TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 146 SPECIALIZED HEALTH CARE DELIVERY SYSTEMS
SECTION 146.910 REIMBURSEMENT


 

Section 146.910  Reimbursement

 

a)         Facilities licensed under Specialized Mental Health Rehabilitation Act of 2013 shall be reimbursed at:

 

1)         the rate in effect on June 30, 2014, less $7.07 for each facility previously licensed under the Nursing Home Care Act on June 30, 2013;

 

2)         the rate in effect on June 30, 2013 for each facility licensed under the Specialized Mental Health Rehabilitation Act on June 30, 2013;

 

3)         effective for services provided on or after July 1, 2017, the rate in effect on June 30, 2017 increased by 2.8%; or

 

4)         effective for services provided on or after July 1, 2018, the rate in effect on June 30, 2018 increased by 4%.

 

b)         Any adjustment in the support component or the capital component for facilities licensed by the Department of Public Health under the Nursing Home Care Act shall apply equally to facilities licensed by the Department of Public Health under the Specialized Mental Health Rehabilitation Act of 2013.

 

c)         Notwithstanding the provisions set forth in 89 Ill. Adm. Code 153, facilities licensed under the Specialized Mental Health Rehabilitation Act of 2013 shall receive a payment in the amount of $29.43 per licensed bed, per day, for the period beginning June 1, 2014 and ending June 30, 2014.

 

d)         Facilities licensed or provisionally licensed under the Specialized Mental Health Rehabilitation Act of 2013 on or before June 1, 2018 will be reimbursed for therapeutic visits that have been indicated by an interdisciplinary team as therapeutically beneficial at the following:

 

1)         Effective for dates of service June 4, 2018 through July 26, 2018, therapeutic visits are reimbursed at a rate of 75% of the facility's rate as of June 4, 2018.

 

2)         Effective for dates of service on or after July 27, 2018, therapeutic visits are reimbursed at a rate of 75% of the facility's rate as of July 27, 2018.

 

3)         Facilities may not be reimbursed for more than 10 consecutive days of therapeutic visits and no more than 20 days of therapeutic visits per State fiscal year.

 

(Source:  Amended at 43 Ill. Reg. 6803, effective May 28, 2019)