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Public Act 093-0020


 

Public Act 93-0020 of the 93rd General Assembly


Public Act 93-0020

SB742 Enrolled                       LRB093 03019 RCE 03036 b

    AN ACT concerning budget implementation.

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

                         ARTICLE 1.

    Section  1-1.  Short  title. This Act may be cited as the
FY2004 Budget Implementation (Health and Human Services) Act.

    Section 1-5.  Purpose. It is the purpose of this  Act  to
make  changes  relating to health and human services that are
necessary to implement the State's FY2004 budget.

                         ARTICLE 3.

    Section 3-5.  The Illinois Administrative  Procedure  Act
is amended by changing Section 5-45 as follows:

    (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
    Sec. 5-45.  Emergency rulemaking.
    (a)  "Emergency"  means  the  existence  of any situation
that any agency finds reasonably constitutes a threat to  the
public interest, safety, or welfare.
    (b)  If  any  agency  finds that an emergency exists that
requires adoption of a rule upon fewer days than is  required
by  Section  5-40  and states in writing its reasons for that
finding, the agency may adopt an emergency rule without prior
notice  or  hearing  upon  filing  a  notice   of   emergency
rulemaking  with  the  Secretary of State under Section 5-70.
The notice shall include the text of the emergency  rule  and
shall  be published in the Illinois Register.  Consent orders
or other court orders adopting settlements negotiated  by  an
agency  may  be  adopted  under  this  Section.   Subject  to
applicable   constitutional   or   statutory  provisions,  an
emergency rule  becomes  effective  immediately  upon  filing
under  Section  5-65  or  at a stated date less than 10  days
thereafter.  The agency's finding  and  a  statement  of  the
specific  reasons  for  the  finding  shall be filed with the
rule.  The  agency  shall  take  reasonable  and  appropriate
measures to make emergency rules known to the persons who may
be affected by them.
    (c)  An  emergency  rule may be effective for a period of
not longer than 150 days, but the agency's authority to adopt
an identical rule under Section 5-40 is  not  precluded.   No
emergency  rule may be adopted more than once in any 24 month
period,  except  that  this  limitation  on  the  number   of
emergency rules that may be adopted in a 24 month period does
not  apply  to (i) emergency rules that make additions to and
deletions from the Drug Manual under Section  5-5.16  of  the
Illinois  Public Aid Code or the generic drug formulary under
Section 3.14 of the Illinois Food, Drug and Cosmetic  Act  or
(ii)  emergency  rules adopted by the Pollution Control Board
before July 1, 1997 to implement portions  of  the  Livestock
Management  Facilities  Act.   Two  or  more  emergency rules
having substantially the same purpose  and  effect  shall  be
deemed to be a single rule for purposes of this Section.
    (d)  In  order  to provide for the expeditious and timely
implementation  of  the  State's  fiscal  year  1999  budget,
emergency rules to implement  any  provision  of  Public  Act
90-587  or  90-588  or any other budget initiative for fiscal
year 1999 may be adopted in accordance with this  Section  by
the  agency  charged  with  administering  that  provision or
initiative,  except  that  the  24-month  limitation  on  the
adoption of emergency rules and the  provisions  of  Sections
5-115  and  5-125  do  not  apply to rules adopted under this
subsection (d).  The adoption of emergency  rules  authorized
by  this  subsection  (d) shall be deemed to be necessary for
the public interest, safety, and welfare.
    (e)  In order to provide for the expeditious  and  timely
implementation  of  the  State's  fiscal  year  2000  budget,
emergency rules to implement any provision of this amendatory
Act  of  the  91st  General  Assembly  or  any  other  budget
initiative  for fiscal year 2000 may be adopted in accordance
with this Section by the agency  charged  with  administering
that  provision  or  initiative,  except  that  the  24-month
limitation  on  the  adoption  of  emergency  rules  and  the
provisions  of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (e).  The adoption of emergency
rules authorized by this subsection (e) shall be deemed to be
necessary for the public interest, safety, and welfare.
    (f)  In order to provide for the expeditious  and  timely
implementation  of  the  State's  fiscal  year  2001  budget,
emergency rules to implement any provision of this amendatory
Act  of  the  91st  General  Assembly  or  any  other  budget
initiative  for fiscal year 2001 may be adopted in accordance
with this Section by the agency  charged  with  administering
that  provision  or  initiative,  except  that  the  24-month
limitation  on  the  adoption  of  emergency  rules  and  the
provisions  of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (f).  The adoption of emergency
rules authorized by this subsection (f) shall be deemed to be
necessary for the public interest, safety, and welfare.
    (g)  In order to provide for the expeditious  and  timely
implementation  of  the  State's  fiscal  year  2002  budget,
emergency rules to implement any provision of this amendatory
Act  of  the  92nd  General  Assembly  or  any  other  budget
initiative  for fiscal year 2002 may be adopted in accordance
with this Section by the agency  charged  with  administering
that  provision  or  initiative,  except  that  the  24-month
limitation  on  the  adoption  of  emergency  rules  and  the
provisions  of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (g).  The adoption of emergency
rules authorized by this subsection (g) shall be deemed to be
necessary for the public interest, safety, and welfare.
    (h)  In order to provide for the expeditious  and  timely
implementation  of  the  State's  fiscal  year  2003  budget,
emergency rules to implement any provision of this amendatory
Act  of  the  92nd  General  Assembly  or  any  other  budget
initiative  for fiscal year 2003 may be adopted in accordance
with this Section by the agency  charged  with  administering
that  provision  or  initiative,  except  that  the  24-month
limitation  on  the  adoption  of  emergency  rules  and  the
provisions  of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (h).  The adoption of emergency
rules authorized by this subsection (h) shall be deemed to be
necessary for the public interest, safety, and welfare.
    (i)  In order to provide for the expeditious  and  timely
implementation  of  the  State's  fiscal  year  2004  budget,
emergency rules to implement any provision of this amendatory
Act  of  the  93rd  General  Assembly  or  any  other  budget
initiative  for fiscal year 2004 may be adopted in accordance
with this Section by the agency  charged  with  administering
that  provision  or  initiative,  except  that  the  24-month
limitation  on  the  adoption  of  emergency  rules  and  the
provisions  of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (i).  The adoption of emergency
rules authorized by this subsection (i) shall be deemed to be
necessary for the public interest, safety, and welfare.
(Source: P.A.  91-24,  eff.  7-1-99;  91-357,  eff.  7-29-99;
91-712,  eff.  7-1-00;  92-10,  eff.  6-11-01;  92-597,  eff.
6-28-02.)

                         ARTICLE 5.

