Sen. Heather A. Steans

Filed: 1/11/2021

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 356

2    AMENDMENT NO. ______. Amend House Bill 356 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5adding Section 5A-2.1 as follows:
 
6    (305 ILCS 5/5A-2.1 new)
7    Sec. 5A-2.1. Continuation of Section 5A-2 of this Code;
8validation.
9    (a) The General Assembly finds and declares that:
10        (1) Public Act 101-650, which took effect on July 7,
11    2020, contained provisions that would have changed the
12    repeal date for Section 5A-2 of this Act from July 1, 2020
13    to December 31, 2022.
14        (2) The Statute on Statutes sets forth general rules on
15    the repeal of statutes and the construction of multiple
16    amendments, but Section 1 of that Act also states that

 

 

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1    these rules will not be observed when the result would be
2    "inconsistent with the manifest intent of the General
3    Assembly or repugnant to the context of the statute".
4        (3) This amendatory Act of the 101st General Assembly
5    manifests the intention of the General Assembly to extend
6    the repeal date for Section 5A-2 of this Code and have
7    Section 5A-2 of this Code, as amended by Public Act
8    101-650, continue in effect until December 31, 2022.
9    (b) Any construction of this Code that results in the
10repeal of Section 5A-2 of this Code on July 1, 2020 would be
11inconsistent with the manifest intent of the General Assembly
12and repugnant to the context of this Code.
13    (c) It is hereby declared to have been the intent of the
14General Assembly that Section 5A-2 of this Code shall not be
15subject to repeal on July 1, 2020.
16    (d) Section 5A-2 of this Code shall be deemed to have been
17in continuous effect since July 8, 1992 (the effective date of
18Public Act 87-861), and it shall continue to be in effect, as
19amended by Public Act 101-650, until it is otherwise lawfully
20amended or repealed. All previously enacted amendments to the
21Section taking effect on or after July 8, 1992, are hereby
22validated.
23    (e) In order to ensure the continuing effectiveness of
24Section 5A-2 of this Code, that Section is set forth in full
25and reenacted by this amendatory Act of the 101st General
26Assembly. In this amendatory Act of the 101st General Assembly,

 

 

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1the base text of the reenacted Section is set forth as amended
2by Public Act 101-650.
3    (f) All actions of the Illinois Department or any other
4person or entity taken in reliance on or pursuant to Section
55A-2 of this Code are hereby validated.
 
6    Section 10. The Illinois Public Aid Code is amended by
7reenacting Section 5A-2 as follows:
 
8    (305 ILCS 5/5A-2)  (from Ch. 23, par. 5A-2)
9    Sec. 5A-2. Assessment.
10    (a)(1) Subject to Sections 5A-3 and 5A-10, for State fiscal
11years 2009 through 2018, or as long as continued under Section
125A-16, an annual assessment on inpatient services is imposed on
13each hospital provider in an amount equal to $218.38 multiplied
14by the difference of the hospital's occupied bed days less the
15hospital's Medicare bed days, provided, however, that the
16amount of $218.38 shall be increased by a uniform percentage to
17generate an amount equal to 75% of the State share of the
18payments authorized under Section 5A-12.5, with such increase
19only taking effect upon the date that a State share for such
20payments is required under federal law. For the period of April
21through June 2015, the amount of $218.38 used to calculate the
22assessment under this paragraph shall, by emergency rule under
23subsection (s) of Section 5-45 of the Illinois Administrative
24Procedure Act, be increased by a uniform percentage to generate

 

 

