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093_SB0742enr
SB742 Enrolled LRB093 03019 RCE 03036 b
1 AN ACT concerning budget implementation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 ARTICLE 1.
5 Section 1-1. Short title. This Act may be cited as the
6 FY2004 Budget Implementation (Health and Human Services) Act.
7 Section 1-5. Purpose. It is the purpose of this Act to
8 make changes relating to health and human services that are
9 necessary to implement the State's FY2004 budget.
10 ARTICLE 3.
11 Section 3-5. The Illinois Administrative Procedure Act
12 is amended by changing Section 5-45 as follows:
13 (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
14 Sec. 5-45. Emergency rulemaking.
15 (a) "Emergency" means the existence of any situation
16 that any agency finds reasonably constitutes a threat to the
17 public interest, safety, or welfare.
18 (b) If any agency finds that an emergency exists that
19 requires adoption of a rule upon fewer days than is required
20 by Section 5-40 and states in writing its reasons for that
21 finding, the agency may adopt an emergency rule without prior
22 notice or hearing upon filing a notice of emergency
23 rulemaking with the Secretary of State under Section 5-70.
24 The notice shall include the text of the emergency rule and
25 shall be published in the Illinois Register. Consent orders
26 or other court orders adopting settlements negotiated by an
27 agency may be adopted under this Section. Subject to
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1 applicable constitutional or statutory provisions, an
2 emergency rule becomes effective immediately upon filing
3 under Section 5-65 or at a stated date less than 10 days
4 thereafter. The agency's finding and a statement of the
5 specific reasons for the finding shall be filed with the
6 rule. The agency shall take reasonable and appropriate
7 measures to make emergency rules known to the persons who may
8 be affected by them.
9 (c) An emergency rule may be effective for a period of
10 not longer than 150 days, but the agency's authority to adopt
11 an identical rule under Section 5-40 is not precluded. No
12 emergency rule may be adopted more than once in any 24 month
13 period, except that this limitation on the number of
14 emergency rules that may be adopted in a 24 month period does
15 not apply to (i) emergency rules that make additions to and
16 deletions from the Drug Manual under Section 5-5.16 of the
17 Illinois Public Aid Code or the generic drug formulary under
18 Section 3.14 of the Illinois Food, Drug and Cosmetic Act or
19 (ii) emergency rules adopted by the Pollution Control Board
20 before July 1, 1997 to implement portions of the Livestock
21 Management Facilities Act. Two or more emergency rules
22 having substantially the same purpose and effect shall be
23 deemed to be a single rule for purposes of this Section.
24 (d) In order to provide for the expeditious and timely
25 implementation of the State's fiscal year 1999 budget,
26 emergency rules to implement any provision of Public Act
27 90-587 or 90-588 or any other budget initiative for fiscal
28 year 1999 may be adopted in accordance with this Section by
29 the agency charged with administering that provision or
30 initiative, except that the 24-month limitation on the
31 adoption of emergency rules and the provisions of Sections
32 5-115 and 5-125 do not apply to rules adopted under this
33 subsection (d). The adoption of emergency rules authorized
34 by this subsection (d) shall be deemed to be necessary for
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1 the public interest, safety, and welfare.
2 (e) In order to provide for the expeditious and timely
3 implementation of the State's fiscal year 2000 budget,
4 emergency rules to implement any provision of this amendatory
5 Act of the 91st General Assembly or any other budget
6 initiative for fiscal year 2000 may be adopted in accordance
7 with this Section by the agency charged with administering
8 that provision or initiative, except that the 24-month
9 limitation on the adoption of emergency rules and the
10 provisions of Sections 5-115 and 5-125 do not apply to rules
11 adopted under this subsection (e). The adoption of emergency
12 rules authorized by this subsection (e) shall be deemed to be
13 necessary for the public interest, safety, and welfare.
14 (f) In order to provide for the expeditious and timely
15 implementation of the State's fiscal year 2001 budget,
16 emergency rules to implement any provision of this amendatory
17 Act of the 91st General Assembly or any other budget
18 initiative for fiscal year 2001 may be adopted in accordance
19 with this Section by the agency charged with administering
20 that provision or initiative, except that the 24-month
21 limitation on the adoption of emergency rules and the
22 provisions of Sections 5-115 and 5-125 do not apply to rules
23 adopted under this subsection (f). The adoption of emergency
24 rules authorized by this subsection (f) shall be deemed to be
25 necessary for the public interest, safety, and welfare.
26 (g) In order to provide for the expeditious and timely
27 implementation of the State's fiscal year 2002 budget,
28 emergency rules to implement any provision of this amendatory
29 Act of the 92nd General Assembly or any other budget
30 initiative for fiscal year 2002 may be adopted in accordance
31 with this Section by the agency charged with administering
32 that provision or initiative, except that the 24-month
33 limitation on the adoption of emergency rules and the
34 provisions of Sections 5-115 and 5-125 do not apply to rules
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1 adopted under this subsection (g). The adoption of emergency
2 rules authorized by this subsection (g) shall be deemed to be
3 necessary for the public interest, safety, and welfare.
4 (h) In order to provide for the expeditious and timely
5 implementation of the State's fiscal year 2003 budget,
6 emergency rules to implement any provision of this amendatory
7 Act of the 92nd General Assembly or any other budget
8 initiative for fiscal year 2003 may be adopted in accordance
9 with this Section by the agency charged with administering
10 that provision or initiative, except that the 24-month
11 limitation on the adoption of emergency rules and the
12 provisions of Sections 5-115 and 5-125 do not apply to rules
13 adopted under this subsection (h). The adoption of emergency
14 rules authorized by this subsection (h) shall be deemed to be
15 necessary for the public interest, safety, and welfare.