    Section   5-5.  The  State  Finance  Act  is  amended  by
changing Sections 6z-30 and 6z-58 as follows:

    (30 ILCS 105/6z-30)
    Sec. 6z-30.  University  of  Illinois  Hospital  Services
Fund.
    (a)  The University of Illinois Hospital Services Fund is
created  as  a  special  fund  in  the  State  Treasury.  The
following moneys shall be deposited into the Fund:
         (1)  As soon as possible after the beginning of each
    fiscal year (starting in fiscal year  1995),  and  in  no
    event  later  than July 30, the State Comptroller and the
    State Treasurer shall automatically transfer  $44,700,000
    from  the  General  Revenue  Fund  to  the  University of
    Illinois Hospital Services Fund.
         (2)  All intergovernmental transfer payments to  the
    Illinois  Department  of  Public Aid by the University of
    Illinois Hospital made pursuant to  an  intergovernmental
    agreement  under subsection (b) or (c) of Section 5A-3 of
    the Illinois Public Aid Code.
         (3)  All federal  matching  funds  received  by  the
    Illinois   Department  of  Public  Aid  as  a  result  of
    expenditures made by the  Illinois  Department  that  are
    attributable to moneys that were deposited in the Fund.
    (b)  Moneys  in  the  fund  may  be  used by the Illinois
Department  of  Public  Aid,  subject  to  appropriation,  to
reimburse the University of Illinois  Hospital  for  hospital
and  pharmacy  services.   The  fund may also be used to make
monthly transfers to the General Revenue Fund as provided  in
subsection (c).
    (c)  The  State  Comptroller  and  State  Treasurer shall
automatically transfer on the last day of each  month  except
June,  beginning  August  31,  1994,  from  the University of
Illinois Hospital Services Fund to the General Revenue  Fund,
an  amount  determined and certified to the State Comptroller
by the Director of Public Aid, equal to the amount  by  which
the  balance  in  the  Fund  exceeds  the amount necessary to
ensure  timely  payments  to  the  University   of   Illinois
Hospital.
    On  June  30, 1995 and each June 30 thereafter, the State
Comptroller and State Treasurer shall automatically  transfer
the  entire  balance  in  the University of Illinois Hospital
Services Fund to the General Revenue Fund.
(Source: P.A. 88-554, eff. 7-26-94; 89-499, eff. 6-28-96.)

    (30 ILCS 105/6z-58)
    Sec. 6z-58. The Family Care Fund.
    (a)  There is created in the State  treasury  the  Family
Care  Fund.  Interest earned by the Fund shall be credited to
the Fund.
    (b)  The Fund is  created  solely  for  the  purposes  of
receiving,  investing,  and distributing moneys in accordance
with  an  approved  waiver  under  the  Social  Security  Act
resulting from the Family Care waiver  request  submitted  by
the  Illinois  Department of Public Aid on February 15, 2002.
The Fund shall consist of:
         (1)  All  federal  financial  participation   moneys
    received  pursuant  to  the  approved  waiver, except for
    moneys received  pursuant  to  expenditures  for  medical
    services  by  the Department of Public Aid from any other
    fund; and
         (2)  All other moneys received by the Fund from  any
    source, including interest thereon.
    (c)  Subject  to  appropriation,  the  moneys in the Fund
shall be disbursed for reimbursement of medical services  and
other  costs  associated with persons receiving such services
under the waiver due  to  their  relationship  with  children
receiving  medical  services  pursuant  to  Article  V of the
Illinois Public Aid Code or the Children's  Health  Insurance
Program Act.
(Source: P.A. 92-600, eff. 6-28-02.)

                         ARTICLE 15.

    Section 15-5.  The Illinois Public Aid Code is amended by
changing  Sections 5-2, 5-5.4, 10-26, 12-8.1, 12-9, 14-8, and
15-5 and adding Section 5-5.4b as follows:

