HB3635 EnrolledLRB097 07244 KTG 47352 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Sections 5-4.2, 5-5.4, 5B-2, 5B-4, and 5B-8 as
6follows:
 
7    (305 ILCS 5/5-4.2)  (from Ch. 23, par. 5-4.2)
8    Sec. 5-4.2. Ambulance services payments.
9    (a) For ambulance services provided to a recipient of aid
10under this Article on or after January 1, 1993, the Illinois
11Department shall reimburse ambulance service providers at
12rates calculated in accordance with this Section. It is the
13intent of the General Assembly to provide adequate
14reimbursement for ambulance services so as to ensure adequate
15access to services for recipients of aid under this Article and
16to provide appropriate incentives to ambulance service
17providers to provide services in an efficient and
18cost-effective manner. Thus, it is the intent of the General
19Assembly that the Illinois Department implement a
20reimbursement system for ambulance services that, to the extent
21practicable and subject to the availability of funds
22appropriated by the General Assembly for this purpose, is
23consistent with the payment principles of Medicare. To ensure

 

 

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1uniformity between the payment principles of Medicare and
2Medicaid, the Illinois Department shall follow, to the extent
3necessary and practicable and subject to the availability of
4funds appropriated by the General Assembly for this purpose,
5the statutes, laws, regulations, policies, procedures,
6principles, definitions, guidelines, and manuals used to
7determine the amounts paid to ambulance service providers under
8Title XVIII of the Social Security Act (Medicare).
9    (b) For ambulance services provided to a recipient of aid
10under this Article on or after January 1, 1996, the Illinois
11Department shall reimburse ambulance service providers based
12upon the actual distance traveled if a natural disaster,
13weather conditions, road repairs, or traffic congestion
14necessitates the use of a route other than the most direct
15route.
16    (c) For purposes of this Section, "ambulance services"
17includes medical transportation services provided by means of
18an ambulance, medi-car, service car, or taxi.
19    (c-1) For purposes of this Section, "ground ambulance
20service" means medical transportation services that are
21described as ground ambulance services by the Centers for
22Medicare and Medicaid Services and provided in a vehicle that
23is licensed as an ambulance by the Illinois Department of
24Public Health pursuant to the Emergency Medical Services (EMS)
25Systems Act.
26    (c-2) For purposes of this Section, "ground ambulance

 

 

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1service provider" means a vehicle service provider as described
2in the Emergency Medical Services (EMS) Systems Act that
3operates licensed ambulances for the purpose of providing
4emergency ambulance services, or non-emergency ambulance
5services, or both. For purposes of this Section, this includes
6both ambulance providers and ambulance suppliers as described
7by the Centers for Medicare and Medicaid Services.
8    (d) This Section does not prohibit separate billing by
9ambulance service providers for oxygen furnished while
10providing advanced life support services.
11    (e) Beginning with services rendered on or after July 1,
122008, all providers of non-emergency medi-car and service car
13transportation must certify that the driver and employee
14attendant, as applicable, have completed a safety program
15approved by the Department to protect both the patient and the
16driver, prior to transporting a patient. The provider must
17maintain this certification in its records. The provider shall
18produce such documentation upon demand by the Department or its
19representative. Failure to produce documentation of such
20training shall result in recovery of any payments made by the
21Department for services rendered by a non-certified driver or
22employee attendant. Medi-car and service car providers must
23maintain legible documentation in their records of the driver
24and, as applicable, employee attendant that actually
25transported the patient. Providers must recertify all drivers
26and employee attendants every 3 years.

