Sen. Don Harmon

Filed: 5/19/2011

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 3635

2    AMENDMENT NO. ______. Amend House Bill 3635 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Public Aid Code is amended by
5changing Sections 5-4.2, 5-5.4, 5B-2, 5B-4, and 5B-8 as
6follows:
 
7    (305 ILCS 5/5-4.2)  (from Ch. 23, par. 5-4.2)
8    Sec. 5-4.2. Ambulance services payments.
9    (a) For ambulance services provided to a recipient of aid
10under this Article on or after January 1, 1993, the Illinois
11Department shall reimburse ambulance service providers at
12rates calculated in accordance with this Section. It is the
13intent of the General Assembly to provide adequate
14reimbursement for ambulance services so as to ensure adequate
15access to services for recipients of aid under this Article and
16to provide appropriate incentives to ambulance service

 

 

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1providers to provide services in an efficient and
2cost-effective manner. Thus, it is the intent of the General
3Assembly that the Illinois Department implement a
4reimbursement system for ambulance services that, to the extent
5practicable and subject to the availability of funds
6appropriated by the General Assembly for this purpose, is
7consistent with the payment principles of Medicare. To ensure
8uniformity between the payment principles of Medicare and
9Medicaid, the Illinois Department shall follow, to the extent
10necessary and practicable and subject to the availability of
11funds appropriated by the General Assembly for this purpose,
12the statutes, laws, regulations, policies, procedures,
13principles, definitions, guidelines, and manuals used to
14determine the amounts paid to ambulance service providers under
15Title XVIII of the Social Security Act (Medicare).
16    (b) For ambulance services provided to a recipient of aid
17under this Article on or after January 1, 1996, the Illinois
18Department shall reimburse ambulance service providers based
19upon the actual distance traveled if a natural disaster,
20weather conditions, road repairs, or traffic congestion
21necessitates the use of a route other than the most direct
22route.
23    (c) For purposes of this Section, "ambulance services"
24includes medical transportation services provided by means of
25an ambulance, medi-car, service car, or taxi.
26    (c-1) For purposes of this Section, "ground ambulance

 

 

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1service" means medical transportation services that are
2described as ground ambulance services by the Centers for
3Medicare and Medicaid Services and provided in a vehicle that
4is licensed as an ambulance by the Illinois Department of
5Public Health pursuant to the Emergency Medical Services (EMS)
6Systems Act.
7    (c-2) For purposes of this Section, "ground ambulance
8service provider" means a vehicle service provider as described
9in the Emergency Medical Services (EMS) Systems Act that
10operates licensed ambulances for the purpose of providing
11emergency ambulance services, or non-emergency ambulance
12services, or both. For purposes of this Section, this includes
13both ambulance providers and ambulance suppliers as described
14by the Centers for Medicare and Medicaid Services.
15    (d) This Section does not prohibit separate billing by
16ambulance service providers for oxygen furnished while
17providing advanced life support services.
18    (e) Beginning with services rendered on or after July 1,
192008, all providers of non-emergency medi-car and service car
20transportation must certify that the driver and employee
21attendant, as applicable, have completed a safety program
22approved by the Department to protect both the patient and the
23driver, prior to transporting a patient. The provider must
24maintain this certification in its records. The provider shall
25produce such documentation upon demand by the Department or its
26representative. Failure to produce documentation of such

 

 