    (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
    Sec.  5-2.  Classes   of   Persons   Eligible.    Medical
assistance  under  this  Article shall be available to any of
the following classes of persons in respect to  whom  a  plan
for  coverage  has  been  submitted  to  the  Governor by the
Illinois Department and approved by him:
    1.  Recipients of basic maintenance grants under Articles
III and IV.
    2.  Persons  otherwise  eligible  for  basic  maintenance
under Articles III and IV but who fail to qualify  thereunder
on  the  basis  of need, and who have insufficient income and
resources to  meet  the  costs  of  necessary  medical  care,
including but not limited to the following:
         (a)  All   persons   otherwise  eligible  for  basic
    maintenance under Article III but  who  fail  to  qualify
    under  that  Article  on  the  basis of need and who meet
    either of the following requirements:
              (i)  their  income,  as   determined   by   the
         Illinois  Department  in accordance with any federal
         requirements, is equal to or less than 70% in fiscal
         year 2001, equal to or less than 85% in fiscal  year
         2002  and  until  a  date  to  be  determined by the
         Department by rule, and equal to or less  than  100%
         beginning  on  the date determined by the Department
         by rule, of  the  nonfarm  income  official  poverty
         line, as defined by the federal Office of Management
         and  Budget  and revised annually in accordance with
         Section 673(2) of the Omnibus Budget  Reconciliation
         Act  of  1981,  applicable  to  families of the same
         size; or
              (ii)  their  income,  after  the  deduction  of
         costs incurred for medical care and for other  types
         of  remedial  care,  is equal to or less than 70% in
         fiscal year 2001, equal  to  or  less  than  85%  in
         fiscal  year  2002 and until a date to be determined
         by the Department by rule, and equal to or less than
         100%  beginning  on  the  date  determined  by   the
         Department  by  rule, of the nonfarm income official
         poverty  line,  as  defined  in  item  (i)  of  this
         subparagraph (a).
         (b)  All persons who would  be  determined  eligible
    for   such   basic   maintenance   under  Article  IV  by
    disregarding  the  maximum  earned  income  permitted  by
    federal law.
    3.  Persons who would otherwise qualify for  Aid  to  the
Medically Indigent under Article VII.
    4.  Persons  not  eligible  under  any  of  the preceding
paragraphs who fall sick, are injured,  or  die,  not  having
sufficient  money,  property  or  other resources to meet the
costs  of  necessary  medical  care  or  funeral  and  burial
expenses.
    5. (a)  Women  during  pregnancy,  after  the   fact   of
    pregnancy  has  been determined by medical diagnosis, and
    during the 60-day period beginning on the last day of the
    pregnancy, together with their infants and children  born
    after  September 30, 1983, whose income and resources are
    insufficient to meet the costs of necessary medical  care
    to  the  maximum  extent  possible under Title XIX of the
    Federal Social Security Act.
         (b)  The Illinois Department and the Governor  shall
    provide a plan for coverage of the persons eligible under
    paragraph 5(a) by April 1, 1990.  Such plan shall provide
    ambulatory  prenatal  care  to  pregnant  women  during a
    presumptive eligibility period and  establish  an  income
    eligibility standard that is equal to 133% of the nonfarm
    income  official  poverty line, as defined by the federal
    Office of Management and Budget and revised  annually  in
    accordance  with  Section  673(2)  of  the Omnibus Budget
    Reconciliation Act of 1981, applicable to families of the
    same size, provided that costs incurred for medical  care
    are  not  taken  into  account in determining such income
    eligibility.
         (c)  The   Illinois   Department   may   conduct   a
    demonstration in at least one county  that  will  provide
    medical assistance to pregnant women, together with their
    infants  and  children  up  to one year of age, where the
    income eligibility standard is set  up  to  185%  of  the
    nonfarm  income  official poverty line, as defined by the
    federal Office of Management  and  Budget.  The  Illinois
    Department  shall seek and obtain necessary authorization
    provided  under  federal  law   to   implement   such   a
    demonstration.  Such demonstration may establish resource
    standards  that  are  not  more  restrictive  than  those
    established under Article IV of this Code.
    6.  Persons  under  the  age of 18 who fail to qualify as
dependent under Article IV and who have  insufficient  income
and  resources to meet the costs of necessary medical care to
the maximum extent permitted under Title XIX of  the  Federal
Social Security Act.
    7.  Persons  who  are under 21 18 years of age or younger
and would qualify as disabled as defined  under  the  Federal
Supplemental   Security   Income  Program,  provided  medical
service for  such  persons  would  be  eligible  for  Federal
Financial Participation, and provided the Illinois Department
determines that:
         (a)  the person requires a level of care provided by
    a  hospital,  skilled  nursing  facility, or intermediate
    care facility, as determined by a physician  licensed  to
    practice medicine in all its branches;
         (b)  it  is appropriate to provide such care outside
    of an institution, as determined by a physician  licensed
    to practice medicine in all its branches;
         (c)  the  estimated  amount  which would be expended
    for care outside the institution is not greater than  the
    estimated   amount   which   would   be  expended  in  an
    institution.
    8.  Persons who become ineligible for  basic  maintenance
assistance   under  Article  IV  of  this  Code  in  programs
administered by the Illinois  Department  due  to  employment
earnings  and persons in assistance units comprised of adults
and children who  become  ineligible  for  basic  maintenance
assistance  under  Article  VI of this Code due to employment
earnings.  The plan for coverage for this  class  of  persons
shall:
         (a)  extend  the  medical assistance coverage for up
    to 12 months following termination of  basic  maintenance
    assistance; and
         (b)  offer  persons  who  have  initially received 6
    months of the coverage provided in paragraph  (a)  above,
    the  option  of  receiving  an  additional  6  months  of
    coverage, subject to the following:
              (i)  such   coverage   shall   be  pursuant  to
         provisions of the federal Social Security Act;
              (ii)  such coverage shall include all  services
         covered  while  the  person  was  eligible for basic
         maintenance assistance;
              (iii)  no premium shall  be  charged  for  such
         coverage; and
              (iv)  such  coverage  shall be suspended in the
         event of a person's failure without  good  cause  to
         file  in  a timely fashion reports required for this
         coverage under the Social Security Act and  coverage
         shall  be reinstated upon the filing of such reports
         if the person remains otherwise eligible.
    9.  Persons  with  acquired   immunodeficiency   syndrome
(AIDS)  or  with AIDS-related conditions with respect to whom
there  has  been  a  determination  that  but  for  home   or
community-based  services  such individuals would require the
level of care provided  in  an  inpatient  hospital,  skilled
nursing  facility  or  intermediate care facility the cost of
which is reimbursed under this Article.  Assistance shall  be
provided  to  such  persons  to  the maximum extent permitted
under Title XIX of the Federal Social Security Act.
    10.  Participants  in  the   long-term   care   insurance
partnership  program  established  under  the Partnership for
Long-Term Care Act who meet the qualifications for protection
of resources described in Section 25 of that Act.
    11.  Persons  with  disabilities  who  are  employed  and
eligible    for     Medicaid,     pursuant     to     Section
1902(a)(10)(A)(ii)(xv)   of   the  Social  Security  Act,  as
provided by the Illinois Department by rule.
    12.  Subject  to  federal  approval,  persons   who   are
eligible  for  medical  assistance  coverage under applicable
provisions of the federal Social Security Act and the federal
Breast and Cervical Cancer Prevention and  Treatment  Act  of
2000.  Those eligible persons are defined to include, but not
be limited to, the following persons:
         (1)  persons  who  have  been screened for breast or
    cervical  cancer  under  the  U.S.  Centers  for  Disease
    Control and Prevention Breast and Cervical Cancer Program
    established under Title XV of the federal  Public  Health
    Services  Act  in  accordance  with  the  requirements of
    Section 1504 of that Act as administered by the  Illinois
    Department of Public Health; and
         (2)  persons   whose   screenings  under  the  above
    program  were  funded  in  whole  or  in  part  by  funds
    appropriated to the Illinois Department of Public  Health
    for breast or cervical cancer screening.
"Medical   assistance"  under  this  paragraph  12  shall  be
identical to the benefits provided under the State's approved
plan under  Title  XIX  of  the  Social  Security  Act.   The
Department  must  request  federal  approval  of the coverage
under this paragraph 12 within 30 days  after  the  effective
date of this amendatory Act of the 92nd General Assembly.
    The  Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under  paragraph  7
as soon as possible after July 1, 1984.
    The eligibility of any such person for medical assistance
under  this  Article  is  not  affected by the payment of any
grant under the Senior Citizens and Disabled Persons Property
Tax  Relief  and  Pharmaceutical  Assistance   Act   or   any
distributions or items of income described under subparagraph
(X)  of paragraph (2) of subsection (a) of Section 203 of the
Illinois Income  Tax  Act.   The  Department  shall  by  rule
establish   the  amounts  of  assets  to  be  disregarded  in
determining eligibility for medical assistance,  which  shall
at  a  minimum  equal the amounts to be disregarded under the
Federal Supplemental Security Income Program.  The amount  of
assets of a single person to be disregarded shall not be less
than  $2,000, and the amount of assets of a married couple to
be disregarded shall not be less than $3,000.
    To the extent permitted under  federal  law,  any  person
found  guilty of a second violation of Article VIIIA shall be
ineligible for medical  assistance  under  this  Article,  as
provided in Section 8A-8.
    The  eligibility  of  any  person  for medical assistance
under this Article shall not be affected by  the  receipt  by
the person of donations or benefits from fundraisers held for
the  person  in  cases of serious illness, as long as neither
the person nor members of the  person's  family  have  actual
control over the donations or benefits or the disbursement of
the donations or benefits.
(Source: P.A.  91-676,  eff.  12-23-99;  91-699, eff. 7-1-00;
91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01;
92-597, eff. 6-28-02.)