 

 

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1    Notwithstanding the requirements above, any public
2transportation provider of medi-car and service car
3transportation that receives federal funding under 49 U.S.C.
45307 and 5311 need not certify its drivers and employee
5attendants under this Section, since safety training is already
6federally mandated.
7    (f) With respect to any policy or program administered by
8the Department or its agent regarding approval of non-emergency
9medical transportation by ground ambulance service providers,
10including, but not limited to, the Non-Emergency
11Transportation Services Prior Approval Program (NETSPAP), the
12Department shall establish by rule a process by which ground
13ambulance service providers of non-emergency medical
14transportation may appeal any decision by the Department or its
15agent for which no denial was received prior to the time of
16transport that either (i) denies a request for approval for
17payment of non-emergency transportation by means of ground
18ambulance service or (ii) grants a request for approval of
19non-emergency transportation by means of ground ambulance
20service at a level of service that entitles the ground
21ambulance service provider to a lower level of compensation
22from the Department than the ground ambulance service provider
23would have received as compensation for the level of service
24requested. The rule shall be established within 12 months after
25the effective date of this amendatory Act of the 97th General
26Assembly and shall provide that, for any decision rendered by

 

 

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1the Department or its agent on or after the date the rule takes
2effect, the ground ambulance service provider shall have 60
3days from the date the decision is received to file an appeal.
4The rule established by the Department shall be, insofar as is
5practical, consistent with the Illinois Administrative
6Procedure Act. The Director's decision on an appeal under this
7Section shall be a final administrative decision subject to
8review under the Administrative Review Law.
9(Source: P.A. 95-501, eff. 8-28-07.)
 
10    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
11    Sec. 5-5.4. Standards of Payment - Department of Healthcare
12and Family Services. The Department of Healthcare and Family
13Services shall develop standards of payment of nursing facility
14and ICF/DD services in facilities providing such services under
15this Article which:
16    (1) Provide for the determination of a facility's payment
17for nursing facility or ICF/DD services on a prospective basis.
18The amount of the payment rate for all nursing facilities
19certified by the Department of Public Health under the MR/DD
20Community Care Act or the Nursing Home Care Act as Intermediate
21Care for the Developmentally Disabled facilities, Long Term
22Care for Under Age 22 facilities, Skilled Nursing facilities,
23or Intermediate Care facilities under the medical assistance
24program shall be prospectively established annually on the
25basis of historical, financial, and statistical data

 

 

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1reflecting actual costs from prior years, which shall be
2applied to the current rate year and updated for inflation,
3except that the capital cost element for newly constructed
4facilities shall be based upon projected budgets. The annually
5established payment rate shall take effect on July 1 in 1984
6and subsequent years. No rate increase and no update for
7inflation shall be provided on or after July 1, 1994 and before
8July 1, 2012, unless specifically provided for in this Section.
9The changes made by Public Act 93-841 extending the duration of
10the prohibition against a rate increase or update for inflation
11are effective retroactive to July 1, 2004.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as Intermediate Care for the
14Developmentally Disabled facilities or Long Term Care for Under
15Age 22 facilities, the rates taking effect on July 1, 1998
16shall include an increase of 3%. For facilities licensed by the
17Department of Public Health under the Nursing Home Care Act as
18Skilled Nursing facilities or Intermediate Care facilities,
19the rates taking effect on July 1, 1998 shall include an
20increase of 3% plus $1.10 per resident-day, as defined by the
21Department. For facilities licensed by the Department of Public
22Health under the Nursing Home Care Act as Intermediate Care
23Facilities for the Developmentally Disabled or Long Term Care
24for Under Age 22 facilities, the rates taking effect on January
251, 2006 shall include an increase of 3%. For facilities
26licensed by the Department of Public Health under the Nursing

 

 