16 (i) In order to provide for the expeditious and timely
17 implementation of the State's fiscal year 2004 budget,
18 emergency rules to implement any provision of this amendatory
19 Act of the 93rd General Assembly or any other budget
20 initiative for fiscal year 2004 may be adopted in accordance
21 with this Section by the agency charged with administering
22 that provision or initiative, except that the 24-month
23 limitation on the adoption of emergency rules and the
24 provisions of Sections 5-115 and 5-125 do not apply to rules
25 adopted under this subsection (i). The adoption of emergency
26 rules authorized by this subsection (i) shall be deemed to be
27 necessary for the public interest, safety, and welfare.
28 (Source: P.A. 91-24, eff. 7-1-99; 91-357, eff. 7-29-99;
29 91-712, eff. 7-1-00; 92-10, eff. 6-11-01; 92-597, eff.
30 6-28-02.)
31 ARTICLE 5.
32 Section 5-5. The State Finance Act is amended by
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1 changing Sections 6z-30 and 6z-58 as follows:
2 (30 ILCS 105/6z-30)
3 Sec. 6z-30. University of Illinois Hospital Services
4 Fund.
5 (a) The University of Illinois Hospital Services Fund is
6 created as a special fund in the State Treasury. The
7 following moneys shall be deposited into the Fund:
8 (1) As soon as possible after the beginning of each
9 fiscal year (starting in fiscal year 1995), and in no
10 event later than July 30, the State Comptroller and the
11 State Treasurer shall automatically transfer $44,700,000
12 from the General Revenue Fund to the University of
13 Illinois Hospital Services Fund.
14 (2) All intergovernmental transfer payments to the
15 Illinois Department of Public Aid by the University of
16 Illinois Hospital made pursuant to an intergovernmental
17 agreement under subsection (b) or (c) of Section 5A-3 of
18 the Illinois Public Aid Code.
19 (3) All federal matching funds received by the
20 Illinois Department of Public Aid as a result of
21 expenditures made by the Illinois Department that are
22 attributable to moneys that were deposited in the Fund.
23 (b) Moneys in the fund may be used by the Illinois
24 Department of Public Aid, subject to appropriation, to
25 reimburse the University of Illinois Hospital for hospital
26 and pharmacy services. The fund may also be used to make
27 monthly transfers to the General Revenue Fund as provided in
28 subsection (c).
29 (c) The State Comptroller and State Treasurer shall
30 automatically transfer on the last day of each month except
31 June, beginning August 31, 1994, from the University of
32 Illinois Hospital Services Fund to the General Revenue Fund,
33 an amount determined and certified to the State Comptroller
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1 by the Director of Public Aid, equal to the amount by which
2 the balance in the Fund exceeds the amount necessary to
3 ensure timely payments to the University of Illinois
4 Hospital.
5 On June 30, 1995 and each June 30 thereafter, the State
6 Comptroller and State Treasurer shall automatically transfer
7 the entire balance in the University of Illinois Hospital
8 Services Fund to the General Revenue Fund.
9 (Source: P.A. 88-554, eff. 7-26-94; 89-499, eff. 6-28-96.)
10 (30 ILCS 105/6z-58)
11 Sec. 6z-58. The Family Care Fund.
12 (a) There is created in the State treasury the Family
13 Care Fund. Interest earned by the Fund shall be credited to
14 the Fund.
15 (b) The Fund is created solely for the purposes of
16 receiving, investing, and distributing moneys in accordance
17 with an approved waiver under the Social Security Act
18 resulting from the Family Care waiver request submitted by
19 the Illinois Department of Public Aid on February 15, 2002.
20 The Fund shall consist of:
21 (1) All federal financial participation moneys
22 received pursuant to the approved waiver, except for
23 moneys received pursuant to expenditures for medical
24 services by the Department of Public Aid from any other
25 fund; and
26 (2) All other moneys received by the Fund from any
27 source, including interest thereon.
28 (c) Subject to appropriation, the moneys in the Fund
29 shall be disbursed for reimbursement of medical services and
30 other costs associated with persons receiving such services
31 under the waiver due to their relationship with children
32 receiving medical services pursuant to Article V of the
33 Illinois Public Aid Code or the Children's Health Insurance
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1 Program Act.
2 (Source: P.A. 92-600, eff. 6-28-02.)
3 ARTICLE 15.
4 Section 15-5. The Illinois Public Aid Code is amended by
5 changing Sections 5-2, 5-5.4, 10-26, 12-8.1, 12-9, 14-8, and
6 15-5 and adding Section 5-5.4b as follows:
7 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
8 Sec. 5-2. Classes of Persons Eligible. Medical
9 assistance under this Article shall be available to any of
10 the following classes of persons in respect to whom a plan
11 for coverage has been submitted to the Governor by the
12 Illinois Department and approved by him:
13 1. Recipients of basic maintenance grants under Articles
14 III and IV.
15 2. Persons otherwise eligible for basic maintenance
16 under Articles III and IV but who fail to qualify thereunder
17 on the basis of need, and who have insufficient income and
18 resources to meet the costs of necessary medical care,
19 including but not limited to the following:
20 (a) All persons otherwise eligible for basic
21 maintenance under Article III but who fail to qualify
22 under that Article on the basis of need and who meet
23 either of the following requirements:
24 (i) their income, as determined by the
25 Illinois Department in accordance with any federal
26 requirements, is equal to or less than 70% in fiscal
27 year 2001, equal to or less than 85% in fiscal year
28 2002 and until a date to be determined by the
29 Department by rule, and equal to or less than 100%
30 beginning on the date determined by the Department
31 by rule, of the nonfarm income official poverty
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1 line, as defined by the federal Office of Management
2 and Budget and revised annually in accordance with
3 Section 673(2) of the Omnibus Budget Reconciliation
4 Act of 1981, applicable to families of the same
5 size; or
6 (ii) their income, after the deduction of
7 costs incurred for medical care and for other types
8 of remedial care, is equal to or less than 70% in
9 fiscal year 2001, equal to or less than 85% in
10 fiscal year 2002 and until a date to be determined
11 by the Department by rule, and equal to or less than
12 100% beginning on the date determined by the
13 Department by rule, of the nonfarm income official
14 poverty line, as defined in item (i) of this
15 subparagraph (a).