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1$20,250,000 in the aggregate for that period from all hospitals
2subject to the annual 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, or as provided in Section 5A-16, in addition
6to any federally required State share as authorized under
7paragraph (1), the amount of $218.38 shall be increased by a
8uniform percentage to generate an amount equal to 75% of the
9ACA Assessment Adjustment, as defined in subsection (b-6) of
10this Section.
11    For State fiscal years 2009 through 2018, or as provided in
12Section 5A-16, a hospital's occupied bed days and Medicare bed
13days shall be determined using the most recent data available
14from each hospital's 2005 Medicare cost report as contained in
15the Healthcare Cost Report Information System file, for the
16quarter ending on December 31, 2006, without regard to any
17subsequent adjustments or changes to such data. If a hospital's
182005 Medicare cost report is not contained in the Healthcare
19Cost Report Information System, then the Illinois Department
20may obtain the hospital provider's occupied bed days and
21Medicare bed days from any source available, including, but not
22limited to, records maintained by the hospital provider, which
23may be inspected at all times during business hours of the day
24by the Illinois Department or its duly authorized agents and
25employees.
26    (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State

 

 

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1fiscal years 2019 and 2020, an annual assessment on inpatient
2services is imposed on each hospital provider in an amount
3equal to $197.19 multiplied by the difference of the hospital's
4occupied bed days less the hospital's Medicare bed days. For
5State fiscal years 2019 and 2020, a hospital's occupied bed
6days and Medicare bed days shall be determined using the most
7recent data available from each hospital's 2015 Medicare cost
8report as contained in the Healthcare Cost Report Information
9System file, for the quarter ending on March 31, 2017, without
10regard to any subsequent adjustments or changes to such data.
11If a hospital's 2015 Medicare cost report is not contained in
12the Healthcare Cost Report Information System, then the
13Illinois Department may obtain the hospital provider's
14occupied bed days and Medicare bed days from any source
15available, including, but not limited to, records maintained by
16the hospital provider, which may be inspected at all times
17during business hours of the day by the Illinois Department or
18its duly authorized agents and employees. Notwithstanding any
19other provision in this Article, for a hospital provider that
20did not have a 2015 Medicare cost report, but paid an
21assessment in State fiscal year 2018 on the basis of
22hypothetical data, that assessment amount shall be used for
23State fiscal years 2019 and 2020.
24    (4) Subject to Sections 5A-3 and 5A-10, for the period of
25July 1, 2020 through December 31, 2020 and calendar years 2021
26and 2022, an annual assessment on inpatient services is imposed

 

 

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1on each hospital provider in an amount equal to $221.50
2multiplied by the difference of the hospital's occupied bed
3days less the hospital's Medicare bed days, provided however:
4for the period of July 1, 2020 through December 31, 2020, (i)
5the assessment shall be equal to 50% of the annual amount; and
6(ii) the amount of $221.50 shall be retroactively adjusted by a
7uniform percentage to generate an amount equal to 50% of the
8Assessment Adjustment, as defined in subsection (b-7). For the
9period of July 1, 2020 through December 31, 2020 and calendar
10years 2021 and 2022, a hospital's occupied bed days and
11Medicare bed days shall be determined using the most recent
12data available from each hospital's 2015 Medicare cost report
13as contained in the Healthcare Cost Report Information System
14file, for the quarter ending on March 31, 2017, without regard
15to any subsequent adjustments or changes to such data. If a
16hospital's 2015 Medicare cost report is not contained in the
17Healthcare Cost Report Information System, then the Illinois
18Department may obtain the hospital provider's occupied bed days
19and Medicare bed days from any source available, including, but
20not limited to, records maintained by the hospital provider,
21which may be inspected at all times during business hours of
22the day by the Illinois Department or its duly authorized
23agents and employees. Should the change in the assessment
24methodology for fiscal years 2021 through December 31, 2022 not
25be approved on or before June 30, 2020, the assessment and
26payments under this Article in effect for fiscal year 2020

 

 