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1Home Care Act as Intermediate Care Facilities for the
2Developmentally Disabled or Long Term Care for Under Age 22
3facilities, the rates taking effect on January 1, 2009 shall
4include an increase sufficient to provide a $0.50 per hour wage
5increase for non-executive staff.
6    For facilities licensed by the Department of Public Health
7under the Nursing Home Care Act as Intermediate Care for the
8Developmentally Disabled facilities or Long Term Care for Under
9Age 22 facilities, the rates taking effect on July 1, 1999
10shall include an increase of 1.6% plus $3.00 per resident-day,
11as defined by the Department. For facilities licensed by the
12Department of Public Health under the Nursing Home Care Act as
13Skilled Nursing facilities or Intermediate Care facilities,
14the rates taking effect on July 1, 1999 shall include an
15increase of 1.6% and, for services provided on or after October
161, 1999, shall be increased by $4.00 per resident-day, as
17defined by the Department.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as Intermediate Care for the
20Developmentally Disabled facilities or Long Term Care for Under
21Age 22 facilities, the rates taking effect on July 1, 2000
22shall include an increase of 2.5% per resident-day, as defined
23by the Department. For facilities licensed by the Department of
24Public Health under the Nursing Home Care Act as Skilled
25Nursing facilities or Intermediate Care facilities, the rates
26taking effect on July 1, 2000 shall include an increase of 2.5%

 

 

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

 

 

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1    by that facility.
2        (B) For a facility that would receive a higher nursing
3    component rate per patient day under the payment
4    methodology in effect on July 1, 2003 than the facility
5    received effective on the date immediately preceding the
6    date that the Department implements the new payment
7    methodology, the nursing component rate per patient day for
8    the facility shall be adjusted.
9        (C) Notwithstanding paragraphs (A) and (B), the
10    nursing component rate per patient day for the facility
11    shall be adjusted subject to appropriations provided by the
12    General Assembly.
13    For facilities licensed by the Department of Public Health
14under the Nursing Home Care Act as Intermediate Care for the
15Developmentally Disabled facilities or Long Term Care for Under
16Age 22 facilities, the rates taking effect on March 1, 2001
17shall include a statewide increase of 7.85%, as defined by the
18Department.
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, except facilities participating
23in the Department's demonstration program pursuant to the
24provisions of Title 77, Part 300, Subpart T of the Illinois
25Administrative Code, the numerator of the ratio used by the
26Department of Healthcare and Family Services to compute the

 

 

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1rate payable under this Section using the Minimum Data Set
2(MDS) methodology shall incorporate the following annual
3amounts as the additional funds appropriated to the Department
4specifically to pay for rates based on the MDS nursing
5component methodology in excess of the funding in effect on
6December 31, 2006:
7        (i) For rates taking effect January 1, 2007,
8    $60,000,000.
9        (ii) For rates taking effect January 1, 2008,
10    $110,000,000.
11        (iii) For rates taking effect January 1, 2009,
12    $194,000,000.
13        (iv) For rates taking effect April 1, 2011, or the
14    first day of the month that begins at least 45 days after
15    the effective date of this amendatory Act of the 96th
16    General Assembly, $416,500,000 or an amount as may be
17    necessary to complete the transition to the MDS methodology
18    for the nursing component of the rate. Increased payments
19    under this item (iv) are not due and payable, however,
20    until (i) the methodologies described in this paragraph are
21    approved by the federal government in an appropriate State
22    Plan amendment and (ii) the assessment imposed by Section
23    5B-2 of this Code is determined to be a permissible tax
24    under Title XIX of the Social Security Act.
25    Notwithstanding any other provision of this Section, for
26facilities licensed by the Department of Public Health under

 

 

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1the Nursing Home Care Act as skilled nursing facilities or
2intermediate care facilities, the support component of the
3rates taking effect on January 1, 2008 shall be computed using
4the most recent cost reports on file with the Department of
5Healthcare and Family Services no later than April 1, 2005,
6updated for inflation to January 1, 2006.
7    For facilities licensed by the Department of Public Health
8under the Nursing Home Care Act as Intermediate Care for the
9Developmentally Disabled facilities or Long Term Care for Under
10Age 22 facilities, the rates taking effect on April 1, 2002
11shall include a statewide increase of 2.0%, as defined by the
12Department. This increase terminates on July 1, 2002; beginning
13July 1, 2002 these rates are reduced to the level of the rates
14in effect on March 31, 2002, as defined by the Department.
15    For facilities licensed by the Department of Public Health
16under the Nursing Home Care Act as skilled nursing facilities
17or intermediate care facilities, the rates taking effect on
18July 1, 2001 shall be computed using the most recent cost
19reports on file with the Department of Public Aid no later than
20April 1, 2000, updated for inflation to January 1, 2001. For
21rates effective July 1, 2001 only, rates shall be the greater
22of the rate computed for July 1, 2001 or the rate effective on
23June 30, 2001.
24    Notwithstanding any other provision of this Section, for
25facilities licensed by the Department of Public Health under
26the Nursing Home Care Act as skilled nursing facilities or

