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91_SB1349
LRB9109818DJcdB
1 AN ACT to amend the Illinois Public Aid Code by changing
2 Section 5-5.4.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Public Aid Code is amended by
6 changing Section 5-5.4 as follows:
7 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
8 Sec. 5-5.4. Standards of Payment - Department of Public
9 Aid. The Department of Public Aid shall develop standards of
10 payment of skilled nursing and intermediate care services in
11 facilities providing such services under this Article which:
12 (1) Provides for the determination of a facility's
13 payment for skilled nursing and intermediate care services on
14 a prospective basis. The amount of the payment rate for all
15 nursing facilities certified under the medical assistance
16 program shall be prospectively established annually on the
17 basis of historical, financial, and statistical data
18 reflecting actual costs from prior years, which shall be
19 applied to the current rate year and updated for inflation,
20 except that the capital cost element for newly constructed
21 facilities shall be based upon projected budgets. The
22 annually established payment rate shall take effect on July 1
23 in 1984 and subsequent years. Rate increases shall be
24 provided annually thereafter on July 1 in 1984 and on each
25 subsequent July 1 in the following years, except that no rate
26 increase and no update for inflation shall be provided on or
27 after July 1, 1994 and before July 1, 2000, unless
28 specifically provided for in this Section.
29 For all facilities that (i) are licensed by the
30 Department of Public Health under the Nursing Home Care Act
31 as Intermediate Care for the Developmentally Disabled
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1 facilities, (ii) have a capacity of 100 or more beds, and
2 (iii) received a permit required under Sections 5 and 13.1 of
3 the Illinois Health Facilities Planning Act after July 1,
4 1994, the capital cost element of the rates shall be
5 increased to reimburse 100% of the permit amount set forth in
6 the permit issued by the Illinois Health Facilities Planning
7 Board and actually incurred. The increase shall take effect
8 on the date the permitted structure is licensed or the
9 permitted equipment is installed. If that date is before the
10 effective date of this amendatory Act of the 91st General
11 Assembly, the increase shall be retroactive to that date of
12 licensure or installation and the total rate shall be
13 adjusted to incorporate all rate increases taking effect
14 after that date.
15 For facilities licensed by the Department of Public
16 Health under the Nursing Home Care Act as Intermediate Care
17 for the Developmentally Disabled facilities or Long Term Care
18 for Under Age 22 facilities, the rates taking effect on July
19 1, 1998 shall include an increase of 3%. For facilities
20 licensed by the Department of Public Health under the Nursing
21 Home Care Act as Skilled Nursing facilities or Intermediate
22 Care facilities, the rates taking effect on July 1, 1998
23 shall include an increase of 3% plus $1.10 per resident-day,
24 as defined by the Department.
25 For facilities licensed by the Department of Public
26 Health under the Nursing Home Care Act as Intermediate Care
27 for the Developmentally Disabled facilities or Long Term Care
28 for Under Age 22 facilities, the rates taking effect on July
29 1, 1999 shall include an increase of 1.6% plus $3.00 per
30 resident-day, as defined by the Department. For facilities
31 licensed by the Department of Public Health under the Nursing
32 Home Care Act as Skilled Nursing facilities or Intermediate
33 Care facilities, the rates taking effect on July 1, 1999
34 shall include an increase of 1.6% and, for services provided
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1 on or after October 1, 1999, shall be increased by $4.00 per
2 resident-day, as defined by the Department.
3 Rates established effective each July 1 shall govern
4 payment for services rendered throughout that fiscal year,
5 except that rates established on July 1, 1996 shall be
6 increased by 6.8% for services provided on or after January
7 1, 1997. Such rates will be based upon the rates calculated
8 for the year beginning July 1, 1990, and for subsequent years
9 thereafter shall be based on the facility cost reports for
10 the facility fiscal year ending at any point in time during
11 the previous calendar year, updated to the midpoint of the
12 rate year. The cost report shall be on file with the
13 Department no later than April 1 of the current rate year.
14 Should the cost report not be on file by April 1, the
15 Department shall base the rate on the latest cost report
16 filed by each skilled care facility and intermediate care
17 facility, updated to the midpoint of the current rate year.
18 In determining rates for services rendered on and after July
19 1, 1985, fixed time shall not be computed at less than zero.
20 The Department shall not make any alterations of regulations
21 which would reduce any component of the Medicaid rate to a
22 level below what that component would have been utilizing in
23 the rate effective on July 1, 1984.
24 (2) Shall take into account the actual costs incurred by
25 facilities in providing services for recipients of skilled
26 nursing and intermediate care services under the medical
27 assistance program.
28 (3) Shall take into account the medical and
29 psycho-social characteristics and needs of the patients.
30 (4) Shall take into account the actual costs incurred by
31 facilities in meeting licensing and certification standards
32 imposed and prescribed by the State of Illinois, any of its
33 political subdivisions or municipalities and by the United
34 States Department of Health, Education and Welfare pursuant
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1 to Title XIX of the Social Security Act.
2 The Department of Public Aid shall develop precise
3 standards for payments to reimburse nursing facilities for
4 any utilization of appropriate rehabilitative personnel for
5 the provision of rehabilitative services which is authorized
6 by federal regulations, including reimbursement for services
7 provided by qualified therapists or qualified assistants, and
8 which is in accordance with accepted professional practices.
9 Reimbursement also may be made for utilization of other
10 supportive personnel under appropriate supervision.
11 (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24,
12 eff. 7-1-99.)
13 Section 99. Effective date. This Act takes effect on
14 July 1, 2000.