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1shall remain in place until the new assessment is approved. If
2the assessment methodology for July 1, 2020 through December
331, 2022, is approved on or after July 1, 2020, it shall be
4retroactive to July 1, 2020, subject to federal approval and
5provided that the payments authorized under Section 5A-12.7
6have the same effective date as the new assessment methodology.
7In giving retroactive effect to the assessment approved after
8June 30, 2020, credit toward the new assessment shall be given
9for any payments of the previous assessment for periods after
10June 30, 2020. Notwithstanding any other provision of this
11Article, for a hospital provider that did not have a 2015
12Medicare cost report, but paid an assessment in State Fiscal
13Year 2020 on the basis of hypothetical data, the data that was
14the basis for the 2020 assessment shall be used to calculate
15the assessment under this paragraph.
16    (b) (Blank).
17    (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the
18portion of State fiscal year 2012, beginning June 10, 2012
19through June 30, 2012, and for State fiscal years 2013 through
202018, or as provided in Section 5A-16, an annual assessment on
21outpatient services is imposed on each hospital provider in an
22amount equal to .008766 multiplied by the hospital's outpatient
23gross revenue, provided, however, that the amount of .008766
24shall be increased by a uniform percentage to generate an
25amount equal to 25% of the State share of the payments
26authorized under Section 5A-12.5, with such increase only

 

 

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1taking effect upon the date that a State share for such
2payments is required under federal law. For the period
3beginning June 10, 2012 through June 30, 2012, the annual
4assessment on outpatient services shall be prorated by
5multiplying the assessment amount by a fraction, the numerator
6of which is 21 days and the denominator of which is 365 days.
7For the period of April through June 2015, the amount of
8.008766 used to calculate the assessment under this paragraph
9shall, by emergency rule under subsection (s) of Section 5-45
10of the Illinois Administrative Procedure Act, be increased by a
11uniform percentage to generate $6,750,000 in the aggregate for
12that period from all hospitals subject to the annual assessment
13under this paragraph.
14    (2) In addition to any other assessments imposed under this
15Article, effective July 1, 2016 and semi-annually thereafter
16through June 2018, in addition to any federally required State
17share as authorized under paragraph (1), the amount of .008766
18shall be increased by a uniform percentage to generate an
19amount equal to 25% of the ACA Assessment Adjustment, as
20defined in subsection (b-6) of this Section.
21    For the portion of State fiscal year 2012, beginning June
2210, 2012 through June 30, 2012, and State fiscal years 2013
23through 2018, or as provided in Section 5A-16, a hospital's
24outpatient gross revenue shall be determined using the most
25recent data available from each hospital's 2009 Medicare cost
26report as contained in the Healthcare Cost Report Information

 

 

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1System file, for the quarter ending on June 30, 2011, without
2regard to any subsequent adjustments or changes to such data.
3If a hospital's 2009 Medicare cost report is not contained in
4the Healthcare Cost Report Information System, then the
5Department may obtain the hospital provider's outpatient gross
6revenue from any source available, including, but not limited
7to, records maintained by the hospital provider, which may be
8inspected at all times during business hours of the day by the
9Department or its duly authorized agents and employees.
10    (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State
11fiscal years 2019 and 2020, an annual assessment on outpatient
12services is imposed on each hospital provider in an amount
13equal to .01358 multiplied by the hospital's outpatient gross
14revenue. For State fiscal years 2019 and 2020, a hospital's
15outpatient gross revenue shall be determined using the most
16recent data available from each hospital's 2015 Medicare cost
17report as contained in the Healthcare Cost Report Information
18System file, for the quarter ending on March 31, 2017, without
19regard to any subsequent adjustments or changes to such data.
20If a hospital's 2015 Medicare cost report is not contained in
21the Healthcare Cost Report Information System, then the
22Department may obtain the hospital provider's outpatient gross
23revenue from any source available, including, but not limited
24to, records maintained by the hospital provider, which may be
25inspected at all times during business hours of the day by the
26Department or its duly authorized agents and employees.