    (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
    Sec. 5-5.4.  Standards of Payment - Department of  Public
Aid.  The Department of Public Aid shall develop standards of
payment  of skilled nursing and intermediate care services in
facilities providing such services under this Article which:
    (1)  Provide  for  the  determination  of  a   facility's
payment for skilled nursing and intermediate care services on
a  prospective basis.  The amount of the payment rate for all
nursing facilities certified  by  the  Department  of  Public
Health  under  the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities, Long  Term  Care
for  Under  Age 22 facilities, Skilled Nursing facilities, or
Intermediate Care facilities  under  the  medical  assistance
program  shall  be  prospectively established annually on the
basis  of  historical,  financial,   and   statistical   data
reflecting  actual  costs  from  prior  years, which shall be
applied to the current rate year and updated  for  inflation,
except  that  the  capital cost element for newly constructed
facilities  shall  be  based  upon  projected  budgets.   The
annually established payment rate shall take effect on July 1
in 1984 and subsequent years.  No rate increase and no update
for inflation shall be provided on or after July 1, 1994  and
before July 1, 2004 2003, unless specifically provided for in
this Section.
    For  facilities  licensed  by  the  Department  of Public
Health under the Nursing Home Care Act as  Intermediate  Care
for the Developmentally Disabled facilities or Long Term Care
for  Under Age 22 facilities, the rates taking effect on July
1, 1998 shall include an  increase  of  3%.   For  facilities
licensed by the Department of Public Health under the Nursing
Home  Care  Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking  effect  on  July  1,  1998
shall  include an increase of 3% plus $1.10 per resident-day,
as defined by the Department.
    For facilities  licensed  by  the  Department  of  Public
Health  under  the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on  July
1,  1999  shall  include  an  increase of 1.6% plus $3.00 per
resident-day, as defined by the Department.   For  facilities
licensed by the Department of Public Health under the Nursing
Home  Care  Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking  effect  on  July  1,  1999
shall  include an increase of 1.6% and, for services provided
on or after October 1, 1999, shall be increased by $4.00  per
resident-day, as defined by the Department.
    For  facilities  licensed  by  the  Department  of Public
Health under the Nursing Home Care Act as  Intermediate  Care
for the Developmentally Disabled facilities or Long Term Care
for  Under Age 22 facilities, the rates taking effect on July
1, 2000 shall include an increase of 2.5%  per  resident-day,
as defined by the Department.  For facilities licensed by the
Department  of  Public Health under the Nursing Home Care Act
as  Skilled   Nursing   facilities   or   Intermediate   Care
facilities,  the  rates  taking  effect on July 1, 2000 shall
include an increase of 2.5% per resident-day, as  defined  by
the Department.
    For  facilities  licensed  by  the  Department  of Public
Health under the Nursing Home Care  Act  as  skilled  nursing
facilities  or  intermediate  care  facilities, a new payment
methodology must be implemented for the nursing component  of
the rate effective July 1, 2003. The Department of Public Aid
shall  develop  the new payment methodology using the Minimum
Data Set (MDS)  as  the  instrument  to  collect  information
concerning  nursing  home  resident  condition  necessary  to
compute  the rate. The Department of Public Aid shall develop
the new payment methodology  to  meet  the  unique  needs  of
Illinois  nursing  home  residents while remaining subject to
the  appropriations  provided  by  the  General  Assembly.  A
transition period from the payment methodology in  effect  on
June 30, 2003 to the payment methodology in effect on July 1,
2003  shall  be  provided  for a period not exceeding 2 years
after  implementation  of  the  new  payment  methodology  as
follows:
         (A)  For a  facility  that  would  receive  a  lower
    nursing  component  rate  per  patient  day under the new
    system than the facility received effective on  the  date
    immediately   preceding  the  date  that  the  Department
    implements  the  new  payment  methodology,  the  nursing
    component rate per patient day for the facility shall  be
    held  at  the  level  in  effect  on the date immediately
    preceding the date that the Department implements the new
    payment methodology until a higher nursing component rate
    of reimbursement is achieved by that facility.
         (B)  For a facility  that  would  receive  a  higher
    nursing  component rate per patient day under the payment
    methodology in effect on July 1, 2003 than  the  facility
    received  effective on the date immediately preceding the
    date that  the  Department  implements  the  new  payment
    methodology,  the  nursing component rate per patient day
    for the facility shall be adjusted.
         (C)  Notwithstanding paragraphs  (A)  and  (B),  the
    nursing  component  rate per patient day for the facility
    shall be adjusted subject to appropriations  provided  by
    the General Assembly.
    For  facilities  licensed  by  the  Department  of Public
Health under the Nursing Home Care Act as  Intermediate  Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on March
1,  2001  shall  include  a  statewide  increase of 7.85%, as
defined by the Department.
    For facilities  licensed  by  the  Department  of  Public
Health  under  the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on April
1, 2002 shall  include  a  statewide  increase  of  2.0%,  as
defined  by  the Department. This increase terminates on July
1, 2002; beginning July 1, 2002 these rates  are  reduced  to
the  level  of  the  rates  in  effect  on March 31, 2002, as
defined by the Department.
    For facilities  licensed  by  the  Department  of  Public
Health  under  the  Nursing  Home Care Act as skilled nursing
facilities or intermediate care facilities, the rates  taking
effect  on July 1, 2001, and each subsequent year thereafter,
shall be computed using the most recent cost reports on  file
with  the  Department  of  Public  Aid no later than April 1,
2000, updated for inflation to January 1,  2001.   For  rates
effective  July  1,  2001 only, rates shall be the greater of
the rate computed for July 1, 2001 or the rate  effective  on
June 30, 2001.
    Notwithstanding  any other provision of this Section, for
facilities licensed by the Department of Public Health  under
the  Nursing  Home  Care Act as skilled nursing facilities or
intermediate care facilities, the Illinois  Department  shall
determine  by  rule  the rates taking effect on July 1, 2002,
which shall be 5.9% less than the rates in effect on June 30,
2002.
    Rates established effective  each  July  1  shall  govern
payment  for  services  rendered throughout that fiscal year,
except that rates  established  on  July  1,  1996  shall  be
increased  by  6.8% for services provided on or after January
1, 1997.  Such rates will be based upon the rates  calculated
for the year beginning July 1, 1990, and for subsequent years
thereafter until June 30, 2001 shall be based on the facility
cost reports for the facility fiscal year ending at any point
in  time  during  the  previous calendar year, updated to the
midpoint of the rate year.  The cost report shall be on  file
with the Department no later than April 1 of the current rate
year.   Should the cost report not be on file by April 1, the
Department shall base the rate  on  the  latest  cost  report
filed  by  each  skilled  care facility and intermediate care
facility, updated to the midpoint of the current  rate  year.
In  determining rates for services rendered on and after July
1, 1985, fixed time shall not be computed at less than  zero.
The  Department shall not make any alterations of regulations
which would reduce any component of the Medicaid  rate  to  a
level  below what that component would have been utilizing in
the rate effective on July 1, 1984.
    (2)  Shall take into account the actual costs incurred by
facilities in providing services for  recipients  of  skilled
nursing  and  intermediate  care  services  under the medical
assistance program.
    (3)  Shall   take   into   account   the   medical    and
psycho-social characteristics and needs of the patients.
    (4)  Shall take into account the actual costs incurred by
facilities  in  meeting licensing and certification standards
imposed and prescribed by the State of Illinois, any  of  its
political  subdivisions  or  municipalities  and  by the U.S.
Department of Health and Human Services pursuant to Title XIX
of the Social Security Act.
    The  Department  of  Public  Aid  shall  develop  precise
standards for payments to reimburse  nursing  facilities  for
any  utilization  of appropriate rehabilitative personnel for
the provision of rehabilitative services which is  authorized
by  federal regulations, including reimbursement for services
provided by qualified therapists or qualified assistants, and
which is in accordance with accepted professional  practices.
Reimbursement  also  may  be  made  for  utilization of other
supportive personnel under appropriate supervision.
(Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
eff. 6-11-01; 92-31,  eff.  6-28-01;  92-597,  eff.  6-28-02;
92-651, eff. 7-11-02; 92-848, eff. 1-1-03; revised 9-20-02.)

    (305 ILCS 5/5-5.4b new)
    Sec. 5-5.4b.  Publicly owned or publicly operated nursing
facilities.   The  Illinois  Department may by rule establish
alternative   reimbursement   methodologies    for    nursing
facilities  that  are  owned  or  operated  by  a  county,  a
township,  a  municipality, a hospital district, or any other
local government in Illinois.