16 (b) All persons who would be determined eligible
17 for such basic maintenance under Article IV by
18 disregarding the maximum earned income permitted by
19 federal law.
20 3. Persons who would otherwise qualify for Aid to the
21 Medically Indigent under Article VII.
22 4. Persons not eligible under any of the preceding
23 paragraphs who fall sick, are injured, or die, not having
24 sufficient money, property or other resources to meet the
25 costs of necessary medical care or funeral and burial
26 expenses.
27 5. (a) Women during pregnancy, after the fact of
28 pregnancy has been determined by medical diagnosis, and
29 during the 60-day period beginning on the last day of the
30 pregnancy, together with their infants and children born
31 after September 30, 1983, whose income and resources are
32 insufficient to meet the costs of necessary medical care
33 to the maximum extent possible under Title XIX of the
34 Federal Social Security Act.
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1 (b) The Illinois Department and the Governor shall
2 provide a plan for coverage of the persons eligible under
3 paragraph 5(a) by April 1, 1990. Such plan shall provide
4 ambulatory prenatal care to pregnant women during a
5 presumptive eligibility period and establish an income
6 eligibility standard that is equal to 133% of the nonfarm
7 income official poverty line, as defined by the federal
8 Office of Management and Budget and revised annually in
9 accordance with Section 673(2) of the Omnibus Budget
10 Reconciliation Act of 1981, applicable to families of the
11 same size, provided that costs incurred for medical care
12 are not taken into account in determining such income
13 eligibility.
14 (c) The Illinois Department may conduct a
15 demonstration in at least one county that will provide
16 medical assistance to pregnant women, together with their
17 infants and children up to one year of age, where the
18 income eligibility standard is set up to 185% of the
19 nonfarm income official poverty line, as defined by the
20 federal Office of Management and Budget. The Illinois
21 Department shall seek and obtain necessary authorization
22 provided under federal law to implement such a
23 demonstration. Such demonstration may establish resource
24 standards that are not more restrictive than those
25 established under Article IV of this Code.
26 6. Persons under the age of 18 who fail to qualify as
27 dependent under Article IV and who have insufficient income
28 and resources to meet the costs of necessary medical care to
29 the maximum extent permitted under Title XIX of the Federal
30 Social Security Act.
31 7. Persons who are under 2118 years of age or younger
32 and would qualify as disabled as defined under the Federal
33 Supplemental Security Income Program, provided medical
34 service for such persons would be eligible for Federal
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1 Financial Participation, and provided the Illinois Department
2 determines that:
3 (a) the person requires a level of care provided by
4 a hospital, skilled nursing facility, or intermediate
5 care facility, as determined by a physician licensed to
6 practice medicine in all its branches;
7 (b) it is appropriate to provide such care outside
8 of an institution, as determined by a physician licensed
9 to practice medicine in all its branches;
10 (c) the estimated amount which would be expended
11 for care outside the institution is not greater than the
12 estimated amount which would be expended in an
13 institution.
14 8. Persons who become ineligible for basic maintenance
15 assistance under Article IV of this Code in programs
16 administered by the Illinois Department due to employment
17 earnings and persons in assistance units comprised of adults
18 and children who become ineligible for basic maintenance
19 assistance under Article VI of this Code due to employment
20 earnings. The plan for coverage for this class of persons
21 shall:
22 (a) extend the medical assistance coverage for up
23 to 12 months following termination of basic maintenance
24 assistance; and
25 (b) offer persons who have initially received 6
26 months of the coverage provided in paragraph (a) above,
27 the option of receiving an additional 6 months of
28 coverage, subject to the following:
29 (i) such coverage shall be pursuant to
30 provisions of the federal Social Security Act;
31 (ii) such coverage shall include all services
32 covered while the person was eligible for basic
33 maintenance assistance;
34 (iii) no premium shall be charged for such
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1 coverage; and
2 (iv) such coverage shall be suspended in the
3 event of a person's failure without good cause to
4 file in a timely fashion reports required for this
5 coverage under the Social Security Act and coverage
6 shall be reinstated upon the filing of such reports
7 if the person remains otherwise eligible.
8 9. Persons with acquired immunodeficiency syndrome
9 (AIDS) or with AIDS-related conditions with respect to whom
10 there has been a determination that but for home or
11 community-based services such individuals would require the
12 level of care provided in an inpatient hospital, skilled
13 nursing facility or intermediate care facility the cost of
14 which is reimbursed under this Article. Assistance shall be
15 provided to such persons to the maximum extent permitted
16 under Title XIX of the Federal Social Security Act.
17 10. Participants in the long-term care insurance
18 partnership program established under the Partnership for
19 Long-Term Care Act who meet the qualifications for protection
20 of resources described in Section 25 of that Act.
21 11. Persons with disabilities who are employed and
22 eligible for Medicaid, pursuant to Section
23 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
24 provided by the Illinois Department by rule.
25 12. Subject to federal approval, persons who are
26 eligible for medical assistance coverage under applicable
27 provisions of the federal Social Security Act and the federal
28 Breast and Cervical Cancer Prevention and Treatment Act of
29 2000. Those eligible persons are defined to include, but not
30 be limited to, the following persons:
31 (1) persons who have been screened for breast or
32 cervical cancer under the U.S. Centers for Disease
33 Control and Prevention Breast and Cervical Cancer Program
34 established under Title XV of the federal Public Health
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1 Services Act in accordance with the requirements of
2 Section 1504 of that Act as administered by the Illinois
3 Department of Public Health; and
4 (2) persons whose screenings under the above
5 program were funded in whole or in part by funds
6 appropriated to the Illinois Department of Public Health
7 for breast or cervical cancer screening.