 

 

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1Notwithstanding any other provision in this Article, for a
2hospital provider that did not have a 2015 Medicare cost
3report, but paid an assessment in State fiscal year 2018 on the
4basis of hypothetical data, that assessment amount shall be
5used for State fiscal years 2019 and 2020.
6    (4) Subject to Sections 5A-3 and 5A-10, for the period of
7July 1, 2020 through December 31, 2020 and calendar years 2021
8and 2022, an annual assessment on outpatient services is
9imposed on each hospital provider in an amount equal to .01525
10multiplied by the hospital's outpatient gross revenue,
11provided however: (i) for the period of July 1, 2020 through
12December 31, 2020, the assessment shall be equal to 50% of the
13annual amount; and (ii) the amount of .01525 shall be
14retroactively adjusted by a uniform percentage to generate an
15amount equal to 50% of the Assessment Adjustment, as defined in
16subsection (b-7). For the period of July 1, 2020 through
17December 31, 2020 and calendar years 2021 and 2022, a
18hospital's outpatient gross revenue shall be determined using
19the most recent data available from each hospital's 2015
20Medicare cost report as contained in the Healthcare Cost Report
21Information System file, for the quarter ending on March 31,
222017, without regard to any subsequent adjustments or changes
23to such data. If a hospital's 2015 Medicare cost report is not
24contained in the Healthcare Cost Report Information System,
25then the Illinois Department may obtain the hospital provider's
26outpatient revenue data from any source available, including,

 

 

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1but not limited to, records maintained by the hospital
2provider, which may be inspected at all times during business
3hours of the day by the Illinois Department or its duly
4authorized agents and employees. Should the change in the
5assessment methodology above for fiscal years 2021 through
6calendar year 2022 not be approved prior to July 1, 2020, the
7assessment and payments under this Article in effect for fiscal
8year 2020 shall remain in place until the new assessment is
9approved. If the change in the assessment methodology above for
10July 1, 2020 through December 31, 2022, is approved after June
1130, 2020, it shall have a retroactive effective date of July 1,
122020, subject to federal approval and provided that the
13payments authorized under Section 12A-7 have the same effective
14date as the new assessment methodology. In giving retroactive
15effect to the assessment approved after June 30, 2020, credit
16toward the new assessment shall be given for any payments of
17the previous assessment for periods after June 30, 2020.
18Notwithstanding any other provision of this Article, for a
19hospital provider that did not have a 2015 Medicare cost
20report, but paid an assessment in State Fiscal Year 2020 on the
21basis of hypothetical data, the data that was the basis for the
222020 assessment shall be used to calculate the assessment under
23this paragraph.
24    (b-6)(1) As used in this Section, "ACA Assessment
25Adjustment" means:
26        (A) For the period of July 1, 2016 through December 31,

 

 

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

 

 

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

 

 

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1        if any, estimated to be paid to hospitals under
2        subsection (b) of Section 5A-12.5.
3    (2) The Department shall complete and apply a final
4reconciliation of the ACA Assessment Adjustment prior to June
530, 2018 to account for:
6        (A) any differences between the actual payments issued
7    or scheduled to be issued prior to June 30, 2018 as
8    authorized in Section 5A-12.5 for the period of January 1,
9    2018 through June 30, 2018 and the estimated payments due
10    and payable in the month of October 2017 multiplied by 6 as
11    described in subparagraph (D); and
12        (B) any difference between the estimated
13    fee-for-service payments under subsection (b) of Section
14    5A-12.5 and the amount of such payments that are actually
15    scheduled to be paid.
16    The Department shall notify hospitals of any additional
17amounts owed or reduction credits to be applied to the June
182018 ACA Assessment Adjustment. This is to be considered the
19final reconciliation for the ACA Assessment Adjustment.
20    (3) Notwithstanding any other provision of this Section, if
21for any reason the scheduled payments under subsection (b) of
22Section 5A-12.5 are not issued in full by the final day of the
23period authorized under subsection (b) of Section 5A-12.5,
24funds collected from each hospital pursuant to subparagraph (D)
25of paragraph (1) and pursuant to paragraph (2), attributable to
26the scheduled payments authorized under subsection (b) of

 

 

