sec. 5A-14. Repeal of assessments and disbursements.
17    (a) Section 5A-2 is repealed on July 1, 2014 2013.
18    (b) Section 5A-12 is repealed on July 1, 2005.
19    (c) Section 5A-12.1 is repealed on July 1, 2008.
20    (d) Section 5A-12.2 is repealed on July 1, 2014 2013.
21    (e) Section 5A-12.3 is repealed on July 1, 2011.
22(Source: P.A. 95-859, eff. 8-19-08; 96-821, eff. 11-20-09.)
 
23    (305 ILCS 5/5B-1)  (from Ch. 23, par. 5B-1)
24    Sec. 5B-1. Definitions. As used in this Article, unless the

 

 

09600SB3088ham002- 53 -LRB096 20288 KTG 44846 a

1context requires otherwise:
2    "Fund" means the Long-Term Care Provider Fund.
3    "Long-term care facility" means (i) a skilled nursing or
4intermediate long term care facility, whether public or private
5and whether organized for profit or not-for-profit, that is
6subject to licensure by the Illinois Department of Public
7Health under the Nursing Home Care Act or the MR/DD Community
8Care Act, including a county nursing home directed and
9maintained under Section 5-1005 of the Counties Code, and (ii)
10a part of a hospital in which skilled or intermediate long-term
11care services within the meaning of Title XVIII or XIX of the
12Social Security Act are provided; except that the term
13"long-term care facility" does not include a facility operated
14by a State agency, a facility participating in the Illinois
15Department's demonstration program pursuant to the provisions
16of Title 77, Part 300, Subpart T of the Illinois Administrative
17Code, or operated solely as an intermediate care facility for
18the mentally retarded within the meaning of Title XIX of the
19Social Security Act.
20    "Long-term care provider" means (i) a person licensed by
21the Department of Public Health to operate and maintain a
22skilled nursing or intermediate long-term care facility or (ii)
23a hospital provider that provides skilled or intermediate
24long-term care services within the meaning of Title XVIII or
25XIX of the Social Security Act. For purposes of this paragraph,
26"person" means any political subdivision of the State,

 

 

09600SB3088ham002- 54 -LRB096 20288 KTG 44846 a

1municipal corporation, individual, firm, partnership,
2corporation, company, limited liability company, association,
3joint stock association, or trust, or a receiver, executor,
4trustee, guardian, or other representative appointed by order
5of any court. "Hospital provider" means a person licensed by
6the Department of Public Health to conduct, operate, or
7maintain a hospital.
8    "Occupied bed days" shall be computed separately for each
9long-term care facility operated or maintained by a long-term
10care provider, and means the sum for all beds of the number of
11days during the month year on which each bed was is occupied by
12a resident, other than a resident for whom Medicare Part A is
13the primary payer (other than a resident receiving care at an
14intermediate care facility for the mentally retarded within the
15meaning of Title XIX of the Social Security Act).
16    "Intergovernmental transfer payment" means the payments
17established under Section 15-3 of this Code, and includes
18without limitation payments payable under that Section for
19July, August, and September of 1992.
20(Source: P.A. 96-339, eff. 7-1-10.)
 
21    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
22    Sec. 5B-2. Assessment; no local authorization to tax.
23    (a) For the privilege of engaging in the occupation of
24long-term care provider, beginning July 1, 2011 an assessment
25is imposed upon each long-term care provider in an amount equal

 

 

09600SB3088ham002- 55 -LRB096 20288 KTG 44846 a

1to $6.07 times the number of occupied bed days due and payable
2each month for the State fiscal year beginning on July 1, 1992
3and ending on June 30, 1993, in an amount equal to $6.30 times
4the number of occupied bed days for the most recent calendar
5year ending before the beginning of that State fiscal year.
6Notwithstanding any provision of any other Act to the contrary,
7this assessment shall be construed as a tax, but may not be
8added to the charges of an individual's nursing home care that
9is paid for in whole, or in part, by a federal, State, or
10combined federal-state medical care program, except those
11individuals receiving Medicare Part B benefits solely.
12    (b) Nothing in this amendatory Act of 1992 shall be
13construed to authorize any home rule unit or other unit of
14local government to license for revenue or impose a tax or
15assessment upon long-term care providers or the occupation of
16long-term care provider, or a tax or assessment measured by the
17income or earnings or occupied bed days of a long-term care
18provider.
19(Source: P.A. 87-861.)
 