8 "Medical assistance" under this paragraph 12 shall be
9 identical to the benefits provided under the State's approved
10 plan under Title XIX of the Social Security Act. The
11 Department must request federal approval of the coverage
12 under this paragraph 12 within 30 days after the effective
13 date of this amendatory Act of the 92nd General Assembly.
14 The Illinois Department and the Governor shall provide a
15 plan for coverage of the persons eligible under paragraph 7
16 as soon as possible after July 1, 1984.
17 The eligibility of any such person for medical assistance
18 under this Article is not affected by the payment of any
19 grant under the Senior Citizens and Disabled Persons Property
20 Tax Relief and Pharmaceutical Assistance Act or any
21 distributions or items of income described under subparagraph
22 (X) of paragraph (2) of subsection (a) of Section 203 of the
23 Illinois Income Tax Act. The Department shall by rule
24 establish the amounts of assets to be disregarded in
25 determining eligibility for medical assistance, which shall
26 at a minimum equal the amounts to be disregarded under the
27 Federal Supplemental Security Income Program. The amount of
28 assets of a single person to be disregarded shall not be less
29 than $2,000, and the amount of assets of a married couple to
30 be disregarded shall not be less than $3,000.
31 To the extent permitted under federal law, any person
32 found guilty of a second violation of Article VIIIA shall be
33 ineligible for medical assistance under this Article, as
34 provided in Section 8A-8.
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1 The eligibility of any person for medical assistance
2 under this Article shall not be affected by the receipt by
3 the person of donations or benefits from fundraisers held for
4 the person in cases of serious illness, as long as neither
5 the person nor members of the person's family have actual
6 control over the donations or benefits or the disbursement of
7 the donations or benefits.
8 (Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00;
9 91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff. 7-3-01;
10 92-597, eff. 6-28-02.)
11 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
12 Sec. 5-5.4. Standards of Payment - Department of Public
13 Aid. The Department of Public Aid shall develop standards of
14 payment of skilled nursing and intermediate care services in
15 facilities providing such services under this Article which:
16 (1) Provide for the determination of a facility's
17 payment for skilled nursing and intermediate care services on
18 a prospective basis. The amount of the payment rate for all
19 nursing facilities certified by the Department of Public
20 Health under the Nursing Home Care Act as Intermediate Care
21 for the Developmentally Disabled facilities, Long Term Care
22 for Under Age 22 facilities, Skilled Nursing facilities, or
23 Intermediate Care facilities under the medical assistance
24 program shall be prospectively established annually on the
25 basis of historical, financial, and statistical data
26 reflecting actual costs from prior years, which shall be
27 applied to the current rate year and updated for inflation,
28 except that the capital cost element for newly constructed
29 facilities shall be based upon projected budgets. The
30 annually established payment rate shall take effect on July 1
31 in 1984 and subsequent years. No rate increase and no update
32 for inflation shall be provided on or after July 1, 1994 and
33 before July 1, 20042003, unless specifically provided for in
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1 this Section.
2 For facilities licensed by the Department of Public
3 Health under the Nursing Home Care Act as Intermediate Care
4 for the Developmentally Disabled facilities or Long Term Care
5 for Under Age 22 facilities, the rates taking effect on July
6 1, 1998 shall include an increase of 3%. For facilities
7 licensed by the Department of Public Health under the Nursing
8 Home Care Act as Skilled Nursing facilities or Intermediate
9 Care facilities, the rates taking effect on July 1, 1998
10 shall include an increase of 3% plus $1.10 per resident-day,
11 as defined by the Department.
12 For facilities licensed by the Department of Public
13 Health under the Nursing Home Care Act as Intermediate Care
14 for the Developmentally Disabled facilities or Long Term Care
15 for Under Age 22 facilities, the rates taking effect on July
16 1, 1999 shall include an increase of 1.6% plus $3.00 per
17 resident-day, as defined by the Department. For facilities
18 licensed by the Department of Public Health under the Nursing
19 Home Care Act as Skilled Nursing facilities or Intermediate
20 Care facilities, the rates taking effect on July 1, 1999
21 shall include an increase of 1.6% and, for services provided
22 on or after October 1, 1999, shall be increased by $4.00 per
23 resident-day, as defined by the Department.
24 For facilities licensed by the Department of Public
25 Health under the Nursing Home Care Act as Intermediate Care
26 for the Developmentally Disabled facilities or Long Term Care
27 for Under Age 22 facilities, the rates taking effect on July
28 1, 2000 shall include an increase of 2.5% per resident-day,
29 as defined by the Department. For facilities licensed by the
30 Department of Public Health under the Nursing Home Care Act
31 as Skilled Nursing facilities or Intermediate Care
32 facilities, the rates taking effect on July 1, 2000 shall
33 include an increase of 2.5% per resident-day, as defined by
34 the Department.
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1 For facilities licensed by the Department of Public
2 Health under the Nursing Home Care Act as skilled nursing
3 facilities or intermediate care facilities, a new payment
4 methodology must be implemented for the nursing component of
5 the rate effective July 1, 2003. The Department of Public Aid
6 shall develop the new payment methodology using the Minimum
7 Data Set (MDS) as the instrument to collect information
8 concerning nursing home resident condition necessary to
9 compute the rate. The Department of Public Aid shall develop
10 the new payment methodology to meet the unique needs of
11 Illinois nursing home residents while remaining subject to
12 the appropriations provided by the General Assembly. A
13 transition period from the payment methodology in effect on
14 June 30, 2003 to the payment methodology in effect on July 1,
15 2003 shall be provided for a period not exceeding 2 years
16 after implementation of the new payment methodology as
17 follows:
18 (A) For a facility that would receive a lower
19 nursing component rate per patient day under the new
20 system than the facility received effective on the date
21 immediately preceding the date that the Department
22 implements the new payment methodology, the nursing
23 component rate per patient day for the facility shall be
24 held at the level in effect on the date immediately
25 preceding the date that the Department implements the new
26 payment methodology until a higher nursing component rate
27 of reimbursement is achieved by that facility.
