101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB1159

 

Introduced 2/5/2019, by Sen. Mattie Hunter

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5e

    Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for dates of service from January 1, 2020 through December 31, 2020, rates or payments for home health visits shall be $91; for dates of service from January 1, 2021 through December 31, 2021, rates or payments for home health visits shall be $111; and for dates of service on and after January 1, 2022, rates or payments for home health visits shall be $131. Provides that for dates of service from January 1, 2020 through December 31, 2020, rates or payments for the certified nursing assistant component of the home health agency rate shall be $25; for dates of service from January 1, 2021 through December 31, 2021, rates or payments for the certified nursing assistant component of the home health agency rate shall be $30; and for dates of service on and after January 1, 2022, rates or payments for the certified nursing assistant component of the home health agency rate shall be $35. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB1159LRB101 07283 KTG 52322 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5e as follows:
 
6    (305 ILCS 5/5-5e)
7    Sec. 5-5e. Adjusted rates of reimbursement.
8    (a) Rates or payments for services in effect on June 30,
92012 shall be adjusted and services shall be affected as
10required by any other provision of Public Act 97-689. In
11addition, the Department shall do the following:
12        (1) Delink the per diem rate paid for supportive living
13    facility services from the per diem rate paid for nursing
14    facility services, effective for services provided on or
15    after May 1, 2011.
16        (2) Cease payment for bed reserves in nursing
17    facilities and specialized mental health rehabilitation
18    facilities; for purposes of therapeutic home visits for
19    individuals scoring as TBI on the MDS 3.0, beginning June
20    1, 2015, the Department shall approve payments for bed
21    reserves in nursing facilities and specialized mental
22    health rehabilitation facilities that have at least a 90%
23    occupancy level and at least 80% of their residents are

 

 

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1    Medicaid eligible. Payment shall be at a daily rate of 75%
2    of an individual's current Medicaid per diem and shall not
3    exceed 10 days in a calendar month.
4        (2.5) Cease payment for bed reserves for purposes of
5    inpatient hospitalizations to intermediate care facilities
6    for persons with development disabilities, except in the
7    instance of residents who are under 21 years of age.
8        (3) Cease payment of the $10 per day add-on payment to
9    nursing facilities for certain residents with
10    developmental disabilities.
11    (b) After the application of subsection (a),
12notwithstanding any other provision of this Code to the
13contrary and to the extent permitted by federal law, on and
14after July 1, 2012, the rates of reimbursement for services and
15other payments provided under this Code shall further be
16reduced as follows:
17        (1) Rates or payments for physician services, dental
18    services, or community health center services reimbursed
19    through an encounter rate, and services provided under the
20    Medicaid Rehabilitation Option of the Illinois Title XIX
21    State Plan shall not be further reduced, except as provided
22    in Section 5-5b.1.
23        (2) Rates or payments, or the portion thereof, paid to
24    a provider that is operated by a unit of local government
25    or State University that provides the non-federal share of
26    such services shall not be further reduced, except as

 

 

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1    provided in Section 5-5b.1.
2        (3) Rates or payments for hospital services delivered
3    by a hospital defined as a Safety-Net Hospital under
4    Section 5-5e.1 of this Code shall not be further reduced,
5    except as provided in Section 5-5b.1.
6        (4) Rates or payments for hospital services delivered
7    by a Critical Access Hospital, which is an Illinois
8    hospital designated as a critical care hospital by the
9    Department of Public Health in accordance with 42 CFR 485,
10    Subpart F, shall not be further reduced, except as provided
11    in Section 5-5b.1.
12        (5) Rates or payments for Nursing Facility Services
13    shall only be further adjusted pursuant to Section 5-5.2 of
14    this Code.
15        (6) Rates or payments for services delivered by long
16    term care facilities licensed under the ID/DD Community
17    Care Act or the MC/DD Act and developmental training
18    services shall not be further reduced.
19        (7) Rates or payments for services provided under
20    capitation rates shall be adjusted taking into
21    consideration the rates reduction and covered services
22    required by Public Act 97-689.
23        (8) For hospitals not previously described in this
24    subsection, the rates or payments for hospital services
25    shall be further reduced by 3.5%, except for payments
26    authorized under Section 5A-12.4 of this Code.

 

 

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1        (9) For all other rates or payments for services
2    delivered by providers not specifically referenced in
3    paragraphs (1) through (8), rates or payments shall be
4    further reduced by 2.7%.
5    (c) Any assessment imposed by this Code shall continue and
6nothing in this Section shall be construed to cause it to
7cease.
8    (d) Notwithstanding any other provision of this Code to the
9contrary, subject to federal approval under Title XIX of the
10Social Security Act, for dates of service on and after July 1,
112014, rates or payments for services provided for the purpose
12of transitioning children from a hospital to home placement or
13other appropriate setting by a children's community-based
14health care center authorized under the Alternative Health Care
15Delivery Act shall be $683 per day.
16    (e) Notwithstanding any other provision of this Code to the
17contrary, subject to federal approval under Title XIX of the
18Social Security Act, for dates of service on and after July 1,
192014 through December 31, 2019, rates or payments for home
20health visits shall be $72. For dates of service from January
211, 2020 through December 31, 2020, rates or payments for home
22health visits shall be $91. For dates of service from January
231, 2021 through December 31, 2021, rates or payments for home
24health visits shall be $111. For dates of service on and after
25January 1, 2022, rates or payments for home health visits shall
26be $131.

 

 

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1    (f) Notwithstanding any other provision of this Code to the
2contrary, subject to federal approval under Title XIX of the
3Social Security Act, for dates of service on and after July 1,
42014 through December 31, 2019, rates or payments for the
5certified nursing assistant component of the home health agency
6rate shall be $20. For dates of service from January 1, 2020
7through December 31, 2020, rates or payments for the certified
8nursing assistant component of the home health agency rate
9shall be $25. For dates of service from January 1, 2021 through
10December 31, 2021, rates or payments for the certified nursing
11assistant component of the home health agency rate shall be
12$30. For dates of service on and after January 1, 2022, rates
13or payments for the certified nursing assistant component of
14the home health agency rate shall be $35.
15(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14;
1698-1166, eff. 6-1-15; 99-2, eff. 3-26-15; 99-180, eff. 7-29-15;
1799-642, eff. 7-28-16.)
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.