State of Illinois
92nd General Assembly
Legislation

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92_HB3538

 
                                               LRB9207062DJgc

 1        AN ACT in relation to public aid.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Illinois  Public Aid Code is amended by
 5    changing Section 5-5.4 as follows:

 6        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 7        Sec. 5-5.4.  Standards of Payment - Department of  Public
 8    Aid.  The Department of Public Aid shall develop standards of
 9    payment  of skilled nursing and intermediate care services in
10    facilities providing such services under this Article which:
11        (1)  Provides  for  the  determination  of  a  facility's
12    payment for skilled nursing and intermediate care services on
13    a prospective basis.  The amount of the payment rate for  all
14    nursing  facilities  certified  under  the medical assistance
15    program shall be prospectively established  annually  on  the
16    basis   of   historical,   financial,  and  statistical  data
17    reflecting actual costs from  prior  years,  which  shall  be
18    applied  to  the current rate year and updated for inflation,
19    except that the capital cost element  for  newly  constructed
20    facilities  shall  be  based  upon  projected  budgets.   The
21    annually established payment rate shall take effect on July 1
22    in  1984  and  subsequent  years.   Rate  increases  shall be
23    provided annually thereafter on July 1 in 1984  and  on  each
24    subsequent July 1 in the following years, except that no rate
25    increase  and no update for inflation shall be provided on or
26    after  July  1,  1994  and  before  July  1,   2001,   unless
27    specifically provided for in this Section.
28        For  facilities  licensed  by  the  Department  of Public
29    Health under the Nursing Home Care Act as  Intermediate  Care
30    for the Developmentally Disabled facilities or Long Term Care
31    for  Under Age 22 facilities, the rates taking effect on July
 
                            -2-                LRB9207062DJgc
 1    1, 1998 shall include an  increase  of  3%.   For  facilities
 2    licensed by the Department of Public Health under the Nursing
 3    Home  Care  Act as Skilled Nursing facilities or Intermediate
 4    Care facilities, the rates taking  effect  on  July  1,  1998
 5    shall  include an increase of 3% plus $1.10 per resident-day,
 6    as defined by the Department.
 7        For facilities  licensed  by  the  Department  of  Public
 8    Health  under  the Nursing Home Care Act as Intermediate Care
 9    for the Developmentally Disabled facilities or Long Term Care
10    for Under Age 22 facilities, the rates taking effect on  July
11    1,  1999  shall  include  an  increase of 1.6% plus $3.00 per
12    resident-day, as defined by the Department.   For  facilities
13    licensed by the Department of Public Health under the Nursing
14    Home  Care  Act as Skilled Nursing facilities or Intermediate
15    Care facilities, the rates taking  effect  on  July  1,  1999
16    shall  include an increase of 1.6% and, for services provided
17    on or after October 1, 1999, shall be increased by $4.00  per
18    resident-day, as defined by the Department.
19        For  facilities  licensed  by  the  Department  of Public
20    Health under the Nursing Home Care Act as  Intermediate  Care
21    for the Developmentally Disabled facilities or Long Term Care
22    for  Under Age 22 facilities, the rates taking effect on July
23    1, 2000 shall include an increase of 2.5%  per  resident-day,
24    as defined by the Department.  For facilities licensed by the
25    Department  of  Public Health under the Nursing Home Care Act
26    as  Skilled   Nursing   facilities   or   Intermediate   Care
27    facilities,  the  rates  taking  effect on July 1, 2000 shall
28    include an increase of 2.5% per resident-day, as  defined  by
29    the Department.
30        Rates  established  effective  each  July  1 shall govern
31    payment for services rendered throughout  that  fiscal  year,
32    except  that  rates  established  on  July  1,  1996 shall be
33    increased by 6.8% for services provided on or  after  January
34    1,  1997.  Such rates will be based upon the rates calculated
 
                            -3-                LRB9207062DJgc
 1    for the year beginning July 1, 1990, and for subsequent years
 2    thereafter shall be based  on  the  most  recent  operational
 3    facility  cost report reports for the facility filed with the
 4    Department fiscal year ending at any point in time during the
 5    previous calendar year, updated to the midpoint of  the  rate
 6    year.   The  cost report shall be on file with the Department
 7    no later than April 1 of the current rate year.   Should  the
 8    cost  report  not be on file by April 1, the Department shall
 9    base the rate on the latest cost report filed by each skilled
10    care facility and intermediate care facility, updated to  the
11    midpoint  of the current rate year.  In determining rates for
12    services rendered on and after July 1, 1985, fixed time shall
13    not be computed at less than zero.  The Department shall  not
14    make  any  alterations  of regulations which would reduce any
15    component of the Medicaid rate to a  level  below  what  that
16    component  would have been utilizing in the rate effective on
17    July 1, 1984.
18        (2)  Shall take into account the actual costs incurred by
19    facilities in providing services for  recipients  of  skilled
20    nursing  and  intermediate  care  services  under the medical
21    assistance program.
22        (3)  Shall   take   into   account   the   medical    and
23    psycho-social characteristics and needs of the patients.
24        (4)  Shall take into account the actual costs incurred by
25    facilities  in  meeting licensing and certification standards
26    imposed and prescribed by the State of Illinois, any  of  its
27    political  subdivisions  or  municipalities  and  by the U.S.
28    Department of Health and Human Services pursuant to Title XIX
29    of the Social Security Act.
30        The  Department  of  Public  Aid  shall  develop  precise
31    standards for payments to reimburse  nursing  facilities  for
32    any  utilization  of appropriate rehabilitative personnel for
33    the provision of rehabilitative services which is  authorized
34    by  federal regulations, including reimbursement for services
 
                            -4-                LRB9207062DJgc
 1    provided by qualified therapists or qualified assistants, and
 2    which is in accordance with accepted professional  practices.
 3    Reimbursement  also  may  be  made  for  utilization of other
 4    supportive personnel under appropriate supervision.
 5    (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98;  91-24,
 6    eff. 7-1-99; 91-712, eff. 7-1-00.)

 7        Section  99.  Effective date.  This Act takes effect upon
 8    becoming law.

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