28 (B) For a facility that would receive a higher
29 nursing component rate per patient day under the payment
30 methodology in effect on July 1, 2003 than the facility
31 received effective on the date immediately preceding the
32 date that the Department implements the new payment
33 methodology, the nursing component rate per patient day
34 for the facility shall be adjusted.
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1 (C) Notwithstanding paragraphs (A) and (B), the
2 nursing component rate per patient day for the facility
3 shall be adjusted subject to appropriations provided by
4 the General Assembly.
5 For facilities licensed by the Department of Public
6 Health under the Nursing Home Care Act as Intermediate Care
7 for the Developmentally Disabled facilities or Long Term Care
8 for Under Age 22 facilities, the rates taking effect on March
9 1, 2001 shall include a statewide increase of 7.85%, as
10 defined by the Department.
11 For facilities licensed by the Department of Public
12 Health under the Nursing Home Care Act as Intermediate Care
13 for the Developmentally Disabled facilities or Long Term Care
14 for Under Age 22 facilities, the rates taking effect on April
15 1, 2002 shall include a statewide increase of 2.0%, as
16 defined by the Department. This increase terminates on July
17 1, 2002; beginning July 1, 2002 these rates are reduced to
18 the level of the rates in effect on March 31, 2002, as
19 defined by the Department.
20 For facilities licensed by the Department of Public
21 Health under the Nursing Home Care Act as skilled nursing
22 facilities or intermediate care facilities, the rates taking
23 effect on July 1, 2001, and each subsequent year thereafter,
24 shall be computed using the most recent cost reports on file
25 with the Department of Public Aid no later than April 1,
26 2000, updated for inflation to January 1, 2001. For rates
27 effective July 1, 2001 only, rates shall be the greater of
28 the rate computed for July 1, 2001 or the rate effective on
29 June 30, 2001.
30 Notwithstanding any other provision of this Section, for
31 facilities licensed by the Department of Public Health under
32 the Nursing Home Care Act as skilled nursing facilities or
33 intermediate care facilities, the Illinois Department shall
34 determine by rule the rates taking effect on July 1, 2002,
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1 which shall be 5.9% less than the rates in effect on June 30,
2 2002.
3 Rates established effective each July 1 shall govern
4 payment for services rendered throughout that fiscal year,
5 except that rates established on July 1, 1996 shall be
6 increased by 6.8% for services provided on or after January
7 1, 1997. Such rates will be based upon the rates calculated
8 for the year beginning July 1, 1990, and for subsequent years
9 thereafter until June 30, 2001 shall be based on the facility
10 cost reports for the facility fiscal year ending at any point
11 in time during the previous calendar year, updated to the
12 midpoint of the rate year. The cost report shall be on file
13 with the Department no later than April 1 of the current rate
14 year. Should the cost report not be on file by April 1, the
15 Department shall base the rate on the latest cost report
16 filed by each skilled care facility and intermediate care
17 facility, updated to the midpoint of the current rate year.
18 In determining rates for services rendered on and after July
19 1, 1985, fixed time shall not be computed at less than zero.
20 The Department shall not make any alterations of regulations
21 which would reduce any component of the Medicaid rate to a
22 level below what that component would have been utilizing in
23 the rate effective on July 1, 1984.
24 (2) Shall take into account the actual costs incurred by
25 facilities in providing services for recipients of skilled
26 nursing and intermediate care services under the medical
27 assistance program.
28 (3) Shall take into account the medical and
29 psycho-social characteristics and needs of the patients.
30 (4) Shall take into account the actual costs incurred by
31 facilities in meeting licensing and certification standards
32 imposed and prescribed by the State of Illinois, any of its
33 political subdivisions or municipalities and by the U.S.
34 Department of Health and Human Services pursuant to Title XIX
SB742 Enrolled -18- LRB093 03019 RCE 03036 b
1 of the Social Security Act.
2 The Department of Public Aid shall develop precise
3 standards for payments to reimburse nursing facilities for
4 any utilization of appropriate rehabilitative personnel for
5 the provision of rehabilitative services which is authorized
6 by federal regulations, including reimbursement for services
7 provided by qualified therapists or qualified assistants, and
8 which is in accordance with accepted professional practices.
9 Reimbursement also may be made for utilization of other
10 supportive personnel under appropriate supervision.
11 (Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
12 eff. 6-11-01; 92-31, eff. 6-28-01; 92-597, eff. 6-28-02;
13 92-651, eff. 7-11-02; 92-848, eff. 1-1-03; revised 9-20-02.)
14 (305 ILCS 5/5-5.4b new)
15 Sec. 5-5.4b. Publicly owned or publicly operated nursing
16 facilities. The Illinois Department may by rule establish
17 alternative reimbursement methodologies for nursing
18 facilities that are owned or operated by a county, a
19 township, a municipality, a hospital district, or any other
20 local government in Illinois.
21 (305 ILCS 5/10-26)
22 Sec. 10-26. State Disbursement Unit.
23 (a) Effective October 1, 1999 the Illinois Department
24 shall establish a State Disbursement Unit in accordance with
25 the requirements of Title IV-D of the Social Security Act.
26 The Illinois Department shall enter into an agreement with a
27 State or local governmental unit or private entity to perform
28 the functions of the State Disbursement Unit as set forth in
29 this Section. The State Disbursement Unit shall collect and
30 disburse support payments made under court and administrative
31 support orders:
32 (1) being enforced in cases in which child and
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1 spouse support services are being provided under this
2 Article X; and
3 (2) in all cases in which child and spouse support
4 services are not being provided under this Article X and
5 in which support payments are made under the provisions
6 of the Income Withholding for Support Act.