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1Section 5A-12.5 that are not issued in full by the final day of
2the period attributable to each payment authorized under
3subsection (b) of Section 5A-12.5, shall be refunded.
4    (4) The increases authorized under paragraph (2) of
5subsection (a) and paragraph (2) of subsection (b-5) shall be
6limited to the federally required State share of the total
7payments authorized under Section 5A-12.5 if the sum of such
8payments yields an annualized amount equal to or less than
9$450,000,000, or if the adjustments authorized under
10subsection (t) of Section 5A-12.2 are found not to be
11actuarially sound; however, this limitation shall not apply to
12the fee-for-service payments described in subsection (b) of
13Section 5A-12.5.
14    (b-7)(1) As used in this Section, "Assessment Adjustment"
15means:
16        (A) For the period of July 1, 2020 through December 31,
17    2020, the product of .3853 multiplied by the total of the
18    actual payments made under subsections (c) through (k) of
19    Section 5A-12.7 attributable to the period, less the total
20    of the assessment imposed under subsections (a) and (b-5)
21    of this Section for the period.
22        (B) For each calendar quarter beginning on and after
23    January 1, 2021, the product of .3853 multiplied by the
24    total of the actual payments made under subsections (c)
25    through (k) of Section 5A-12.7 attributable to the period,
26    less the total of the assessment imposed under subsections

 

 

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1    (a) and (b-5) of this Section for the period.
2    (2) The Department shall calculate and notify each hospital
3of the total Assessment Adjustment and any additional
4assessment owed by the hospital or refund owed to the hospital
5on either a semi-annual or annual basis. Such notice shall be
6issued at least 30 days prior to any period in which the
7assessment will be adjusted. Any additional assessment owed by
8the hospital or refund owed to the hospital shall be uniformly
9applied to the assessment owed by the hospital in monthly
10installments for the subsequent semi-annual period or calendar
11year. If no assessment is owed in the subsequent year, any
12amount owed by the hospital or refund due to the hospital,
13shall be paid in a lump sum.
14    (3) The Department shall publish all details of the
15Assessment Adjustment calculation performed each year on its
16website within 30 days of completing the calculation, and also
17submit the details of the Assessment Adjustment calculation as
18part of the Department's annual report to the General Assembly.
19    (c) (Blank).
20    (d) Notwithstanding any of the other provisions of this
21Section, the Department is authorized to adopt rules to reduce
22the rate of any annual assessment imposed under this Section,
23as authorized by Section 5-46.2 of the Illinois Administrative
24Procedure Act.
25    (e) Notwithstanding any other provision of this Section,
26any plan providing for an assessment on a hospital provider as

 

 

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1a permissible tax under Title XIX of the federal Social
2Security Act and Medicaid-eligible payments to hospital
3providers from the revenues derived from that assessment shall
4be reviewed by the Illinois Department of Healthcare and Family
5Services, as the Single State Medicaid Agency required by
6federal law, to determine whether those assessments and
7hospital provider payments meet federal Medicaid standards. If
8the Department determines that the elements of the plan may
9meet federal Medicaid standards and a related State Medicaid
10Plan Amendment is prepared in a manner and form suitable for
11submission, that State Plan Amendment shall be submitted in a
12timely manner for review by the Centers for Medicare and
13Medicaid Services of the United States Department of Health and
14Human Services and subject to approval by the Centers for
15Medicare and Medicaid Services of the United States Department
16of Health and Human Services. No such plan shall become
17effective without approval by the Illinois General Assembly by
18the enactment into law of related legislation. Notwithstanding
19any other provision of this Section, the Department is
20authorized to adopt rules to reduce the rate of any annual
21assessment imposed under this Section. Any such rules may be
22adopted by the Department under Section 5-50 of the Illinois
23Administrative Procedure Act.
24(Source: P.A. 100-581, eff. 3-12-18; 101-10, eff. 6-5-19;
25101-650, eff. 7-7-20.)
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".