 

 

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1intermediate care facilities, the Illinois Department shall
2determine by rule the rates taking effect on July 1, 2002,
3which shall be 5.9% less than the rates in effect on June 30,
42002.
5    Notwithstanding any other provision of this Section, for
6facilities licensed by the Department of Public Health under
7the Nursing Home Care Act as skilled nursing facilities or
8intermediate care facilities, if the payment methodologies
9required under Section 5A-12 and the waiver granted under 42
10CFR 433.68 are approved by the United States Centers for
11Medicare and Medicaid Services, the rates taking effect on July
121, 2004 shall be 3.0% greater than the rates in effect on June
1330, 2004. These rates shall take effect only upon approval and
14implementation of the payment methodologies required under
15Section 5A-12.
16    Notwithstanding any other provisions 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, the rates taking effect on
20January 1, 2005 shall be 3% more than the rates in effect on
21December 31, 2004.
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, effective January 1, 2009, the
26per diem support component of the rates effective on January 1,

 

 

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12008, computed using the most recent cost reports on file with
2the Department of Healthcare and Family Services no later than
3April 1, 2005, updated for inflation to January 1, 2006, shall
4be increased to the amount that would have been derived using
5standard Department of Healthcare and Family Services methods,
6procedures, and inflators.
7    Notwithstanding any other provisions of this Section, for
8facilities licensed by the Department of Public Health under
9the Nursing Home Care Act as intermediate care facilities that
10are federally defined as Institutions for Mental Disease, a
11socio-development component rate equal to 6.6% of the
12facility's nursing component rate as of January 1, 2006 shall
13be established and paid effective July 1, 2006. The
14socio-development component of the rate shall be increased by a
15factor of 2.53 on the first day of the month that begins at
16least 45 days after January 11, 2008 (the effective date of
17Public Act 95-707). As of August 1, 2008, the socio-development
18component rate shall be equal to 6.6% of the facility's nursing
19component rate as of January 1, 2006, multiplied by a factor of
203.53. For services provided on or after April 1, 2011, or the
21first day of the month that begins at least 45 days after the
22effective date of this amendatory Act of the 96th General
23Assembly, whichever is later, the Illinois Department may by
24rule adjust these socio-development component rates, and may
25use different adjustment methodologies for those facilities
26participating, and those not participating, in the Illinois

 

 

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1Department's demonstration program pursuant to the provisions
2of Title 77, Part 300, Subpart T of the Illinois Administrative
3Code, but in no case may such rates be diminished below those
4in effect on August 1, 2008.
5    For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as Intermediate Care for the
7Developmentally Disabled facilities or as long-term care
8facilities for residents under 22 years of age, the rates
9taking effect on July 1, 2003 shall include a statewide
10increase of 4%, as defined by the Department.
11    For facilities licensed by the Department of Public Health
12under the Nursing Home Care Act as Intermediate Care for the
13Developmentally Disabled facilities or Long Term Care for Under
14Age 22 facilities, the rates taking effect on the first day of
15the month that begins at least 45 days after the effective date
16of this amendatory Act of the 95th General Assembly shall
17include a statewide increase of 2.5%, as defined by the
18Department.
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, 2005,
23facility rates shall be increased by the difference between (i)
24a facility's per diem property, liability, and malpractice
25insurance costs as reported in the cost report filed with the
26Department of Public Aid and used to establish rates effective

 

 