20    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)
21    Sec. 5B-4. Payment of assessment; penalty.
22    (a) The assessment imposed by Section 5B-2 for a State
23fiscal year shall be due and payable monthly, on the last State
24business day of the month for occupied bed days reported for
25the preceding third month prior to the month in which the tax

 

 

09600SB3088ham002- 56 -LRB096 20288 KTG 44846 a

1is payable and due. A facility that has delayed payment due to
2the State's failure to reimburse for services rendered may
3request an extension on the due date for payment pursuant to
4subsection (b) and shall pay the assessment within 30 days of
5reimbursement by the Department in quarterly installments,
6each equalling one-fourth of the assessment for the year, on
7September 30, December 31, March 31, and June 30 of the year.
8The Illinois Department may provide that county nursing homes
9directed and maintained pursuant to Section 5-1005 of the
10Counties Code may meet their assessment obligation by
11certifying to the Illinois Department that county expenditures
12have been obligated for the operation of the county nursing
13home in an amount at least equal to the amount of the
14assessment.
15    (a-5) Each assessment payment shall be accompanied by an
16assessment report to be completed by the long-term care
17provider. A separate report shall be completed for each
18long-term care facility in this State operated by a long-term
19care provider. The report shall be in a form and manner
20prescribed by the Illinois Department and shall at a minimum
21provide for the reporting of the number of occupied bed days of
22the long-term care facility for the reporting period and other
23reasonable information the Illinois Department requires for
24the administration of its responsibilities under this Code. To
25the extent practicable, the Department shall coordinate the
26assessment reporting requirements with other reporting

 

 

09600SB3088ham002- 57 -LRB096 20288 KTG 44846 a

1required of long term care facilities.
2    (b) The Illinois Department is authorized to establish
3delayed payment schedules for long-term care providers that are
4unable to make assessment installment payments when due under
5this Section due to financial difficulties, as determined by
6the Illinois Department. The Illinois Department may not deny a
7request for delay of payment of the assessment imposed under
8this Article if the long-term care provider has not been paid
9for services provided during the month on which the assessment
10is levied.
11    (c) If a long-term care provider fails to pay the full
12amount of an assessment payment installment when due (including
13any extensions granted under subsection (b)), there shall,
14unless waived by the Illinois Department for reasonable cause,
15be added to the assessment imposed by Section 5B-2 for the
16State fiscal year a penalty assessment equal to the lesser of
17(i) 5% of the amount of the assessment payment installment not
18paid on or before the due date plus 5% of the portion thereof
19remaining unpaid on the last day of each month thereafter or
20(ii) 100% of the assessment payment installment amount not paid
21on or before the due date. For purposes of this subsection,
22payments will be credited first to unpaid assessment payment
23installment amounts (rather than to penalty or interest),
24beginning with the most delinquent assessment payments
25installments. Payment cycles of longer than 60 days shall be
26one factor the Director takes into account in granting a waiver

 

 

09600SB3088ham002- 58 -LRB096 20288 KTG 44846 a

1under this Section.
2    (c-5) If a long-term care provider fails to file its report
3with payment, there shall, unless waived by the Illinois
4Department for reasonable cause, be added to the assessment due
5a penalty assessment equal to 25% of the assessment due.
6    (d) Nothing in this amendatory Act of 1993 shall be
7construed to prevent the Illinois Department from collecting
8all amounts due under this Article pursuant to an assessment
9imposed before the effective date of this amendatory Act of
101993.
11    (e) Nothing in this amendatory Act of the 96th General
12Assembly shall be construed to prevent the Illinois Department
13from collecting all amounts due under this Code pursuant to an
14assessment, tax, fee, or penalty imposed before the effective
15date of this amendatory Act of the 96th General Assembly.
16(Source: P.A. 96-444, eff. 8-14-09.)
 
17    (305 ILCS 5/5B-5)  (from Ch. 23, par. 5B-5)
18    Sec. 5B-5. Annual reporting Reporting; penalty;
19maintenance of records.
20    (a) After December 31 of each year, and on or before March
2131 of the succeeding year, every long-term care provider
22subject to assessment under this Article shall file a report
23return with the Illinois Department. The return shall report
24the occupied bed days for the calendar year just ended and
25shall be utilized by the Illinois Department to calculate the

 

 

09600SB3088ham002- 59 -LRB096 20288 KTG 44846 a

1assessment for the State fiscal year commencing on the next
2July 1, except that the return for the State fiscal year
3commencing July 1, 1992 and the report of occupied bed days for
4calendar year 1991 shall be filed on or before September 30,
51992. The report return shall be in a form and manner
6prescribed on a form prepared by the Illinois Department and
7shall state the revenue received by the long-term care
8provider, reported in such categories as may be required by the
9Illinois Department, and other the following:
10        (1) The name of the long-term care provider.
11        (2) The address of the long-term care provider's
12    principal place of business from which the provider engages
13    in the occupation of long-term care provider in this State,
14    and the name and address of each long-term care facility
15    operated or maintained by the provider in this State.
16        (3) The number of occupied bed days of the long-term
17    care provider for the calendar year just ended, the amount
18    of assessment imposed under Section 5B-2 for the State
19    fiscal year for which the return is filed, and the amount
20    of each quarterly installment to be paid during the State
21    fiscal year.
22        (4) The amount of penalty due, if any.
23        (5) Other reasonable information the Illinois
24    Department requires for the administration of its
25    responsibilities under this Code.
26    (b) If a long-term care provider operates or maintains more

