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Full Text of SB1520  100th General Assembly

SB1520 100TH GENERAL ASSEMBLY


 


 
100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB1520

 

Introduced 2/9/2017, by Sen. Heather A. Steans

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5A-2  from Ch. 23, par. 5A-2

    Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning an assessment on inpatient services that is imposed on hospital providers.


LRB100 09152 KTG 19307 b

 

 

A BILL FOR

 

SB1520LRB100 09152 KTG 19307 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 Section 5A-2 as follows:
 
6    (305 ILCS 5/5A-2)  (from Ch. 23, par. 5A-2)
7    (Section scheduled to be repealed on July 1, 2018)
8    Sec. 5A-2. Assessment.
9    (a)(1) Subject to Sections 5A-3 and and 5A-10, for State
10fiscal years 2009 through 2018, an annual assessment on
11inpatient services is imposed on each hospital provider in an
12amount equal to $218.38 multiplied by the difference of the
13hospital's occupied bed days less the hospital's Medicare bed
14days, provided, however, that the amount of $218.38 shall be
15increased by a uniform percentage to generate an amount equal
16to 75% of the State share of the payments authorized under
17Section 5A-12.5, with such increase only taking effect upon the
18date that a State share for such payments is required under
19federal law. For the period of April through June 2015, the
20amount of $218.38 used to calculate the assessment under this
21paragraph shall, by emergency rule under subsection (s) of
22Section 5-45 of the Illinois Administrative Procedure Act, be
23increased by a uniform percentage to generate $20,250,000 in

 

 

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1the aggregate for that period from all hospitals subject to the
2annual assessment under this paragraph.
3    (2) In addition to any other assessments imposed under this
4Article, effective July 1, 2016 and semi-annually thereafter
5through June 2018, in addition to any federally required State
6share as authorized under paragraph (1), the amount of $218.38
7shall be increased by a uniform percentage to generate an
8amount equal to 75% of the ACA Assessment Adjustment, as
9defined in subsection (b-6) of this Section.
10    For State fiscal years 2009 through 2014 and after, a
11hospital's occupied bed days and Medicare bed days shall be
12determined using the most recent data available from each
13hospital's 2005 Medicare cost report as contained in the
14Healthcare Cost Report Information System file, for the quarter
15ending on December 31, 2006, without regard to any subsequent
16adjustments or changes to such data. If a hospital's 2005
17Medicare cost report is not contained in the Healthcare Cost
18Report Information System, then the Illinois Department may
19obtain the hospital provider's occupied bed days and Medicare
20bed days from any source available, including, but not limited
21to, records maintained by the hospital provider, which may be
22inspected at all times during business hours of the day by the
23Illinois Department or its duly authorized agents and
24employees.
25    (b) (Blank).
26    (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the

 

 

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1portion of State fiscal year 2012, beginning June 10, 2012
2through June 30, 2012, and for State fiscal years 2013 through
32018, an annual assessment on outpatient services is imposed on
4each hospital provider in an amount equal to .008766 multiplied
5by the hospital's outpatient gross revenue, provided, however,
6that the amount of .008766 shall be increased by a uniform
7percentage to generate an amount equal to 25% of the State
8share of the payments authorized under Section 5A-12.5, with
9such increase only taking effect upon the date that a State
10share for such payments is required under federal law. For the
11period beginning June 10, 2012 through June 30, 2012, the
12annual assessment on outpatient services shall be prorated by
13multiplying the assessment amount by a fraction, the numerator
14of which is 21 days and the denominator of which is 365 days.
15For the period of April through June 2015, the amount of
16.008766 used to calculate the assessment under this paragraph
17shall, by emergency rule under subsection (s) of Section 5-45
18of the Illinois Administrative Procedure Act, be increased by a
19uniform percentage to generate $6,750,000 in the aggregate for
20that period from all hospitals subject to the annual assessment
21under this paragraph.
22    (2) In addition to any other assessments imposed under this
23Article, effective July 1, 2016 and semi-annually thereafter
24through June 2018, in addition to any federally required State
25share as authorized under paragraph (1), the amount of .008766
26shall be increased by a uniform percentage to generate an

 

 

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1amount equal to 25% of the ACA Assessment Adjustment, as
2defined in subsection (b-6) of this Section.
3    For the portion of State fiscal year 2012, beginning June
410, 2012 through June 30, 2012, and State fiscal years 2013
5through 2018, a hospital's outpatient gross revenue shall be
6determined using the most recent data available from each
7hospital's 2009 Medicare cost report as contained in the
8Healthcare Cost Report Information System file, for the quarter
9ending on June 30, 2011, without regard to any subsequent
10adjustments or changes to such data. If a hospital's 2009
11Medicare cost report is not contained in the Healthcare Cost
12Report Information System, then the Department may obtain the
13hospital provider's outpatient gross revenue from any source
14available, including, but not limited to, records maintained by
15the hospital provider, which may be inspected at all times
16during business hours of the day by the Department or its duly
17authorized agents and employees.
18    (b-6)(1) As used in this Section, "ACA Assessment
19Adjustment" means:
20        (A) For the period of July 1, 2016 through December 31,
21    2016, the product of .19125 multiplied by the sum of the
22    fee-for-service payments to hospitals as authorized under
23    Section 5A-12.5 and the adjustments authorized under
24    subsection (t) of Section 5A-12.2 to managed care
25    organizations for hospital services due and payable in the
26    month of April 2016 multiplied by 6.