    (305 ILCS 5/10-26)
    Sec. 10-26. State Disbursement Unit.
    (a)  Effective October 1, 1999  the  Illinois  Department
shall  establish a State Disbursement Unit in accordance with
the requirements of Title IV-D of the  Social  Security  Act.
The  Illinois Department shall enter into an agreement with a
State or local governmental unit or private entity to perform
the functions of the State Disbursement Unit as set forth  in
this  Section.  The State Disbursement Unit shall collect and
disburse support payments made under court and administrative
support orders:
         (1)  being enforced in  cases  in  which  child  and
    spouse  support  services  are  being provided under this
    Article X; and
         (2)  in all cases in which child and spouse  support
    services  are not being provided under this Article X and
    in which support payments are made under  the  provisions
    of the Income Withholding for Support Act.
    (a-2)  The   contract   entered   into  by  the  Illinois
Department with a public or private entity or  an  individual
for  the  operation of the State Disbursement Unit is subject
to competitive bidding.  In addition, the contract is subject
to Section 10-26.2 of this Code.  As used in this  subsection
(a-2),  "contract"  has  the  same meaning as in the Illinois
Procurement Code.
    (a-5)  If the State Disbursement Unit receives a  support
payment  that  was  not  appropriately made to the Unit under
this Section, the Unit shall immediately return  the  payment
to the sender, including, if possible, instructions detailing
where to send the support payments.
    (b)  All  payments  received  by  the  State Disbursement
Unit:
         (1)  shall be deposited into an account obtained  by
    the  Illinois  Department the State or local governmental
    unit or private entity, as the case may be, and
         (2)  distributed  and   disbursed   by   the   State
    Disbursement  Unit,  in accordance with the directions of
    the Illinois Department, pursuant to Title  IV-D  of  the
    Social   Security   Act  and  rules  promulgated  by  the
    Department.
    (c)  All  support  payments  assigned  to  the   Illinois
Department under Article X of this Code and rules promulgated
by the Illinois Department that are disbursed to the Illinois
Department  by the State Disbursement Unit shall be paid into
the Child Support Enforcement Trust Fund.
    (d)  If  the  agreement   with   the   State   or   local
governmental  unit  or  private  entity  provided for in this
Section is not in effect for any reason, the Department shall
perform the functions of the State Disbursement Unit  as  set
forth  in this Section for a maximum of 12 months before July
1, 2001, and for a maximum of 24 months after June 30,  2001.
If the Illinois Department is performing the functions of the
State  Disbursement  Unit  on July 1, 2001, then the Illinois
Department shall make an award  on  or  before  December  31,
2002,  to  a State or local government unit or private entity
to perform the functions  of  the  State  Disbursement  Unit.
Payments  received  by the Illinois Department in performance
of the  duties  of  the  State  Disbursement  Unit  shall  be
deposited  into  the  State  Disbursement Unit Revolving Fund
established under Section 12-8.1.  Nothing  in  this  Section
shall prohibit the Illinois Department from holding the State
Disbursement Unit Revolving Fund after June 30, 2003.
    (e)  By  February  1, 2000, the Illinois Department shall
conduct at least 4 regional training and educational seminars
to educate the clerks of the circuit  court  on  the  general
operation  of  the  State  Disbursement Unit, the role of the
State Disbursement Unit, and the role of the  clerks  of  the
circuit  court  in  the  collection and distribution of child
support payments.
    (f)  By March 1,  2000,  the  Illinois  Department  shall
conduct at least 4 regional educational and training seminars
to  educate  payors, as defined in the Income Withholding for
Support  Act,  on  the  general  operation   of   the   State
Disbursement  Unit,  the role of the State Disbursement Unit,
and the distribution of income withholding payments  pursuant
to this Section and the Income Withholding for Support Act.
(Source:  P.A.  91-212,  eff.  7-20-99;  91-677, eff. 1-5-00;
91-712, eff. 7-1-00; 92-44, eff. 7-1-01.)

    (305 ILCS 5/12-8.1)
    Sec. 12-8.1.  State Disbursement Unit Revolving Fund.
    (a)  There is created a revolving fund to be known as the
State Disbursement Unit Revolving Fund, to  be  held  by  the
Director  of  the  Illinois  Department,  outside  the  State
treasury, for the following purposes:
         (1)  the deposit of all support payments received by
    the Illinois Department's State Disbursement Unit;
         (2)  the  deposit  of other funds including, but not
    limited  to,  transfers  of  funds  from  other  accounts
    attributable to support payments received by the Illinois
    Department's State Disbursement Unit;
         (3)  the deposit of  any  interest  accrued  by  the
    revolving  fund,  which  interest  shall be available for
    payment of (i) any amounts considered to  be  Title  IV-D
    program  income  that must be paid to the U.S. Department
    of  Health  and  Human  Services  and  (ii)  any  balance
    remaining after payments made  under  item  (i)  of  this
    subsection  (3) to the General Revenue Fund; however, the
    disbursements under this subdivision (3) may  not  exceed
    the amount of the interest accrued by the revolving fund;
         (4)  the  disbursement  of such payments to obligees
    or to the assignees of the obligees  in  accordance  with
    the  provisions  of Title IV-D of the Social Security Act
    and rules promulgated by the  Department,  provided  that
    such  disbursement  is based upon a payment by a payor or
    obligor deposited into the revolving fund established  by
    this Section; and
         (5)  the disbursement of funds to payors or obligors
    to   correct   erroneous   payments   to   the   Illinois
    Department's State Disbursement Unit, in an amount not to
    exceed the erroneous payments.
    (b)  (Blank).  The provisions of this Section shall apply
only if the Department performs the functions of the Illinois
Department's State Disbursement Unit under paragraph  (d)  of
Section 10-26.
(Source: P.A. 91-712, eff. 7-1-00; 92-44, eff. 7-1-01.)

    (305 ILCS 5/12-9) (from Ch. 23, par. 12-9)
    Sec.  12-9.  Public Aid Recoveries Trust Fund; uses.  The
Public  Aid  Recoveries  Trust  Fund  shall  consist  of  (1)
recoveries  by  the  Illinois  Department   of   Public   Aid
authorized   by   this  Code  in  respect  to  applicants  or
recipients under Articles  III,  IV,  V,  and  VI,  including
recoveries made by the Illinois Department of Public Aid from
the  estates  of  deceased recipients, (2) recoveries made by
the  Illinois  Department  of  Public  Aid  in   respect   to
applicants   and   recipients  under  the  Children's  Health
Insurance Program, and (3) federal funds received  on  behalf
of  and  earned  by State universities and local governmental
entities for services provided to  applicants  or  recipients
covered under this Code.  The Fund shall be held as a special
fund in the State Treasury.
    Disbursements  from  this  Fund shall be only (1) for the
reimbursement of claims collected by the Illinois  Department
of  Public  Aid  through error or mistake, (2) for payment to
persons or agencies designated as payees or co-payees on  any
instrument,  whether  or  not  negotiable,  delivered  to the
Illinois Department of Public Aid as a  recovery  under  this
Section,  such  payment to be in proportion to the respective
interests of the payees in the amount so collected,  (3)  for
payments  to the Department of Human Services for collections
made by the Illinois Department of Public Aid  on  behalf  of
the  Department  of  Human  Services under this Code, (4) for
payment of administrative expenses incurred in performing the
activities authorized under this Code,  (5)  for  payment  of
fees  to persons or agencies in the performance of activities
pursuant to the collection of monies owed the State that  are
collected  under  this  Code, (6) for payments of any amounts
which are reimbursable to the federal  government  which  are
required  to  be paid by State warrant by either the State or
federal  government,  and   (7)   for   payments   to   State
universities and local governmental entities of federal funds
for  services  provided  to  applicants or recipients covered
under this Code.  Disbursements from this Fund  for  purposes
of  items  (4)  and (5) of this paragraph shall be subject to
appropriations from the Fund to the  Illinois  Department  of
Public Aid.
    The  balance  in  this  Fund  on  the  first  day of each
calendar quarter, after payment  therefrom  of   any  amounts
reimbursable  to the federal government, and minus the amount
reasonably anticipated to be needed to make the disbursements
during that quarter authorized  by  this  Section,  shall  be
certified  by  the  Director  of  the  Illinois Department of
Public Aid and transferred by the State  Comptroller  to  the
Drug  Rebate  Fund  or  the General Revenue Fund in the State
Treasury, as appropriate, within 30 days of the first day  of
each calendar quarter.
    On July 1, 1999, the State Comptroller shall transfer the
sum  of  $5,000,000 from the Public Aid Recoveries Trust Fund
(formerly the Public Assistance Recoveries Trust  Fund)  into
the DHS Recoveries Trust Fund.
(Source:  P.A.  91-24,  eff.  7-1-99;  91-212,  eff. 7-20-99;
92-10, eff. 6-11-01; 92-16, eff. 6-28-01.)

