103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5095

 

Introduced 2/8/2024, by Rep. Anna Moeller

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 45/3-401.1  from Ch. 111 1/2, par. 4153-401.1

    Amends the Nursing Home Care Act. Adds (in addition to other criteria) that if a resident fails to pay or has a late payment and the facility follows the federal discharge and transfer requirements, including the issuance of a notice of facility-initiated discharge, then a facility that participates in the Medical Assistance Program may refuse to retain as a resident any person who resides in a part of the facility that does not participate in the Medical Assistance Program and who is unable to pay for his or her care in the facility without medical assistance.


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A BILL FOR

 

HB5095LRB103 39315 CES 69469 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Nursing Home Care Act is amended by
5changing Section 3-401.1 as follows:
 
6    (210 ILCS 45/3-401.1)  (from Ch. 111 1/2, par. 4153-401.1)
7    Sec. 3-401.1. (a) A facility participating in the Medical
8Assistance Program is prohibited from failing or refusing to
9retain as a resident any person because he or she is a
10recipient of or an applicant for the Medical Assistance
11Program.
12    (a-5) A After the effective date of this amendatory Act of
131997, a facility of which only a distinct part is certified to
14participate in the Medical Assistance Program may refuse to
15retain as a resident any person who resides in a part of the
16facility that does not participate in the Medical Assistance
17Program and who is unable to pay for his or her care in the
18facility without Medical Assistance only if:
19        (1) the facility, no later than at the time of
20    admission and at the time of the resident's contract
21    renewal, explains to the resident (unless he or she is
22    incompetent), and to the resident's representative, and to
23    the person making payment on behalf of the resident for

 

 

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1    the resident's stay, in writing, that the facility may
2    discharge the resident if the resident is no longer able
3    to pay for his or her care in the facility without Medical
4    Assistance;
5        (2) the resident (unless he or she is incompetent),
6    the resident's representative, and the person making
7    payment on behalf of the resident for the resident's stay,
8    acknowledge in writing that they have received the written
9    explanation; .
10        (3) the resident fails to pay or has a late payment as
11    described in subsection (d) of Section 3-401 of this Act
12    and the facility follows the federal discharge and
13    transfer requirements including the issuance of a notice
14    of facility-initiated discharge as described in 45 CFR
15    483.15(c).
16    (a-10) For the purposes of this Section, a recipient or
17applicant shall be considered a resident in the facility
18during any hospital stay totaling 10 days or less following a
19hospital admission. The Department of Healthcare and Family
20Services shall recoup funds from a facility when, as a result
21of the facility's refusal to readmit a recipient after
22hospitalization for 10 days or less, the recipient incurs
23hospital bills in an amount greater than the amount that would
24have been paid by that Department (formerly the Illinois
25Department of Public Aid) for care of the recipient in the
26facility. The amount of the recoupment shall be the difference

 

 

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1between the Department of Healthcare and Family Services'
2(formerly the Illinois Department of Public Aid's) payment for
3hospital care and the amount that Department would have paid
4for care in the facility.
5    (b) A facility which violates this Section shall be guilty
6of a business offense and fined not less than $500 nor more
7than $1,000 for the first offense and not less than $1,000 nor
8more than $5,000 for each subsequent offense.
9(Source: P.A. 95-331, eff. 8-21-07.)