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1July 1, 2001 and (ii) those same costs as reported in the
2facility's 2002 cost report. These costs shall be passed
3through to the facility without caps or limitations, except for
4adjustments required under normal auditing procedures.
5    Rates established effective each July 1 shall govern
6payment for services rendered throughout that fiscal year,
7except that rates established on July 1, 1996 shall be
8increased by 6.8% for services provided on or after January 1,
91997. Such rates will be based upon the rates calculated for
10the year beginning July 1, 1990, and for subsequent years
11thereafter until June 30, 2001 shall be based on the facility
12cost reports for the facility fiscal year ending at any point
13in time during the previous calendar year, updated to the
14midpoint of the rate year. The cost report shall be on file
15with the Department no later than April 1 of the current rate
16year. Should the cost report not be on file by April 1, the
17Department shall base the rate on the latest cost report filed
18by each skilled care facility and intermediate care facility,
19updated to the midpoint of the current rate year. In
20determining rates for services rendered on and after July 1,
211985, fixed time shall not be computed at less than zero. The
22Department shall not make any alterations of regulations which
23would reduce any component of the Medicaid rate to a level
24below what that component would have been utilizing in the rate
25effective on July 1, 1984.
26    (2) Shall take into account the actual costs incurred by

 

 

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1facilities in providing services for recipients of skilled
2nursing and intermediate care services under the medical
3assistance program.
4    (3) Shall take into account the medical and psycho-social
5characteristics and needs of the patients.
6    (4) Shall take into account the actual costs incurred by
7facilities in meeting licensing and certification standards
8imposed and prescribed by the State of Illinois, any of its
9political subdivisions or municipalities and by the U.S.
10Department of Health and Human Services pursuant to Title XIX
11of the Social Security Act.
12    The Department of Healthcare and Family Services shall
13develop precise standards for payments to reimburse nursing
14facilities for any utilization of appropriate rehabilitative
15personnel for the provision of rehabilitative services which is
16authorized by federal regulations, including reimbursement for
17services provided by qualified therapists or qualified
18assistants, and which is in accordance with accepted
19professional practices. Reimbursement also may be made for
20utilization of other supportive personnel under appropriate
21supervision.
22    The Department shall develop enhanced payments to offset
23the additional costs incurred by a facility serving exceptional
24need residents and shall allocate at least $8,000,000 of the
25funds collected from the assessment established by Section 5B-2
26of this Code for such payments. For the purpose of this

 

 

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1Section, "exceptional needs" means, but need not be limited to,
2ventilator care, tracheotomy care, bariatric care, complex
3wound care, and traumatic brain injury care. The enhanced
4payments for exceptional need residents under this paragraph
5are not due and payable, however, until (i) the methodologies
6described in this paragraph are approved by the federal
7government in an appropriate State Plan amendment and (ii) the
8assessment imposed by Section 5B-2 of this Code is determined
9to be a permissible tax under Title XIX of the Social Security
10Act.
11    (5) Beginning July 1, 2012 the methodologies for
12reimbursement of nursing facility services as provided under
13this Section 5-5.4 shall no longer be applicable for bills
14payable for State fiscal years 2012 and thereafter.
15    (6) No payment increase under this Section for the MDS
16methodology, exceptional care residents, or the
17socio-development component rate established by Public Act
1896-1530 of the 96th General Assembly and funded by the
19assessment imposed under Section 5B-2 of this Code shall be due
20and payable until after the Department notifies the long-term
21care providers, in writing, that the payment methodologies to
22long-term care providers required under this Section have been
23approved by the Centers for Medicare and Medicaid Services of
24the U.S. Department of Health and Human Services and the
25waivers under 42 CFR 433.68 for the assessment imposed by this
26Section, if necessary, have been granted by the Centers for

 

 

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1Medicare and Medicaid Services of the U.S. Department of Health
2and Human Services. Upon notification to the Department of
3approval of the payment methodologies required under this
4Section and the waivers granted under 42 CFR 433.68, all
5increased payments otherwise due under this Section prior to
6the date of notification shall be due and payable within 90
7days of the date federal approval is received.
8(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
9eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09;
1096-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff. 7-2-10;
1196-1530, eff. 2-16-11.)
 