 

 

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1        (B) For the period of January 1, 2017 through June 30,
2    2017, the product of .19125 multiplied by the sum of the
3    fee-for-service payments to hospitals as authorized under
4    Section 5A-12.5 and the adjustments authorized under
5    subsection (t) of Section 5A-12.2 to managed care
6    organizations for hospital services due and payable in the
7    month of October 2016 multiplied by 6, except that the
8    amount calculated under this subparagraph (B) shall be
9    adjusted, either positively or negatively, to account for
10    the difference between the actual payments issued under
11    Section 5A-12.5 for the period beginning July 1, 2016
12    through December 31, 2016 and the estimated payments due
13    and payable in the month of April 2016 multiplied by 6 as
14    described in subparagraph (A).
15        (C) For the period of July 1, 2017 through December 31,
16    2017, the product of .19125 multiplied by the sum of the
17    fee-for-service payments to hospitals as authorized under
18    Section 5A-12.5 and the adjustments authorized under
19    subsection (t) of Section 5A-12.2 to managed care
20    organizations for hospital services due and payable in the
21    month of April 2017 multiplied by 6, except that the amount
22    calculated under this subparagraph (C) shall be adjusted,
23    either positively or negatively, to account for the
24    difference between the actual payments issued under
25    Section 5A-12.5 for the period beginning January 1, 2017
26    through June 30, 2017 and the estimated payments due and

 

 

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1    payable in the month of October 2016 multiplied by 6 as
2    described in subparagraph (B).
3        (D) For the period of January 1, 2018 through June 30,
4    2018, the product of .19125 multiplied by the sum of the
5    fee-for-service payments to hospitals as authorized under
6    Section 5A-12.5 and the adjustments authorized under
7    subsection (t) of Section 5A-12.2 to managed care
8    organizations for hospital services due and payable in the
9    month of October 2017 multiplied by 6, except that:
10            (i) the amount calculated under this subparagraph
11        (D) shall be adjusted, either positively or
12        negatively, to account for the difference between the
13        actual payments issued under Section 5A-12.5 for the
14        period of July 1, 2017 through December 31, 2017 and
15        the estimated payments due and payable in the month of
16        April 2017 multiplied by 6 as described in subparagraph
17        (C); and
18            (ii) the amount calculated under this subparagraph
19        (D) shall be adjusted to include the product of .19125
20        multiplied by the sum of the fee-for-service payments,
21        if any, estimated to be paid to hospitals under
22        subsection (b) of Section 5A-12.5.
23    (2) The Department shall complete and apply a final
24reconciliation of the ACA Assessment Adjustment prior to June
2530, 2018 to account for:
26        (A) any differences between the actual payments issued

 

 

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1    or scheduled to be issued prior to June 30, 2018 as
2    authorized in Section 5A-12.5 for the period of January 1,
3    2018 through June 30, 2018 and the estimated payments due
4    and payable in the month of October 2017 multiplied by 6 as
5    described in subparagraph (D); and
6        (B) any difference between the estimated
7    fee-for-service payments under subsection (b) of Section
8    5A-12.5 and the amount of such payments that are actually
9    scheduled to be paid.
10    The Department shall notify hospitals of any additional
11amounts owed or reduction credits to be applied to the June
122018 ACA Assessment Adjustment. This is to be considered the
13final reconciliation for the ACA Assessment Adjustment.
14    (3) Notwithstanding any other provision of this Section, if
15for any reason the scheduled payments under subsection (b) of
16Section 5A-12.5 are not issued in full by the final day of the
17period authorized under subsection (b) of Section 5A-12.5,
18funds collected from each hospital pursuant to subparagraph (D)
19of paragraph (1) and pursuant to paragraph (2), attributable to
20the scheduled payments authorized under subsection (b) of
21Section 5A-12.5 that are not issued in full by the final day of
22the period attributable to each payment authorized under
23subsection (b) of Section 5A-12.5, shall be refunded.
24    (4) The increases authorized under paragraph (2) of
25subsection (a) and paragraph (2) of subsection (b-5) shall be
26limited to the federally required State share of the total

 

 

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1payments authorized under Section 5A-12.5 if the sum of such
2payments yields an annualized amount equal to or less than
3$450,000,000, or if the adjustments authorized under
4subsection (t) of Section 5A-12.2 are found not to be
5actuarially sound; however, this limitation shall not apply to
6the fee-for-service payments described in subsection (b) of
7Section 5A-12.5.
8    (c) (Blank).
9    (d) Notwithstanding any of the other provisions of this
10Section, the Department is authorized to adopt rules to reduce
11the rate of any annual assessment imposed under this Section,
12as authorized by Section 5-46.2 of the Illinois Administrative
13Procedure Act.
14    (e) Notwithstanding any other provision of this Section,
15any plan providing for an assessment on a hospital provider as
16a permissible tax under Title XIX of the federal Social
17Security Act and Medicaid-eligible payments to hospital
18providers from the revenues derived from that assessment shall
19be reviewed by the Illinois Department of Healthcare and Family
20Services, as the Single State Medicaid Agency required by
21federal law, to determine whether those assessments and
22hospital provider payments meet federal Medicaid standards. If
23the Department determines that the elements of the plan may
24meet federal Medicaid standards and a related State Medicaid
25Plan Amendment is prepared in a manner and form suitable for
26submission, that State Plan Amendment shall be submitted in a

 

 

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1timely manner for review by the Centers for Medicare and
2Medicaid Services of the United States Department of Health and
3Human Services and subject to approval by the Centers for
4Medicare and Medicaid Services of the United States Department
5of Health and Human Services. No such plan shall become
6effective without approval by the Illinois General Assembly by
7the enactment into law of related legislation. Notwithstanding
8any other provision of this Section, the Department is
9authorized to adopt rules to reduce the rate of any annual
10assessment imposed under this Section. Any such rules may be
11adopted by the Department under Section 5-50 of the Illinois
12Administrative Procedure Act.
13(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14; 99-2,
14eff. 3-26-15; 99-516, eff. 6-30-16.)