 

 

09600SB3088ham002- 60 -LRB096 20288 KTG 44846 a

1than one long-term care facility in this State, the provider
2may not file a single return covering all those long-term care
3facilities, but shall file a separate return for each long-term
4care facility and shall compute and pay the assessment for each
5long-term care facility separately.
6    (c) Notwithstanding any other provision in this Article, in
7the case of a person who ceases to operate or maintain a
8long-term care facility in respect of which the person is
9subject to assessment under this Article as a long-term care
10provider, the assessment for the State fiscal year in which the
11cessation occurs shall be adjusted by multiplying the
12assessment computed under Section 5B-2 by a fraction, the
13numerator of which is the number of months in the year during
14which the provider operates or maintains the long-term care
15facility and the denominator of which is 12. The person shall
16file a final, amended return with the Illinois Department not
17more than 90 days after the cessation reflecting the adjustment
18and shall pay with the final return the assessment for the year
19as so adjusted (to the extent not previously paid). If a person
20fails to file a final amended return on a timely basis, there
21shall, unless waived by the Illinois Department for reasonable
22cause, be added to the assessment due a penalty assessment
23equal to 25% of the assessment due.
24    (d) Notwithstanding any other provision of this Article, a
25provider who commences operating or maintaining a long-term
26care facility that was under a prior ownership and remained

 

 

09600SB3088ham002- 61 -LRB096 20288 KTG 44846 a

1licensed by the Department of Public Health shall notify the
2Illinois Department of the change in ownership and shall be
3responsible to immediately pay any prior amounts owed by the
4facility. shall file an initial return for the State fiscal
5year in which the commencement occurs within 90 days thereafter
6and shall pay the assessment computed under Section 5B-2 and
7subsection (e) in equal installments on the due date of the
8return and on the regular installment due dates for the State
9fiscal year occurring after the due date of the initial return.
10    (e) The Department shall develop a procedure for sharing
11with a potential buyer of a facility information regarding
12outstanding assessments and penalties owed by that facility.
13Notwithstanding any other provision of this Article, in the
14case of a long-term care provider that did not operate or
15maintain a long-term care facility throughout the calendar year
16preceding a State fiscal year, the assessment for that State
17fiscal year shall be computed on the basis of hypothetical
18occupied bed days for the full calendar year as determined by
19rules adopted by the Illinois Department (which may be based on
20annualization of the provider's actual occupied bed days for a
21portion of the calendar year, or the occupied bed days of a
22comparable facility for the year, including the same facility
23while operated by a prior provider).
24    (f) In the case of a long-term care provider existing as a
25corporation or legal entity other than an individual, the
26return filed by it shall be signed by its president,

 

 

09600SB3088ham002- 62 -LRB096 20288 KTG 44846 a

1vice-president, secretary, or treasurer or by its properly
2authorized agent.
3    (g) If a long-term care provider fails to file its return
4for a State fiscal year on or before the due date of the
5return, there shall, unless waived by the Illinois Department
6for reasonable cause, be added to the assessment imposed by
7Section 5B-2 for the State fiscal year a penalty assessment
8equal to 25% of the assessment imposed for the year.
9    (h) Every long-term care provider subject to assessment
10under this Article shall keep records and books that will
11permit the determination of occupied bed days on a calendar
12year basis. All such books and records shall be kept in the
13English language and shall, at all times during business hours
14of the day, be subject to inspection by the Illinois Department
15or its duly authorized agents and employees.
16(Source: P.A. 87-861.)
 
17    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
18    Sec. 5B-8. Long-Term Care Provider Fund.
19    (a) There is created in the State Treasury the Long-Term
20Care Provider Fund. Interest earned by the Fund shall be
21credited to the Fund. The Fund shall not be used to replace any
22moneys appropriated to the Medicaid program by the General
23Assembly.
24    (b) The Fund is created for the purpose of receiving and
25disbursing moneys in accordance with this Article.