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1training shall result in recovery of any payments made by the
2Department for services rendered by a non-certified driver or
3employee attendant. Medi-car and service car providers must
4maintain legible documentation in their records of the driver
5and, as applicable, employee attendant that actually
6transported the patient. Providers must recertify all drivers
7and employee attendants every 3 years.
8    Notwithstanding the requirements above, any public
9transportation provider of medi-car and service car
10transportation that receives federal funding under 49 U.S.C.
115307 and 5311 need not certify its drivers and employee
12attendants under this Section, since safety training is already
13federally mandated.
14    (f) With respect to any policy or program administered by
15the Department or its agent regarding approval of non-emergency
16medical transportation by ground ambulance service providers,
17including, but not limited to, the Non-Emergency
18Transportation Services Prior Approval Program (NETSPAP), the
19Department shall establish by rule a process by which ground
20ambulance service providers of non-emergency medical
21transportation may appeal any decision by the Department or its
22agent for which no denial was received prior to the time of
23transport that either (i) denies a request for approval for
24payment of non-emergency transportation by means of ground
25ambulance service or (ii) grants a request for approval of
26non-emergency transportation by means of ground ambulance

 

 

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1service at a level of service that entitles the ground
2ambulance service provider to a lower level of compensation
3from the Department than the ground ambulance service provider
4would have received as compensation for the level of service
5requested. The rule shall be established within 12 months after
6the effective date of this amendatory Act of the 97th General
7Assembly and shall provide that, for any decision rendered by
8the Department or its agent on or after the date the rule takes
9effect, the ground ambulance service provider shall have 60
10days from the date the decision is received to file an appeal.
11The rule established by the Department shall be, insofar as is
12practical, consistent with the Illinois Administrative
13Procedure Act. The Director's decision on an appeal under this
14Section shall be a final administrative decision subject to
15review under the Administrative Review Law.
16(Source: P.A. 95-501, eff. 8-28-07.)
 
17    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
18    Sec. 5-5.4. Standards of Payment - Department of Healthcare
19and Family Services. The Department of Healthcare and Family
20Services shall develop standards of payment of nursing facility
21and ICF/DD services in facilities providing such services under
22this Article which:
23    (1) Provide for the determination of a facility's payment
24for nursing facility or ICF/DD services on a prospective basis.
25The amount of the payment rate for all nursing facilities

 

 

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1certified by the Department of Public Health under the MR/DD
2Community Care Act or the Nursing Home Care Act as Intermediate
3Care for the Developmentally Disabled facilities, Long Term
4Care for Under Age 22 facilities, Skilled Nursing facilities,
5or Intermediate Care facilities under the medical assistance
6program shall be prospectively established annually on the
7basis of historical, financial, and statistical data
8reflecting actual costs from prior years, which shall be
9applied to the current rate year and updated for inflation,
10except that the capital cost element for newly constructed
11facilities shall be based upon projected budgets. The annually
12established payment rate shall take effect on July 1 in 1984
13and subsequent years. No rate increase and no update for
14inflation shall be provided on or after July 1, 1994 and before
15July 1, 2012, unless specifically provided for in this Section.
16The changes made by Public Act 93-841 extending the duration of
17the prohibition against a rate increase or update for inflation
18are effective retroactive to July 1, 2004.
19    For facilities licensed by the Department of Public Health
20under the Nursing Home Care Act as Intermediate Care for the
21Developmentally Disabled facilities or Long Term Care for Under
22Age 22 facilities, the rates taking effect on July 1, 1998
23shall include an increase of 3%. For facilities licensed by the
24Department of Public Health under the Nursing Home Care Act as
25Skilled Nursing facilities or Intermediate Care facilities,
26the rates taking effect on July 1, 1998 shall include an

 

 

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1increase of 3% plus $1.10 per resident-day, as defined by the
2Department. For facilities licensed by the Department of Public
3Health under the Nursing Home Care Act as Intermediate Care
4Facilities for the Developmentally Disabled or Long Term Care
5for Under Age 22 facilities, the rates taking effect on January
61, 2006 shall include an increase of 3%. For facilities
7licensed by the Department of Public Health under the Nursing
8Home Care Act as Intermediate Care Facilities for the
9Developmentally Disabled or Long Term Care for Under Age 22
10facilities, the rates taking effect on January 1, 2009 shall
11include an increase sufficient to provide a $0.50 per hour wage
12increase for non-executive staff.
13    For facilities licensed by the Department of Public Health
14under the Nursing Home Care Act as Intermediate Care for the
15Developmentally Disabled facilities or Long Term Care for Under
16Age 22 facilities, the rates taking effect on July 1, 1999
17shall include an increase of 1.6% plus $3.00 per resident-day,
18as defined by the Department. For facilities licensed by the
19Department of Public Health under the Nursing Home Care Act as
20Skilled Nursing facilities or Intermediate Care facilities,
21the rates taking effect on July 1, 1999 shall include an
22increase of 1.6% and, for services provided on or after October
231, 1999, shall be increased by $4.00 per resident-day, as
24defined by the Department.
25    For facilities licensed by the Department of Public Health
26under the Nursing Home Care Act as Intermediate Care for the