12    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
13    Sec. 5B-2. Assessment; no local authorization to tax.
14    (a) For the privilege of engaging in the occupation of
15long-term care provider, beginning July 1, 2011 an assessment
16is imposed upon each long-term care provider in an amount equal
17to $6.07 times the number of occupied bed days due and payable
18each month. Notwithstanding any provision of any other Act to
19the contrary, this assessment shall be construed as a tax, but
20shall not be billed or passed on to any resident of a nursing
21home operated by the nursing home provider may not be added to
22the charges of an individual's nursing home care that is paid
23for in whole, or in part, by a federal, State, or combined
24federal-state medical care program.
25    (b) Nothing in this amendatory Act of 1992 shall be

 

 

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1construed to authorize any home rule unit or other unit of
2local government to license for revenue or impose a tax or
3assessment upon long-term care providers or the occupation of
4long-term care provider, or a tax or assessment measured by the
5income or earnings or occupied bed days of a long-term care
6provider.
7    (c) The assessment imposed by this Section shall not be due
8and payable, however, until after the Department notifies the
9long-term care providers, in writing, that the payment
10methodologies to long-term care providers required under
11Section 5-5.4 of this Code have been approved by the Centers
12for Medicare and Medicaid Services of the U.S. Department of
13Health and Human Services and the waivers under 42 CFR 433.68
14for the assessment imposed by this Section, if necessary, have
15been granted by the Centers for Medicare and Medicaid Services
16of the U.S. Department of Health and Human Services.
17(Source: P.A. 96-1530, eff. 2-16-11.)
 
18    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)
19    Sec. 5B-4. Payment of assessment; penalty.
20    (a) The assessment imposed by Section 5B-2 shall be due and
21payable monthly, on the last State business day of the month
22for occupied bed days reported for the preceding third month
23prior to the month in which the tax is payable and due. A
24facility that has delayed payment due to the State's failure to
25reimburse for services rendered may request an extension on the

 

 

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1due date for payment pursuant to subsection (b) and shall pay
2the assessment within 30 days of reimbursement by the
3Department. The Illinois Department may provide that county
4nursing homes directed and maintained pursuant to Section
55-1005 of the Counties Code may meet their assessment
6obligation by certifying to the Illinois Department that county
7expenditures have been obligated for the operation of the
8county nursing home in an amount at least equal to the amount
9of the assessment.
10    (a-5) Each assessment payment shall be accompanied by an
11assessment report to be completed by the long-term care
12provider. A separate report shall be completed for each
13long-term care facility in this State operated by a long-term
14care provider. The report shall be in a form and manner
15prescribed by the Illinois Department and shall at a minimum
16provide for the reporting of the number of occupied bed days of
17the long-term care facility for the reporting period and other
18reasonable information the Illinois Department requires for
19the administration of its responsibilities under this Code. To
20the extent practicable, the Department shall coordinate the
21assessment reporting requirements with other reporting
22required of long-term care facilities.
23    (b) The Illinois Department is authorized to establish
24delayed payment schedules for long-term care providers that are
25unable to make assessment payments when due under this Section
26due to financial difficulties, as determined by the Illinois

 

 

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

 

 

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1all amounts due under this Article pursuant to an assessment
2imposed before the effective date of this amendatory Act of
31993.
4    (e) Nothing in this amendatory Act of the 96th General
5Assembly shall be construed to prevent the Illinois Department
6from collecting all amounts due under this Code pursuant to an
7assessment, tax, fee, or penalty imposed before the effective
8date of this amendatory Act of the 96th General Assembly.
9    (f) No installment of the assessment imposed by Section
105B-2 shall be due and payable until after the Department
11notifies the long-term care providers, in writing, that the
12payment methodologies to long-term care providers required
13under Section 5-5.4 of this Code have been approved by the
14Centers for Medicare and Medicaid Services of the U.S.
15Department of Health and Human Services and the waivers under
1642 CFR 433.68 for the assessment imposed by this Section, if
17necessary, have been granted by the Centers for Medicare and
18Medicaid Services of the U.S. Department of Health and Human
19Services. Upon notification to the Department of approval of
20the payment methodologies required under Section 5-5.4 of this
21Code and the waivers granted under 42 CFR 433.68, all
22installments otherwise due under Section 5B-4 prior to the date
23of notification shall be due and payable to the Department upon
24written direction from the Department within 90 days after
25issuance by the Comptroller of the payments required under
26Section 5-5.4 of this Code.