    (305 ILCS 5/14-8) (from Ch. 23, par. 14-8)
    Sec. 14-8.  Disbursements to Hospitals.
    (a)  For inpatient  hospital  services  rendered  on  and
after  September  1,  1991,  the  Illinois  Department  shall
reimburse  hospitals  for  inpatient services at an inpatient
payment rate calculated for  each  hospital  based  upon  the
Medicare  Prospective Payment System as set forth in Sections
1886(b), (d), (g), and (h) of  the  federal  Social  Security
Act,   and   the   regulations,   policies,   and  procedures
promulgated thereunder, except as modified by  this  Section.
Payment  rates for inpatient hospital services rendered on or
after September 1, 1991 and on or before September  30,  1992
shall  be  calculated  using the Medicare Prospective Payment
rates in effect on September  1,  1991.   Payment  rates  for
inpatient  hospital  services rendered on or after October 1,
1992 and on or before March  31,  1994  shall  be  calculated
using  the  Medicare  Prospective  Payment rates in effect on
September 1, 1992.   Payment  rates  for  inpatient  hospital
services  rendered  on  or  after  April  1,  1994  shall  be
calculated  using  the  Medicare  Prospective  Payment  rates
(including  the  Medicare  grouping methodology and weighting
factors  as  adjusted  pursuant  to  paragraph  (1)  of  this
subsection)  in   effect  90  days  prior  to  the  date   of
admission.   For  services rendered on or after July 1, 1995,
the  reimbursement   methodology   implemented   under   this
subsection  shall  not  include  those  costs  referred to in
Sections 1886(d)(5)(B) and 1886(h)  of  the  Social  Security
Act.  The  additional  payment amounts required under Section
1886(d)(5)(F) of  the  Social  Security  Act,  for  hospitals
serving  a  disproportionate  share of low-income or indigent
patients, are not required under this Section.  For  hospital
inpatient  services  rendered  on  or after July 1, 1995, the
Illinois  Department  shall  reimburse  hospitals  using  the
relative  weighting  factors  and  the  base  payment   rates
calculated  for each hospital that were in effect on June 30,
1995, less the  portion  of  such  rates  attributed  by  the
Illinois Department to the cost of medical education.
         (1)  The weighting factors established under Section
    1886(d)(4)  of  the Social Security Act shall not be used
    in  the  reimbursement  system  established  under   this
    Section.  Rather, the Illinois Department shall establish
    by  rule  Medicaid  weighting  factors  to be used in the
    reimbursement system established under this Section.
         (2)  The Illinois Department shall  define  by  rule
    those hospitals or distinct parts of hospitals that shall
    be exempt from the reimbursement system established under
    this  Section.   In defining such hospitals, the Illinois
    Department shall take into consideration those  hospitals
    exempt from the Medicare Prospective Payment System as of
    September 1, 1991.  For hospitals defined as exempt under
    this  subsection,  the  Illinois Department shall by rule
    establish a reimbursement system for payment of inpatient
    hospital services rendered  on  and  after  September  1,
    1991.  For all hospitals that are children's hospitals as
    defined in Section 5-5.02 of this Code, the reimbursement
    methodology  shall,  through  June  30,  1992, net of all
    applicable fees, at least equal each children's  hospital
    1990  ICARE payment rates, indexed to the current year by
    application of the DRI hospital cost index from  1989  to
    the  year  in  which payments are made.  Excepting county
    providers  as  defined  in  Article  XV  of  this   Code,
    hospitals  licensed  under  the  University  of  Illinois
    Hospital  Act,  and facilities operated by the Department
    of Mental Health and Developmental Disabilities  (or  its
    successor, the Department of Human Services) for hospital
    inpatient services rendered on or after July 1, 1995, the
    Illinois Department shall reimburse children's hospitals,
    as  defined  in  89  Illinois Administrative Code Section
    149.50(c)(3), at the rates in effect on  June  30,  1995,
    and  shall  reimburse all other hospitals at the rates in
    effect on June 30, 1995, less the portion of  such  rates
    attributed  by  the  Illinois  Department  to the cost of
    medical  education.  For  inpatient   hospital   services
    provided  on  or  after  August  1,  1998,  the  Illinois
    Department may establish by rule a means of adjusting the
    rates  of children's hospitals, as defined in 89 Illinois
    Administrative Code Section 149.50(c)(3),  that  did  not
    meet  that  definition on June 30, 1995, in order for the
    inpatient hospital rates of such hospitals to  take  into
    account  the  average  inpatient  hospital rates of those
    children's hospitals that  did  meet  the  definition  of
    children's hospitals on June 30, 1995.
         (3)  (Blank)
         (4)  Notwithstanding  any  other  provision  of this
    Section, hospitals  that  on  August  31,  1991,  have  a
    contract  with  the Illinois Department under Section 3-4
    of the Illinois Health Finance Reform Act  may  elect  to
    continue  to  be  reimbursed  at  rates  stated  in  such
    contracts for general and specialty care.
         (5)  In  addition  to  any  payments made under this
    subsection (a), the Illinois Department  shall  make  the
    adjustment  payments  required  by Section 5-5.02 of this
    Code;  provided,  that  in  the  case  of  any   hospital
    reimbursed  under  a  per  case methodology, the Illinois
    Department shall add an amount equal to  the  product  of
    the  hospital's  average  length  of  stay, less one day,
    multiplied  by  20,  for  inpatient   hospital   services
    rendered  on  or after September 1, 1991 and on or before
    September 30, 1992.
    (b)  (Blank)
    (b-5)  Excepting county providers as defined  in  Article
XV  of  this Code, hospitals licensed under the University of
Illinois  Hospital  Act,  and  facilities  operated  by   the
Illinois   Department  of  Mental  Health  and  Developmental
Disabilities (or  its  successor,  the  Department  of  Human
Services),  for outpatient services rendered on or after July
1, 1995 and before July 1, 1998 the Illinois Department shall
reimburse children's hospitals, as defined  in  the  Illinois
Administrative  Code  Section  149.50(c)(3),  at the rates in
effect on June 30, 1995, less  that  portion  of  such  rates
attributed  by  the  Illinois  Department  to  the outpatient
indigent volume adjustment  and  shall  reimburse  all  other
hospitals  at  the rates in effect on June 30, 1995, less the
portions of such rates attributed by the Illinois  Department
to  the  cost  of  medical  education  and  attributed by the
Illinois  Department  to  the  outpatient   indigent   volume
adjustment.   For  outpatient  services  provided on or after
July 1, 1998, reimbursement rates  shall  be  established  by
rule.
    (c)  In  addition  to any other payments under this Code,
the   Illinois   Department   shall   develop   a    hospital
disproportionate   share   reimbursement   methodology  that,
effective July 1, 1991, through  September  30,  1992,  shall
reimburse  hospitals  sufficiently  to  expend the fee monies
described in subsection (b) of Section 14-3 of this Code  and
the   federal   matching   funds  received  by  the  Illinois
Department as a result of expenditures made by  the  Illinois
Department  as  required  by  this subsection (c) and Section
14-2 that are attributable to fee  monies  deposited  in  the
Fund,  less  amounts  applied  to  adjustment  payments under
Section 5-5.02.
    (d)  Critical Care Access Payments.
         (1)  In addition to any other  payments  made  under
    this  Code,  the  Illinois  Department  shall  develop  a
    reimbursement  methodology  that shall reimburse Critical
    Care Access Hospitals for the specialized  services  that
    qualify  them  as  Critical  Care  Access  Hospitals.  No
    adjustment  payments  shall be made under this subsection
    on or after July 1, 1995.
         (2)  "Critical Care Access Hospitals" includes,  but
    is  not  limited  to, hospitals that meet at least one of
    the following criteria:
              (A)  Hospitals    located    outside    of    a
         metropolitan statistical area that are designated as
         Level  II  Perinatal  Centers  and  that  provide  a
         disproportionate  share  of  perinatal  services  to
         recipients; or
              (B)  Hospitals that are designated as  Level  I
         Trauma  Centers  (adult  or  pediatric)  and certain
         Level  II  Trauma  Centers  as  determined  by   the
         Illinois Department; or
              (C)  Hospitals    located    outside    of    a
         metropolitan  statistical  area  and  that provide a
         disproportionate share of  obstetrical  services  to
         recipients.
    (e)  Inpatient  high  volume  adjustment.   For  hospital
inpatient  services, effective with rate periods beginning on
or after October 1, 1993,  in  addition  to  rates  paid  for
inpatient  services  by the Illinois Department, the Illinois
Department  shall  make  adjustment  payments  for  inpatient
services furnished by Medicaid high  volume  hospitals.   The
Illinois  Department  shall  establish  by  rule criteria for
qualifying as a  Medicaid  high  volume  hospital  and  shall
establish by rule a reimbursement methodology for calculating
these  adjustment payments to Medicaid high volume hospitals.
No adjustment payment shall be made under this subsection for
services rendered on or after July 1, 1995.
    (f)  The Illinois Department  shall  modify  its  current
rules  governing  adjustment  payments  for  targeted access,
critical care access,  and  uncompensated  care  to  classify
those   adjustment   payments   as   not  being  payments  to
disproportionate share  hospitals  under  Title  XIX  of  the
federal   Social  Security  Act.  Rules  adopted  under  this
subsection shall not be effective with  respect  to  services
rendered  on  or after July 1, 1995.  The Illinois Department
has no obligation to adopt or implement any rules or make any
payments under this subsection for services  rendered  on  or
after July 1, 1995.
    (f-5)  The  State  recognizes that adjustment payments to
hospitals providing certain  services  or  incurring  certain
costs  may  be necessary to assure that recipients of medical
assistance  have  adequate  access   to   necessary   medical
services.   These  adjustments  include payments for teaching
costs  and  uncompensated  care,  trauma   center   payments,
rehabilitation  hospital payments, perinatal center payments,
obstetrical care payments, targeted access payments, Medicaid
high  volume  payments,  and   outpatient   indigent   volume
payments.    On   or  before  April  1,  1995,  the  Illinois
Department  shall   issue   recommendations   regarding   (i)
reimbursement  mechanisms  or  adjustment payments to reflect
these costs and services,  including  methods  by  which  the
payments  may  be  calculated  and  the  method  by which the
payments may be financed, and (ii)  reimbursement  mechanisms
or  adjustment  payments  to  reflect  costs  and services of
federally qualified health centers with respect to recipients
of medical assistance.
    (g)  If one or more hospitals  file  suit  in  any  court
challenging  any  part  of  this  Article  XIV,  payments  to
hospitals  under  this  Article XIV shall be made only to the
extent that sufficient monies are available in the  Fund  and
only  to  the  extent  that  any  monies  in the Fund are not
prohibited from disbursement under any order of the court.
    (h)  Payments   under   the   disbursement    methodology
described  in  this  Section  are  subject to approval by the
federal government in an appropriate State plan amendment.
    (i)  The  Illinois  Department  may  by  rule   establish
criteria   for   and  develop  methodologies  for  adjustment
payments to hospitals participating under this Article.
    (j)  Hospital  Residing  Long  Term  Care  Services.   In
addition  to  any  other  payments  made under this Code, the
Illinois  Department  may  by  rule  establish  criteria  and
develop methodologies for payments to hospitals for  Hospital
Residing Long Term Care Services.
(Source:  P.A.  89-21,  eff.  7-1-95;  89-499,  eff. 6-28-96;
89-507, eff. 7-1-97; 90-9, eff. 7-1-97; 90-14,  eff.  7-1-97;
90-588, eff. 7-1-98.)