 

 

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1Developmentally Disabled facilities or Long Term Care for Under
2Age 22 facilities, the rates taking effect on July 1, 2000
3shall include an increase of 2.5% per resident-day, as defined
4by the Department. For facilities licensed by the Department of
5Public Health under the Nursing Home Care Act as Skilled
6Nursing facilities or Intermediate Care facilities, the rates
7taking effect on July 1, 2000 shall include an increase of 2.5%
8per resident-day, as defined by the Department.
9    For facilities licensed by the Department of Public Health
10under the Nursing Home Care Act as skilled nursing facilities
11or intermediate care facilities, a new payment methodology must
12be implemented for the nursing component of the rate effective
13July 1, 2003. The Department of Public Aid (now Healthcare and
14Family Services) shall develop the new payment methodology
15using the Minimum Data Set (MDS) as the instrument to collect
16information concerning nursing home resident condition
17necessary to compute the rate. The Department shall develop the
18new payment methodology to meet the unique needs of Illinois
19nursing home residents while remaining subject to the
20appropriations provided by the General Assembly. A transition
21period from the payment methodology in effect on June 30, 2003
22to the payment methodology in effect on July 1, 2003 shall be
23provided for a period not exceeding 3 years and 184 days after
24implementation of the new payment methodology as follows:
25        (A) For a facility that would receive a lower nursing
26    component rate per patient day under the new system than

 

 

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1    the facility received effective on the date immediately
2    preceding the date that the Department implements the new
3    payment methodology, the nursing component rate per
4    patient day for the facility shall be held at the level in
5    effect on the date immediately preceding the date that the
6    Department implements the new payment methodology until a
7    higher nursing component rate of reimbursement is achieved
8    by that facility.
9        (B) For a facility that would receive a higher nursing
10    component rate per patient day under the payment
11    methodology in effect on July 1, 2003 than the facility
12    received effective on the date immediately preceding the
13    date that the Department implements the new payment
14    methodology, the nursing component rate per patient day for
15    the facility shall be adjusted.
16        (C) Notwithstanding paragraphs (A) and (B), the
17    nursing component rate per patient day for the facility
18    shall be adjusted subject to appropriations provided by the
19    General Assembly.
20    For facilities licensed by the Department of Public Health
21under the Nursing Home Care Act as Intermediate Care for the
22Developmentally Disabled facilities or Long Term Care for Under
23Age 22 facilities, the rates taking effect on March 1, 2001
24shall include a statewide increase of 7.85%, as defined by the
25Department.
26    Notwithstanding any other provision of this Section, for

 

 

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1facilities licensed by the Department of Public Health under
2the Nursing Home Care Act as skilled nursing facilities or
3intermediate care facilities, except facilities participating
4in the Department's demonstration program pursuant to the
5provisions of Title 77, Part 300, Subpart T of the Illinois
6Administrative Code, the numerator of the ratio used by the
7Department of Healthcare and Family Services to compute the
8rate payable under this Section using the Minimum Data Set
9(MDS) methodology shall incorporate the following annual
10amounts as the additional funds appropriated to the Department
11specifically to pay for rates based on the MDS nursing
12component methodology in excess of the funding in effect on
13December 31, 2006:
14        (i) For rates taking effect January 1, 2007,
15    $60,000,000.
16        (ii) For rates taking effect January 1, 2008,
17    $110,000,000.
18        (iii) For rates taking effect January 1, 2009,
19    $194,000,000.
20        (iv) For rates taking effect April 1, 2011, or the
21    first day of the month that begins at least 45 days after
22    the effective date of this amendatory Act of the 96th
23    General Assembly, $416,500,000 or an amount as may be
24    necessary to complete the transition to the MDS methodology
25    for the nursing component of the rate. Increased payments
26    under this item (iv) are not due and payable, however,

