Rep. Anna Moeller

Filed: 4/16/2024

 

 


 

 


 
10300HB5095ham002LRB103 39315 AMC 72474 a

1
AMENDMENT TO HOUSE BILL 5095

2    AMENDMENT NO. ______. Amend House Bill 5095 by replacing
3everything after the enacting clause with the following:
 
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

 

 

10300HB5095ham002- 2 -LRB103 39315 AMC 72474 a

1Program and who is unable to pay for his or her care in the
2facility without Medical Assistance only if:
3        (1) the facility, no later than at the time of
4    admission and at the time of the resident's contract
5    renewal, explains to the resident (unless he or she is
6    incompetent), and to the resident's representative, and to
7    the person making payment on behalf of the resident for
8    the resident's stay, in writing, that the facility may
9    discharge the resident if the resident is no longer able
10    to pay for his or her care in the facility without Medical
11    Assistance;
12        (2) the resident (unless he or she is incompetent),
13    the resident's representative, and the person making
14    payment on behalf of the resident for the resident's stay,
15    acknowledge in writing that they have received the written
16    explanation; .
17        (3) in circumstances where the Medicare coverage is
18    ending prior to the full 100-day benefit period, the
19    facility provides notice to the resident and to the
20    resident's representative that the resident's Medicare
21    coverage will likely end in 5 days. This notification
22    shall specify that the resident shall not be required to
23    move under this Section until these 5 days are up. In cases
24    where the facility is notified in a shorter time frame
25    than 5 days by a managed care organization or the time
26    frame is shorter than 5 days due to inaccurate reporting

 

 

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1    by an outside entity, the facility must provide a minimum
2    of 2 days' notification.
3    (a-10) For the purposes of this Section, a recipient or
4applicant shall be considered a resident in the facility
5during any hospital stay totaling 10 days or less following a
6hospital admission. The Department of Healthcare and Family
7Services shall recoup funds from a facility when, as a result
8of the facility's refusal to readmit a recipient after
9hospitalization for 10 days or less, the recipient incurs
10hospital bills in an amount greater than the amount that would
11have been paid by that Department (formerly the Illinois
12Department of Public Aid) for care of the recipient in the
13facility. The amount of the recoupment shall be the difference
14between the Department of Healthcare and Family Services'
15(formerly the Illinois Department of Public Aid's) payment for
16hospital care and the amount that Department would have paid
17for care in the facility.
18    (b) A facility which violates this Section shall be guilty
19of a business offense and fined not less than $500 nor more
20than $1,000 for the first offense and not less than $1,000 nor
21more than $5,000 for each subsequent offense.
22(Source: P.A. 95-331, eff. 8-21-07.)".