7 (a-2) The contract entered into by the Illinois
8 Department with a public or private entity or an individual
9 for the operation of the State Disbursement Unit is subject
10 to competitive bidding. In addition, the contract is subject
11 to Section 10-26.2 of this Code. As used in this subsection
12 (a-2), "contract" has the same meaning as in the Illinois
13 Procurement Code.
14 (a-5) If the State Disbursement Unit receives a support
15 payment that was not appropriately made to the Unit under
16 this Section, the Unit shall immediately return the payment
17 to the sender, including, if possible, instructions detailing
18 where to send the support payments.
19 (b) All payments received by the State Disbursement
20 Unit:
21 (1) shall be deposited into an account obtained by
22 the Illinois Departmentthe State or local governmental
23 unit or private entity, as the case may be, and
24 (2) distributed and disbursed by the State
25 Disbursement Unit, in accordance with the directions of
26 the Illinois Department, pursuant to Title IV-D of the
27 Social Security Act and rules promulgated by the
28 Department.
29 (c) All support payments assigned to the Illinois
30 Department under Article X of this Code and rules promulgated
31 by the Illinois Department that are disbursed to the Illinois
32 Department by the State Disbursement Unit shall be paid into
33 the Child Support Enforcement Trust Fund.
34 (d) If the agreement with the State or local
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1 governmental unit or private entity provided for in this
2 Section is not in effect for any reason, the Department shall
3 perform the functions of the State Disbursement Unit as set
4 forth in this Section for a maximum of 12 months before July
5 1, 2001, and for a maximum of 24 months after June 30, 2001.
6 If the Illinois Department is performing the functions of the
7 State Disbursement Unit on July 1, 2001, then the Illinois
8 Department shall make an award on or before December 31,
9 2002, to a State or local government unit or private entity
10 to perform the functions of the State Disbursement Unit.
11 Payments received by the Illinois Department in performance
12 of the duties of the State Disbursement Unit shall be
13 deposited into the State Disbursement Unit Revolving Fund
14 established under Section 12-8.1. Nothing in this Section
15 shall prohibit the Illinois Department from holding the State
16 Disbursement Unit Revolving Fund after June 30, 2003.
17 (e) By February 1, 2000, the Illinois Department shall
18 conduct at least 4 regional training and educational seminars
19 to educate the clerks of the circuit court on the general
20 operation of the State Disbursement Unit, the role of the
21 State Disbursement Unit, and the role of the clerks of the
22 circuit court in the collection and distribution of child
23 support payments.
24 (f) By March 1, 2000, the Illinois Department shall
25 conduct at least 4 regional educational and training seminars
26 to educate payors, as defined in the Income Withholding for
27 Support Act, on the general operation of the State
28 Disbursement Unit, the role of the State Disbursement Unit,
29 and the distribution of income withholding payments pursuant
30 to this Section and the Income Withholding for Support Act.
31 (Source: P.A. 91-212, eff. 7-20-99; 91-677, eff. 1-5-00;
32 91-712, eff. 7-1-00; 92-44, eff. 7-1-01.)
33 (305 ILCS 5/12-8.1)
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1 Sec. 12-8.1. State Disbursement Unit Revolving Fund.
2 (a) There is created a revolving fund to be known as the
3 State Disbursement Unit Revolving Fund, to be held by the
4 Director of the Illinois Department, outside the State
5 treasury, for the following purposes:
6 (1) the deposit of all support payments received by
7 the Illinois Department's State Disbursement Unit;
8 (2) the deposit of other funds including, but not
9 limited to, transfers of funds from other accounts
10 attributable to support payments received by the Illinois
11 Department's State Disbursement Unit;
12 (3) the deposit of any interest accrued by the
13 revolving fund, which interest shall be available for
14 payment of (i) any amounts considered to be Title IV-D
15 program income that must be paid to the U.S. Department
16 of Health and Human Services and (ii) any balance
17 remaining after payments made under item (i) of this
18 subsection (3) to the General Revenue Fund; however, the
19 disbursements under this subdivision (3) may not exceed
20 the amount of the interest accrued by the revolving fund;
21 (4) the disbursement of such payments to obligees
22 or to the assignees of the obligees in accordance with
23 the provisions of Title IV-D of the Social Security Act
24 and rules promulgated by the Department, provided that
25 such disbursement is based upon a payment by a payor or
26 obligor deposited into the revolving fund established by
27 this Section; and
28 (5) the disbursement of funds to payors or obligors
29 to correct erroneous payments to the Illinois
30 Department's State Disbursement Unit, in an amount not to
31 exceed the erroneous payments.
32 (b) (Blank).The provisions of this Section shall apply
33 only if the Department performs the functions of the Illinois
34 Department's State Disbursement Unit under paragraph (d) of
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1 Section 10-26.
2 (Source: P.A. 91-712, eff. 7-1-00; 92-44, eff. 7-1-01.)
3 (305 ILCS 5/12-9) (from Ch. 23, par. 12-9)
4 Sec. 12-9. Public Aid Recoveries Trust Fund; uses. The
5 Public Aid Recoveries Trust Fund shall consist of (1)
6 recoveries by the Illinois Department of Public Aid
7 authorized by this Code in respect to applicants or
8 recipients under Articles III, IV, V, and VI, including
9 recoveries made by the Illinois Department of Public Aid from
10 the estates of deceased recipients, (2) recoveries made by
11 the Illinois Department of Public Aid in respect to
12 applicants and recipients under the Children's Health
13 Insurance Program, and (3) federal funds received on behalf
14 of and earned by State universities and local governmental
15 entities for services provided to applicants or recipients
16 covered under this Code. The Fund shall be held as a special
17 fund in the State Treasury.