 

 

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1(Source: P.A. 96-444, eff. 8-14-09; 96-1530, eff. 2-16-11.)
 
2    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
3    Sec. 5B-8. Long-Term Care Provider Fund.
4    (a) There is created in the State Treasury the Long-Term
5Care Provider Fund. Interest earned by the Fund shall be
6credited to the Fund. The Fund shall not be used to replace any
7moneys appropriated to the Medicaid program by the General
8Assembly.
9    (b) The Fund is created for the purpose of receiving and
10disbursing moneys in accordance with this Article.
11Disbursements from the Fund shall be made only as follows:
12        (1) For payments to nursing facilities, including
13    county nursing facilities but excluding State-operated
14    facilities, under Title XIX of the Social Security Act and
15    Article V of this Code.
16        (2) For the reimbursement of moneys collected by the
17    Illinois Department through error or mistake.
18        (3) For payment of administrative expenses incurred by
19    the Illinois Department or its agent in performing the
20    activities authorized by this Article.
21        (3.5) For reimbursement of expenses incurred by
22    long-term care facilities, and payment of administrative
23    expenses incurred by the Department of Public Health, in
24    relation to the conduct and analysis of background checks
25    for identified offenders under the Nursing Home Care Act.

 

 

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1        (4) For payments of any amounts that are reimbursable
2    to the federal government for payments from this Fund that
3    are required to be paid by State warrant.
4        (5) For making transfers to the General Obligation Bond
5    Retirement and Interest Fund, as those transfers are
6    authorized in the proceedings authorizing debt under the
7    Short Term Borrowing Act, but transfers made under this
8    paragraph (5) shall not exceed the principal amount of debt
9    issued in anticipation of the receipt by the State of
10    moneys to be deposited into the Fund.
11        (6) For making transfers, at the direction of the
12    Director of the Governor's Office of Management and Budget
13    during each fiscal year beginning on or after July 1, 2011,
14    to other State funds in an annual amount of $20,000,000 of
15    the tax collected pursuant to this Article for the purpose
16    of enforcement of nursing home standards, support of the
17    ombudsman program, and efforts to expand home and
18    community-based services. No transfer under this paragraph
19    shall occur until (i) the payment methodologies created by
20    Public Act 96-1530 under Section 5-5.4 of this Code have
21    been approved by the Centers for Medicare and Medicaid
22    Services of the U.S. Department of Health and Human
23    Services and (ii) the assessment imposed by Section 5B-2 of
24    this Code is determined to be a permissible tax under Title
25    XIX of the Social Security Act.
26    Disbursements from the Fund, other than transfers made

 

 

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1pursuant to paragraphs (5) and (6) of this subsection, shall be
2by warrants drawn by the State Comptroller upon receipt of
3vouchers duly executed and certified by the Illinois
4Department.
5    (c) The Fund shall consist of the following:
6        (1) All moneys collected or received by the Illinois
7    Department from the long-term care provider assessment
8    imposed by this Article.
9        (2) All federal matching funds received by the Illinois
10    Department as a result of expenditures made by the Illinois
11    Department that are attributable to moneys deposited in the
12    Fund.
13        (3) Any interest or penalty levied in conjunction with
14    the administration of this Article.
15        (4) (Blank).
16        (5) All other monies received for the Fund from any
17    other source, including interest earned thereon.
18(Source: P.A. 95-707, eff. 1-11-08; 96-1530, eff. 2-16-11.)
 
19    Section 99. Effective date. This Act takes effect upon
20becoming law.