    (305 ILCS 5/15-5) (from Ch. 23, par. 15-5)
    Sec. 15-5. Disbursements from the Fund.
    (a)  The  monies  in  the Fund shall be disbursed only as
provided in Section 15-2 of this Code and as follows:
         (1)  To  pay   the   county   hospitals'   inpatient
    reimbursement rate based on actual costs, trended forward
    annually  by  an  inflation  index  and  supplemented  by
    teaching,  capital,  and other direct and indirect costs,
    according  to  a  State  plan  approved  by  the  federal
    government. Effective  October  1,  1992,  the  inpatient
    reimbursement  rate  (including  any  disproportionate or
    supplemental   disproportionate   share   payments)   for
    hospital services provided by county operated  facilities
    within the County shall be no less than the reimbursement
    rates in effect on June 1, 1992, except that this minimum
    shall  be  adjusted  as  of  July 1, 1992 and each July 1
    thereafter through July 1, 2002 by the annual  percentage
    change  in  the  per  diem  cost  of  inpatient  hospital
    services  as  reported in the most recent annual Medicaid
    cost  report.  Effective  July  1,  2003,  the  rate  for
    hospital inpatient services provided by county  hospitals
    shall  be  the  rate in effect on January 1, 2003, except
    that  this  minimum  may  be  adjusted  by  the  Illinois
    Department  to  ensure  compliance  with  aggregate   and
    hospital-specific federal payment limitations.
         (2)  To  pay  county  hospitals  and county operated
    outpatient facilities for outpatient services based on  a
    federally  approved  methodology  to  cover  the  maximum
    allowable  costs  per patient visit. Effective October 1,
    1992, the outpatient reimbursement  rate  for  outpatient
    services provided by county hospitals and county operated
    outpatient   facilities   shall   be  no  less  than  the
    reimbursement rates in effect on  June  1,  1992,  except
    that  this  minimum  shall be adjusted as of July 1, 1992
    and each July 1 thereafter through July 1,  2002  by  the
    annual   percentage  change  in  the  per  diem  cost  of
    inpatient hospital  services  as  reported  in  the  most
    recent  annual  Medicaid  cost  report. Effective July 1,
    2003, the Illinois Department  shall  by  rule  establish
    rates   for   outpatient   services  provided  by  county
    hospitals and other county-operated facilities within the
    County  that  are  in  compliance  with   aggregate   and
    hospital-specific federal payment limitations.
         (3)  To  pay  the county hospitals' disproportionate
    share payments as established by the Illinois  Department
    under  Section  5-5.02 of this Code. Effective October 1,
    1992, the disproportionate share  payments  for  hospital
    services  provided  by  county operated facilities within
    the County shall be no less than the reimbursement  rates
    in effect on June 1, 1992, except that this minimum shall
    be adjusted as of July 1, 1992 and each July 1 thereafter
    through  July  1, 2002 by the annual percentage change in
    the per diem  cost  of  inpatient  hospital  services  as
    reported  in the most recent annual Medicaid cost report.
    Effective July 1, 2003, the Illinois  Department  may  by
    rule  establish rates for disproportionate share payments
    to county hospitals that are in compliance with aggregate
    and hospital-specific federal payment limitations.
         (3.5)  To pay county providers for services provided
    pursuant to Section 5-11 of this Code.
         (4)  To reimburse the county providers for  expenses
    contractually  assumed  pursuant  to Section 15-4 of this
    Code.
         (5)  To pay the Illinois  Department  its  necessary
    administrative  expenses  relative  to the Fund and other
    amounts agreed to, if any, by the county providers in the
    agreement provided for in subsection (c).
         (6)  To pay the county providers  any  other  amount
    due   hospitals'   supplemental   disproportionate  share
    payments,  hereby  authorized,  as   specified   in   the
    agreement provided for in subsection (c) and according to
    a  federally  approved  State  plan,  including  but  not
    limited  to payments made under the provisions of Section
    701(d)(3)(B) of the federal Medicare, Medicaid, and SCHIP
    Benefits  Improvement  and  Protection   Act   of   2000.
    Intergovernmental  transfers  supporting  payments  under
    this   paragraph   (6)   shall  not  be  subject  to  the
    computation described in subsection (a) of  Section  15-3
    of  this  Code,  but  shall be computed as the difference
    between the total of such payments made by  the  Illinois
    Department to county providers less any amount of federal
    financial participation due the Illinois Department under
    Titles XIX and XXI of the Social Security Act as a result
    of  such  payments to county providers. Effective October
    1, 1992, the supplemental disproportionate share payments
    for  hospital  services  provided  by   county   operated
    facilities  within  the  County shall be no less than the
    reimbursement rates in effect on  June  1,  1992,  except
    that  this  minimum  shall be adjusted as of July 1, 1992
    and each July  1  thereafter  by  the  annual  percentage
    change  in  the  per  diem  cost  of  inpatient  hospital
    services  as  reported in the most recent annual Medicaid
    cost report.
    (b)  The Illinois  Department  shall  promptly  seek  all
appropriate  amendments  to the Illinois State Plan to effect
the foregoing payment methodology.
    (c)  The Illinois Department shall implement the  changes
made  by  Article  3 of this amendatory Act of 1992 beginning
October  1,  1992.   All  terms   and   conditions   of   the
disbursement  of monies from the Fund not set forth expressly
in this Article shall be set forth in the agreement  executed
under  the Intergovernmental Cooperation Act so long as those
terms and conditions are not inconsistent with  this  Article
or  applicable  federal  law.   The Illinois Department shall
report  in  writing  to  the  Hospital  Service   Procurement
Advisory  Board  and the Health Care Cost Containment Council
by October 15, 1992, the terms and  conditions  of  all  such
initial  agreements  and, where no such initial agreement has
yet been executed with  a  qualifying  county,  the  Illinois
Department's reasons that each such initial agreement has not
been  executed.   Copies  and  reports  of amended agreements
following the initial agreements shall likewise be  filed  by
the Illinois Department with the Hospital Service Procurement
Advisory  Board  and the Health Care Cost Containment Council
within 30 days  following  their  execution.   The  foregoing
filing   obligations   of   the   Illinois   Department   are
informational   only,   to   allow  the  Board  and  Council,
respectively, to better  perform their public  roles,  except
that  the Board or Council may, at its discretion, advise the
Illinois Department  in  the  case  of  the  failure  of  the
Illinois  Department  to  reach agreement with any qualifying
county by the required date.
    (d)  The payments provided for  herein  are  intended  to
cover  services  rendered  on and after July 1, 1991, and any
agreement  executed  between  a  qualifying  county  and  the
Illinois Department pursuant to this Section may relate  back
to  that  date,  provided  the  Illinois  Department  obtains
federal  approval.   Any  changes  in payment rates resulting
from the provisions of Article 3 of this  amendatory  Act  of
1992  are  intended to apply to services rendered on or after
October  1,  1992,  and  any  agreement  executed  between  a
qualifying county and the  Illinois  Department  pursuant  to
this Section may be effective as of that date.
    (e)  If  one  or  more  hospitals  file suit in any court
challenging  any  part  of  this  Article  XV,  payments   to
hospitals  from  the Fund under this Article XV shall be made
only to the extent that sufficient monies  are  available  in
the  Fund  and only to the extent that any monies in the Fund
are not prohibited from disbursement  and  may  be  disbursed
under any order of the court.
    (f)  All  payments under this Section are contingent upon
federal approval of  changes  to  the  State  plan,  if  that
approval is required.
(Source: P.A. 92-370, eff. 8-15-01.)