18 Disbursements from this Fund shall be only (1) for the
19 reimbursement of claims collected by the Illinois Department
20 of Public Aid through error or mistake, (2) for payment to
21 persons or agencies designated as payees or co-payees on any
22 instrument, whether or not negotiable, delivered to the
23 Illinois Department of Public Aid as a recovery under this
24 Section, such payment to be in proportion to the respective
25 interests of the payees in the amount so collected, (3) for
26 payments to the Department of Human Services for collections
27 made by the Illinois Department of Public Aid on behalf of
28 the Department of Human Services under this Code, (4) for
29 payment of administrative expenses incurred in performing the
30 activities authorized under this Code, (5) for payment of
31 fees to persons or agencies in the performance of activities
32 pursuant to the collection of monies owed the State that are
33 collected under this Code, (6) for payments of any amounts
SB742 Enrolled -23- LRB093 03019 RCE 03036 b
1 which are reimbursable to the federal government which are
2 required to be paid by State warrant by either the State or
3 federal government, and (7) for payments to State
4 universities and local governmental entities of federal funds
5 for services provided to applicants or recipients covered
6 under this Code. Disbursements from this Fund for purposes
7 of items (4) and (5) of this paragraph shall be subject to
8 appropriations from the Fund to the Illinois Department of
9 Public Aid.
10 The balance in this Fund on the first day of each
11 calendar quarter, after payment therefrom of any amounts
12 reimbursable to the federal government, and minus the amount
13 reasonably anticipated to be needed to make the disbursements
14 during that quarter authorized by this Section, shall be
15 certified by the Director of the Illinois Department of
16 Public Aid and transferred by the State Comptroller to the
17 Drug Rebate Fund or the General Revenue Fund in the State
18 Treasury, as appropriate, within 30 days of the first day of
19 each calendar quarter.
20 On July 1, 1999, the State Comptroller shall transfer the
21 sum of $5,000,000 from the Public Aid Recoveries Trust Fund
22 (formerly the Public Assistance Recoveries Trust Fund) into
23 the DHS Recoveries Trust Fund.
24 (Source: P.A. 91-24, eff. 7-1-99; 91-212, eff. 7-20-99;
25 92-10, eff. 6-11-01; 92-16, eff. 6-28-01.)
26 (305 ILCS 5/14-8) (from Ch. 23, par. 14-8)
27 Sec. 14-8. Disbursements to Hospitals.
28 (a) For inpatient hospital services rendered on and
29 after September 1, 1991, the Illinois Department shall
30 reimburse hospitals for inpatient services at an inpatient
31 payment rate calculated for each hospital based upon the
32 Medicare Prospective Payment System as set forth in Sections
33 1886(b), (d), (g), and (h) of the federal Social Security
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1 Act, and the regulations, policies, and procedures
2 promulgated thereunder, except as modified by this Section.
3 Payment rates for inpatient hospital services rendered on or
4 after September 1, 1991 and on or before September 30, 1992
5 shall be calculated using the Medicare Prospective Payment
6 rates in effect on September 1, 1991. Payment rates for
7 inpatient hospital services rendered on or after October 1,
8 1992 and on or before March 31, 1994 shall be calculated
9 using the Medicare Prospective Payment rates in effect on
10 September 1, 1992. Payment rates for inpatient hospital
11 services rendered on or after April 1, 1994 shall be
12 calculated using the Medicare Prospective Payment rates
13 (including the Medicare grouping methodology and weighting
14 factors as adjusted pursuant to paragraph (1) of this
15 subsection) in effect 90 days prior to the date of
16 admission. For services rendered on or after July 1, 1995,
17 the reimbursement methodology implemented under this
18 subsection shall not include those costs referred to in
19 Sections 1886(d)(5)(B) and 1886(h) of the Social Security
20 Act. The additional payment amounts required under Section
21 1886(d)(5)(F) of the Social Security Act, for hospitals
22 serving a disproportionate share of low-income or indigent
23 patients, are not required under this Section. For hospital
24 inpatient services rendered on or after July 1, 1995, the
25 Illinois Department shall reimburse hospitals using the
26 relative weighting factors and the base payment rates
27 calculated for each hospital that were in effect on June 30,
28 1995, less the portion of such rates attributed by the
29 Illinois Department to the cost of medical education.
30 (1) The weighting factors established under Section
31 1886(d)(4) of the Social Security Act shall not be used
32 in the reimbursement system established under this
33 Section. Rather, the Illinois Department shall establish
34 by rule Medicaid weighting factors to be used in the
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1 reimbursement system established under this Section.
2 (2) The Illinois Department shall define by rule
3 those hospitals or distinct parts of hospitals that shall
4 be exempt from the reimbursement system established under
5 this Section. In defining such hospitals, the Illinois
6 Department shall take into consideration those hospitals
7 exempt from the Medicare Prospective Payment System as of
8 September 1, 1991. For hospitals defined as exempt under
9 this subsection, the Illinois Department shall by rule
10 establish a reimbursement system for payment of inpatient
11 hospital services rendered on and after September 1,
12 1991. For all hospitals that are children's hospitals as
13 defined in Section 5-5.02 of this Code, the reimbursement
14 methodology shall, through June 30, 1992, net of all
15 applicable fees, at least equal each children's hospital
16 1990 ICARE payment rates, indexed to the current year by
17 application of the DRI hospital cost index from 1989 to
18 the year in which payments are made. Excepting county
19 providers as defined in Article XV of this Code,
20 hospitals licensed under the University of Illinois
21 Hospital Act, and facilities operated by the Department
22 of Mental Health and Developmental Disabilities (or its
23 successor, the Department of Human Services) for hospital
24 inpatient services rendered on or after July 1, 1995, the
25 Illinois Department shall reimburse children's hospitals,
26 as defined in 89 Illinois Administrative Code Section
27 149.50(c)(3), at the rates in effect on June 30, 1995,
28 and shall reimburse all other hospitals at the rates in
29 effect on June 30, 1995, less the portion of such rates
30 attributed by the Illinois Department to the cost of
31 medical education. For inpatient hospital services
32 provided on or after August 1, 1998, the Illinois
33 Department may establish by rule a means of adjusting the
34 rates of children's hospitals, as defined in 89 Illinois
SB742 Enrolled -26- LRB093 03019 RCE 03036 b
1 Administrative Code Section 149.50(c)(3), that did not
2 meet that definition on June 30, 1995, in order for the
3 inpatient hospital rates of such hospitals to take into
4 account the average inpatient hospital rates of those
5 children's hospitals that did meet the definition of
6 children's hospitals on June 30, 1995.