 

 

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1    until (i) the methodologies described in this paragraph are
2    approved by the federal government in an appropriate State
3    Plan amendment and (ii) the assessment imposed by Section
4    5B-2 of this Code is determined to be a permissible tax
5    under Title XIX of the Social Security Act.
6    Notwithstanding any other provision of this Section, for
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as skilled nursing facilities or
9intermediate care facilities, the support component of the
10rates taking effect on January 1, 2008 shall be computed using
11the most recent cost reports on file with the Department of
12Healthcare and Family Services no later than April 1, 2005,
13updated for inflation to January 1, 2006.
14    For facilities licensed by the Department of Public Health
15under the Nursing Home Care Act as Intermediate Care for the
16Developmentally Disabled facilities or Long Term Care for Under
17Age 22 facilities, the rates taking effect on April 1, 2002
18shall include a statewide increase of 2.0%, as defined by the
19Department. This increase terminates on July 1, 2002; beginning
20July 1, 2002 these rates are reduced to the level of the rates
21in effect on March 31, 2002, as defined by the Department.
22    For facilities licensed by the Department of Public Health
23under the Nursing Home Care Act as skilled nursing facilities
24or intermediate care facilities, the rates taking effect on
25July 1, 2001 shall be computed using the most recent cost
26reports on file with the Department of Public Aid no later than

 

 

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1April 1, 2000, updated for inflation to January 1, 2001. For
2rates effective July 1, 2001 only, rates shall be the greater
3of the rate computed for July 1, 2001 or the rate effective on
4June 30, 2001.
5    Notwithstanding any other provision of this Section, for
6facilities licensed by the Department of Public Health under
7the Nursing Home Care Act as skilled nursing facilities or
8intermediate care facilities, the Illinois Department shall
9determine by rule the rates taking effect on July 1, 2002,
10which shall be 5.9% less than the rates in effect on June 30,
112002.
12    Notwithstanding any other provision of this Section, for
13facilities licensed by the Department of Public Health under
14the Nursing Home Care Act as skilled nursing facilities or
15intermediate care facilities, if the payment methodologies
16required under Section 5A-12 and the waiver granted under 42
17CFR 433.68 are approved by the United States Centers for
18Medicare and Medicaid Services, the rates taking effect on July
191, 2004 shall be 3.0% greater than the rates in effect on June
2030, 2004. These rates shall take effect only upon approval and
21implementation of the payment methodologies required under
22Section 5A-12.
23    Notwithstanding any other provisions of this Section, for
24facilities licensed by the Department of Public Health under
25the Nursing Home Care Act as skilled nursing facilities or
26intermediate care facilities, the rates taking effect on

 

 

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1January 1, 2005 shall be 3% more than the rates in effect on
2December 31, 2004.
3    Notwithstanding any other provision of this Section, for
4facilities licensed by the Department of Public Health under
5the Nursing Home Care Act as skilled nursing facilities or
6intermediate care facilities, effective January 1, 2009, the
7per diem support component of the rates effective on January 1,
82008, computed using the most recent cost reports on file with
9the Department of Healthcare and Family Services no later than
10April 1, 2005, updated for inflation to January 1, 2006, shall
11be increased to the amount that would have been derived using
12standard Department of Healthcare and Family Services methods,
13procedures, and inflators.
14    Notwithstanding any other provisions of this Section, for
15facilities licensed by the Department of Public Health under
16the Nursing Home Care Act as intermediate care facilities that
17are federally defined as Institutions for Mental Disease, a
18socio-development component rate equal to 6.6% of the
19facility's nursing component rate as of January 1, 2006 shall
20be established and paid effective July 1, 2006. The
21socio-development component of the rate shall be increased by a
22factor of 2.53 on the first day of the month that begins at
23least 45 days after January 11, 2008 (the effective date of
24Public Act 95-707). As of August 1, 2008, the socio-development
25component rate shall be equal to 6.6% of the facility's nursing
26component rate as of January 1, 2006, multiplied by a factor of