 

 

09600SB3088ham002- 63 -LRB096 20288 KTG 44846 a

1Disbursements from the Fund shall be made only as follows:
2        (1) For payments to skilled or intermediate nursing
3    facilities, including county nursing facilities but
4    excluding State-operated facilities, under Title XIX of
5    the Social Security Act and Article V of this Code.
6        (2) For the reimbursement of moneys collected by the
7    Illinois Department through error or mistake, and for
8    making required payments under Section 5-4.38(a)(1) if
9    there are no moneys available for such payments in the
10    Medicaid Long Term Care Provider Participation Fee Trust
11    Fund.
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        (3.5) For reimbursement of expenses incurred by
16    long-term care facilities, and payment of administrative
17    expenses incurred by the Department of Public Health, in
18    relation to the conduct and analysis of background checks
19    for identified offenders under the Nursing Home Care Act.
20        (4) For payments of any amounts that are reimbursable
21    to the federal government for payments from this Fund that
22    are required to be paid by State warrant.
23        (5) For making transfers to the General Obligation Bond
24    Retirement and Interest Fund, as those transfers are
25    authorized in the proceedings authorizing debt under the
26    Short Term Borrowing Act, but transfers made under this

 

 

09600SB3088ham002- 64 -LRB096 20288 KTG 44846 a

1    paragraph (5) shall not exceed the principal amount of debt
2    issued in anticipation of the receipt by the State of
3    moneys to be deposited into the Fund.
4        (6) For making transfers, at the direction of the
5    Director of the Governor's Office of Management and Budget
6    during each fiscal year beginning on or after July 1, 2011,
7    to other State funds in an annual amount of $20,000,000 of
8    the tax collected pursuant to this Article for the purpose
9    of enforcement of nursing home standards, support of the
10    ombudsman program, and efforts to expand home and
11    community-based services.
12    Disbursements from the Fund, other than transfers made
13pursuant to paragraphs (5) and (6) of this subsection to the
14General Obligation Bond Retirement and Interest Fund, shall be
15by warrants drawn by the State Comptroller upon receipt of
16vouchers duly executed and certified by the Illinois
17Department.
18    (c) The Fund shall consist of the following:
19        (1) All moneys collected or received by the Illinois
20    Department from the long-term care provider assessment
21    imposed by this Article.
22        (2) All federal matching funds received by the Illinois
23    Department as a result of expenditures made by the Illinois
24    Department that are attributable to moneys deposited in the
25    Fund.
26        (3) Any interest or penalty levied in conjunction with

 

 

09600SB3088ham002- 65 -LRB096 20288 KTG 44846 a

1    the administration of this Article.
2        (4) (Blank). Any balance in the Medicaid Long Term Care
3    Provider Participation Fee Fund in the State Treasury. The
4    balance shall be transferred to the Fund upon certification
5    by the Illinois Department to the State Comptroller that
6    all of the disbursements required by Section 5-4.31(b) of
7    this Code have been made.
8        (5) All other monies received for the Fund from any
9    other source, including interest earned thereon.
10(Source: P.A. 95-707, eff. 1-11-08.)
 
11    (305 ILCS 5/5-4.20 rep.)
12    (305 ILCS 5/5-4.21 rep.)
13    (305 ILCS 5/5-4.22 rep.)
14    (305 ILCS 5/5-4.23 rep.)
15    (305 ILCS 5/5-4.24 rep.)
16    (305 ILCS 5/5-4.25 rep.)
17    (305 ILCS 5/5-4.26 rep.)
18    (305 ILCS 5/5-4.27 rep.)
19    (305 ILCS 5/5-4.28 rep.)
20    (305 ILCS 5/5-4.29 rep.)
21    (305 ILCS 5/5-4.30 rep.)
22    (305 ILCS 5/5-4.31 rep.)
23    (305 ILCS 5/5-4.32 rep.)
24    (305 ILCS 5/5-4.33 rep.)
25    (305 ILCS 5/5-4.34 rep.)

 

 

09600SB3088ham002- 66 -LRB096 20288 KTG 44846 a

1    (305 ILCS 5/5-4.35 rep.)
2    (305 ILCS 5/5-4.36 rep.)
3    (305 ILCS 5/5-4.37 rep.)
4    (305 ILCS 5/5-4.38 rep.)
5    (305 ILCS 5/5-4.39 rep.)
6    (305 ILCS 5/5-5.6a rep.)
7    (305 ILCS 5/5-5.11 rep.)
8    (305 ILCS 5/5-5.21 rep.)
9    Section 35. The Illinois Public Aid Code is amended by
10repealing Sections 5-4.20, 5-4.21, 5-4.22, 5-4.23, 5-4.24,
115-4.25, 5-4.26, 5-4.27, 5-4.28, 5-4.29, 5-4.30, 5-4.31,
125-4.32, 5-4.33, 5-4.34, 5-4.35, 5-4.36, 5-4.37, 5-4.38,
135-4.39, 5-5.6a, 5-5.11, and 5-5.21.
 
14    Section 99. Effective date. This Act takes effect upon
15becoming law.".