    (305 ILCS 5/5-7 rep.)
    Section 15-6.  The Illinois Public Aid Code is amended by
repealing Section 5-7.

                         ARTICLE 20.

    Section  20-5.  The Alzheimer's Disease Assistance Act is
amended by changing Section 7 as follows:

    (410 ILCS 405/7) (from Ch. 111 1/2, par. 6957)
    Sec.  7.   Regional  ADA  center  funding  grants-in-aid.
Pursuant to appropriations enacted by the  General  Assembly,
the Department shall provide funds grants-in-aid to hospitals
affiliated  with  each  Regional  ADA  Center  for  necessary
research  and for the development and maintenance of services
for victims of Alzheimer's disease and related disorders  and
their  families.  For the fiscal year beginning July 1, 2003,
and  each  year  thereafter,  the  Department  shall   effect
payments under this Section to hospitals affiliated with each
Regional ADA Center through the Illinois Department of Public
Aid.   The  Department  shall include the annual expenditures
for this purpose in the plan required by Section  5  of  this
Act.  in  accordance  with  the  State Alzheimer's Assistance
Plan. The first $2,000,000 of any grants-in-aid  appropriated
by the General Assembly for Regional ADA Centers in any State
fiscal  year  shall be distributed in equal portions to those
Regional ADA Centers receiving the appropriated grants-in-aid
for the State fiscal year beginning July 1, 1996.  The  first
$400,000  appropriated  by  the General Assembly in excess of
$2,000,000 in any State fiscal year  beginning  on  or  after
July  1, 1997 shall be distributed in equal portions to those
Regional ADA Centers receiving the appropriated grants-in-aid
for the State fiscal year beginning July 1, 1996.  Any monies
appropriated by the General Assembly in excess of  $2,400,000
for  any State fiscal year beginning on or after July 1, 1997
shall be distributed in equal portions to each  Regional  ADA
Center.  The Department shall promulgate rules and procedures
governing the distribution and  specific  purposes  for  such
grants, including any contributions of recipients of services
toward the cost of care.
(Source: P.A. 90-404, eff. 8-15-97.)

                         ARTICLE 99.

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

Effective Date: 6/20/2003