 

 

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13.53. For services provided on or after April 1, 2011, or the
2first day of the month that begins at least 45 days after the
3effective date of this amendatory Act of the 96th General
4Assembly, whichever is later, the Illinois Department may by
5rule adjust these socio-development component rates, and may
6use different adjustment methodologies for those facilities
7participating, and those not participating, in the Illinois
8Department's demonstration program pursuant to the provisions
9of Title 77, Part 300, Subpart T of the Illinois Administrative
10Code, but in no case may such rates be diminished below those
11in effect on August 1, 2008.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as Intermediate Care for the
14Developmentally Disabled facilities or as long-term care
15facilities for residents under 22 years of age, the rates
16taking effect on July 1, 2003 shall include a statewide
17increase of 4%, as defined by the Department.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as Intermediate Care for the
20Developmentally Disabled facilities or Long Term Care for Under
21Age 22 facilities, the rates taking effect on the first day of
22the month that begins at least 45 days after the effective date
23of this amendatory Act of the 95th General Assembly shall
24include a statewide increase of 2.5%, as defined by the
25Department.
26    Notwithstanding any other provision of this Section, for

 

 

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1facilities licensed by the Department of Public Health under
2the Nursing Home Care Act as skilled nursing facilities or
3intermediate care facilities, effective January 1, 2005,
4facility rates shall be increased by the difference between (i)
5a facility's per diem property, liability, and malpractice
6insurance costs as reported in the cost report filed with the
7Department of Public Aid and used to establish rates effective
8July 1, 2001 and (ii) those same costs as reported in the
9facility's 2002 cost report. These costs shall be passed
10through to the facility without caps or limitations, except for
11adjustments required under normal auditing procedures.
12    Rates established effective each July 1 shall govern
13payment for services rendered throughout that fiscal year,
14except that rates established on July 1, 1996 shall be
15increased by 6.8% for services provided on or after January 1,
161997. Such rates will be based upon the rates calculated for
17the year beginning July 1, 1990, and for subsequent years
18thereafter until June 30, 2001 shall be based on the facility
19cost reports for the facility fiscal year ending at any point
20in time during the previous calendar year, updated to the
21midpoint of the rate year. The cost report shall be on file
22with the Department no later than April 1 of the current rate
23year. Should the cost report not be on file by April 1, the
24Department shall base the rate on the latest cost report filed
25by each skilled care facility and intermediate care facility,
26updated to the midpoint of the current rate year. In

 

 

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1determining rates for services rendered on and after July 1,
21985, fixed time shall not be computed at less than zero. The
3Department shall not make any alterations of regulations which
4would reduce any component of the Medicaid rate to a level
5below what that component would have been utilizing in the rate
6effective on July 1, 1984.
7    (2) Shall take into account the actual costs incurred by
8facilities in providing services for recipients of skilled
9nursing and intermediate care services under the medical
10assistance program.
11    (3) Shall take into account the medical and psycho-social
12characteristics and needs of the patients.
13    (4) Shall take into account the actual costs incurred by
14facilities in meeting licensing and certification standards
15imposed and prescribed by the State of Illinois, any of its
16political subdivisions or municipalities and by the U.S.
17Department of Health and Human Services pursuant to Title XIX
18of the Social Security Act.
19    The Department of Healthcare and Family Services shall
20develop precise standards for payments to reimburse nursing
21facilities for any utilization of appropriate rehabilitative
22personnel for the provision of rehabilitative services which is
23authorized by federal regulations, including reimbursement for
24services provided by qualified therapists or qualified
25assistants, and which is in accordance with accepted
26professional practices. Reimbursement also may be made for

 

 

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1utilization of other supportive personnel under appropriate
2supervision.
3    The Department shall develop enhanced payments to offset
4the additional costs incurred by a facility serving exceptional
5need residents and shall allocate at least $8,000,000 of the
6funds collected from the assessment established by Section 5B-2
7of this Code for such payments. For the purpose of this
8Section, "exceptional needs" means, but need not be limited to,
9ventilator care, tracheotomy care, bariatric care, complex
10wound care, and traumatic brain injury care. The enhanced
11payments for exceptional need residents under this paragraph
12are not due and payable, however, until (i) the methodologies
13described in this paragraph are approved by the federal
14government in an appropriate State Plan amendment and (ii) the
15assessment imposed by Section 5B-2 of this Code is determined
16to be a permissible tax under Title XIX of the Social Security
17Act.
18    (5) Beginning July 1, 2012 the methodologies for
19reimbursement of nursing facility services as provided under
20this Section 5-5.4 shall no longer be applicable for bills
21payable for State fiscal years 2012 and thereafter.
22    (6) No payment increase under this Section for the MDS
23methodology, exceptional care residents, or the
24socio-development component rate established by Public Act
2596-1530 of the 96th General Assembly and funded by the
26assessment imposed under Section 5B-2 of this Code shall be due

 

 

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1and payable until after the Department notifies the long-term
2care providers, in writing, that the payment methodologies to
3long-term care providers required under this Section have been
4approved by the Centers for Medicare and Medicaid Services of
5the U.S. Department of Health and Human Services and the
6waivers under 42 CFR 433.68 for the assessment imposed by this
7Section, if necessary, have been granted by the Centers for
8Medicare and Medicaid Services of the U.S. Department of Health
9and Human Services. Upon notification to the Department of
10approval of the payment methodologies required under this
11Section and the waivers granted under 42 CFR 433.68, all
12increased payments otherwise due under this Section prior to
13the date of notification shall be due and payable within 90
14days of the date federal approval is received.
15(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
16eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09;
1796-339, eff. 7-1-10; 96-959, eff. 7-1-10; 96-1000, eff. 7-2-10;
1896-1530, eff. 2-16-11.)
 
19    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
20    Sec. 5B-2. Assessment; no local authorization to tax.
21    (a) For the privilege of engaging in the occupation of
22long-term care provider, beginning July 1, 2011 an assessment
23is imposed upon each long-term care provider in an amount equal
24to $6.07 times the number of occupied bed days due and payable
25each month. Notwithstanding any provision of any other Act to

 

 

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1the contrary, this assessment shall be construed as a tax, but
2shall not be billed or passed on to any resident of a nursing
3home operated by the nursing home provider may not be added to
4the charges of an individual's nursing home care that is paid
5for in whole, or in part, by a federal, State, or combined
6federal-state medical care program.
7    (b) Nothing in this amendatory Act of 1992 shall be
8construed to authorize any home rule unit or other unit of
9local government to license for revenue or impose a tax or
10assessment upon long-term care providers or the occupation of
11long-term care provider, or a tax or assessment measured by the
12income or earnings or occupied bed days of a long-term care
13provider.
14    (c) The assessment imposed by this Section shall not be due
15and payable, however, until after the Department notifies the
16long-term care providers, in writing, that the payment
17methodologies to long-term care providers required under
18Section 5-5.4 of this Code have been approved by the Centers
19for Medicare and Medicaid Services of the U.S. Department of
20Health and Human Services and the waivers under 42 CFR 433.68
21for the assessment imposed by this Section, if necessary, have
22been granted by the Centers for Medicare and Medicaid Services
23of the U.S. Department of Health and Human Services.
24(Source: P.A. 96-1530, eff. 2-16-11.)
 
25    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)

 

 

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1    Sec. 5B-4. Payment of assessment; penalty.
2    (a) The assessment imposed by Section 5B-2 shall be due and
3payable monthly, on the last State business day of the month
4for occupied bed days reported for the preceding third month
5prior to the month in which the tax is payable and due. A
6facility that has delayed payment due to the State's failure to
7reimburse for services rendered may request an extension on the
8due date for payment pursuant to subsection (b) and shall pay
9the assessment within 30 days of reimbursement by the
10Department. The Illinois Department may provide that county
11nursing homes directed and maintained pursuant to Section
125-1005 of the Counties Code may meet their assessment
13obligation by certifying to the Illinois Department that county
14expenditures have been obligated for the operation of the
15county nursing home in an amount at least equal to the amount
16of the assessment.
17    (a-5) Each assessment payment shall be accompanied by an
18assessment report to be completed by the long-term care
19provider. A separate report shall be completed for each
20long-term care facility in this State operated by a long-term
21care provider. The report shall be in a form and manner
22prescribed by the Illinois Department and shall at a minimum
23provide for the reporting of the number of occupied bed days of
24the long-term care facility for the reporting period and other
25reasonable information the Illinois Department requires for
26the administration of its responsibilities under this Code. To

 

 

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1the extent practicable, the Department shall coordinate the
2assessment reporting requirements with other reporting
3required of long-term care facilities.
4    (b) The Illinois Department is authorized to establish
5delayed payment schedules for long-term care providers that are
6unable to make assessment payments when due under this Section
7due to financial difficulties, as determined by the Illinois
8Department. The Illinois Department may not deny a request for
9delay of payment of the assessment imposed under this Article
10if the long-term care provider has not been paid for services
11provided during the month on which the assessment is levied.
12    (c) If a long-term care provider fails to pay the full
13amount of an assessment payment when due (including any
14extensions granted under subsection (b)), there shall, unless
15waived by the Illinois Department for reasonable cause, be
16added to the assessment imposed by Section 5B-2 a penalty
17assessment equal to the lesser of (i) 5% of the amount of the
18assessment payment not paid on or before the due date plus 5%
19of the portion thereof remaining unpaid on the last day of each
20month thereafter or (ii) 100% of the assessment payment amount
21not paid on or before the due date. For purposes of this
22subsection, payments will be credited first to unpaid
23assessment payment amounts (rather than to penalty or
24interest), beginning with the most delinquent assessment
25payments. Payment cycles of longer than 60 days shall be one
26factor the Director takes into account in granting a waiver

 

 

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1under this Section.
2    (c-5) If a long-term care provider fails to file its report
3with payment, there shall, unless waived by the Illinois
4Department for reasonable cause, be added to the assessment due
5a penalty assessment equal to 25% of the assessment due.
6    (d) Nothing in this amendatory Act of 1993 shall be
7construed to prevent the Illinois Department from collecting
8all amounts due under this Article pursuant to an assessment
9imposed before the effective date of this amendatory Act of
101993.
11    (e) Nothing in this amendatory Act of the 96th General
12Assembly shall be construed to prevent the Illinois Department
13from collecting all amounts due under this Code pursuant to an
14assessment, tax, fee, or penalty imposed before the effective
15date of this amendatory Act of the 96th General Assembly.
16    (f) No installment of the assessment imposed by Section
175B-2 shall be due and payable until after the Department
18notifies the long-term care providers, in writing, that the
19payment methodologies to long-term care providers required
20under Section 5-5.4 of this Code have been approved by the
21Centers for Medicare and Medicaid Services of the U.S.
22Department of Health and Human Services and the waivers under
2342 CFR 433.68 for the assessment imposed by this Section, if
24necessary, have been granted by the Centers for Medicare and
25Medicaid Services of the U.S. Department of Health and Human
26Services. Upon notification to the Department of approval of

 

 

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1the payment methodologies required under Section 5-5.4 of this
2Code and the waivers granted under 42 CFR 433.68, all
3installments otherwise due under Section 5B-4 prior to the date
4of notification shall be due and payable to the Department upon
5written direction from the Department within 90 days after
6issuance by the Comptroller of the payments required under
7Section 5-5.4 of this Code.
8(Source: P.A. 96-444, eff. 8-14-09; 96-1530, eff. 2-16-11.)
 
9    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
10    Sec. 5B-8. Long-Term Care Provider Fund.
11    (a) There is created in the State Treasury the Long-Term
12Care Provider Fund. Interest earned by the Fund shall be
13credited to the Fund. The Fund shall not be used to replace any
14moneys appropriated to the Medicaid program by the General
15Assembly.
16    (b) The Fund is created for the purpose of receiving and
17disbursing moneys in accordance with this Article.
18Disbursements from the Fund shall be made only as follows:
19        (1) For payments to nursing facilities, including
20    county nursing facilities but excluding State-operated
21    facilities, under Title XIX of the Social Security Act and
22    Article V of this Code.
23        (2) For the reimbursement of moneys collected by the
24    Illinois Department through error or mistake.
25        (3) For payment of administrative expenses incurred by

 

 

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1    the Illinois Department or its agent in performing the
2    activities authorized by this Article.
3        (3.5) For reimbursement of expenses incurred by
4    long-term care facilities, and payment of administrative
5    expenses incurred by the Department of Public Health, in
6    relation to the conduct and analysis of background checks
7    for identified offenders under the Nursing Home Care Act.
8        (4) For payments of any amounts that are reimbursable
9    to the federal government for payments from this Fund that
10    are required to be paid by State warrant.
11        (5) For making transfers to the General Obligation Bond
12    Retirement and Interest Fund, as those transfers are
13    authorized in the proceedings authorizing debt under the
14    Short Term Borrowing Act, but transfers made under this
15    paragraph (5) shall not exceed the principal amount of debt
16    issued in anticipation of the receipt by the State of
17    moneys to be deposited into the Fund.
18        (6) For making transfers, at the direction of the
19    Director of the Governor's Office of Management and Budget
20    during each fiscal year beginning on or after July 1, 2011,
21    to other State funds in an annual amount of $20,000,000 of
22    the tax collected pursuant to this Article for the purpose
23    of enforcement of nursing home standards, support of the
24    ombudsman program, and efforts to expand home and
25    community-based services. No transfer under this paragraph
26    shall occur until (i) the payment methodologies created by

 

 

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1    Public Act 96-1530 under Section 5-5.4 of this Code have
2    been approved by the Centers for Medicare and Medicaid
3    Services of the U.S. Department of Health and Human
4    Services and (ii) the assessment imposed by Section 5B-2 of
5    this Code is determined to be a permissible tax under Title
6    XIX of the Social Security Act.
7    Disbursements from the Fund, other than transfers made
8pursuant to paragraphs (5) and (6) of this subsection, shall be
9by warrants drawn by the State Comptroller upon receipt of
10vouchers duly executed and certified by the Illinois
11Department.
12    (c) The Fund shall consist of the following:
13        (1) All moneys collected or received by the Illinois
14    Department from the long-term care provider assessment
15    imposed by this Article.
16        (2) All federal matching funds received by the Illinois
17    Department as a result of expenditures made by the Illinois
18    Department that are attributable to moneys deposited in the
19    Fund.
20        (3) Any interest or penalty levied in conjunction with
21    the administration of this Article.
22        (4) (Blank).
23        (5) All other monies received for the Fund from any
24    other source, including interest earned thereon.
25(Source: P.A. 95-707, eff. 1-11-08; 96-1530, eff. 2-16-11.)
 

 

 

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