7 (3) (Blank)
8 (4) Notwithstanding any other provision of this
9 Section, hospitals that on August 31, 1991, have a
10 contract with the Illinois Department under Section 3-4
11 of the Illinois Health Finance Reform Act may elect to
12 continue to be reimbursed at rates stated in such
13 contracts for general and specialty care.
14 (5) In addition to any payments made under this
15 subsection (a), the Illinois Department shall make the
16 adjustment payments required by Section 5-5.02 of this
17 Code; provided, that in the case of any hospital
18 reimbursed under a per case methodology, the Illinois
19 Department shall add an amount equal to the product of
20 the hospital's average length of stay, less one day,
21 multiplied by 20, for inpatient hospital services
22 rendered on or after September 1, 1991 and on or before
23 September 30, 1992.
24 (b) (Blank)
25 (b-5) Excepting county providers as defined in Article
26 XV of this Code, hospitals licensed under the University of
27 Illinois Hospital Act, and facilities operated by the
28 Illinois Department of Mental Health and Developmental
29 Disabilities (or its successor, the Department of Human
30 Services), for outpatient services rendered on or after July
31 1, 1995 and before July 1, 1998 the Illinois Department shall
32 reimburse children's hospitals, as defined in the Illinois
33 Administrative Code Section 149.50(c)(3), at the rates in
34 effect on June 30, 1995, less that portion of such rates
SB742 Enrolled -27- LRB093 03019 RCE 03036 b
1 attributed by the Illinois Department to the outpatient
2 indigent volume adjustment and shall reimburse all other
3 hospitals at the rates in effect on June 30, 1995, less the
4 portions of such rates attributed by the Illinois Department
5 to the cost of medical education and attributed by the
6 Illinois Department to the outpatient indigent volume
7 adjustment. For outpatient services provided on or after
8 July 1, 1998, reimbursement rates shall be established by
9 rule.
10 (c) In addition to any other payments under this Code,
11 the Illinois Department shall develop a hospital
12 disproportionate share reimbursement methodology that,
13 effective July 1, 1991, through September 30, 1992, shall
14 reimburse hospitals sufficiently to expend the fee monies
15 described in subsection (b) of Section 14-3 of this Code and
16 the federal matching funds received by the Illinois
17 Department as a result of expenditures made by the Illinois
18 Department as required by this subsection (c) and Section
19 14-2 that are attributable to fee monies deposited in the
20 Fund, less amounts applied to adjustment payments under
21 Section 5-5.02.
22 (d) Critical Care Access Payments.
23 (1) In addition to any other payments made under
24 this Code, the Illinois Department shall develop a
25 reimbursement methodology that shall reimburse Critical
26 Care Access Hospitals for the specialized services that
27 qualify them as Critical Care Access Hospitals. No
28 adjustment payments shall be made under this subsection
29 on or after July 1, 1995.
30 (2) "Critical Care Access Hospitals" includes, but
31 is not limited to, hospitals that meet at least one of
32 the following criteria:
33 (A) Hospitals located outside of a
34 metropolitan statistical area that are designated as
SB742 Enrolled -28- LRB093 03019 RCE 03036 b
1 Level II Perinatal Centers and that provide a
2 disproportionate share of perinatal services to
3 recipients; or
4 (B) Hospitals that are designated as Level I
5 Trauma Centers (adult or pediatric) and certain
6 Level II Trauma Centers as determined by the
7 Illinois Department; or
8 (C) Hospitals located outside of a
9 metropolitan statistical area and that provide a
10 disproportionate share of obstetrical services to
11 recipients.
12 (e) Inpatient high volume adjustment. For hospital
13 inpatient services, effective with rate periods beginning on
14 or after October 1, 1993, in addition to rates paid for
15 inpatient services by the Illinois Department, the Illinois
16 Department shall make adjustment payments for inpatient
17 services furnished by Medicaid high volume hospitals. The
18 Illinois Department shall establish by rule criteria for
19 qualifying as a Medicaid high volume hospital and shall
20 establish by rule a reimbursement methodology for calculating
21 these adjustment payments to Medicaid high volume hospitals.
22 No adjustment payment shall be made under this subsection for
23 services rendered on or after July 1, 1995.
24 (f) The Illinois Department shall modify its current
25 rules governing adjustment payments for targeted access,
26 critical care access, and uncompensated care to classify
27 those adjustment payments as not being payments to
28 disproportionate share hospitals under Title XIX of the
29 federal Social Security Act. Rules adopted under this
30 subsection shall not be effective with respect to services
31 rendered on or after July 1, 1995. The Illinois Department
32 has no obligation to adopt or implement any rules or make any
33 payments under this subsection for services rendered on or
34 after July 1, 1995.
SB742 Enrolled -29- LRB093 03019 RCE 03036 b
1 (f-5) The State recognizes that adjustment payments to
2 hospitals providing certain services or incurring certain
3 costs may be necessary to assure that recipients of medical
4 assistance have adequate access to necessary medical
5 services. These adjustments include payments for teaching
6 costs and uncompensated care, trauma center payments,
7 rehabilitation hospital payments, perinatal center payments,
8 obstetrical care payments, targeted access payments, Medicaid
9 high volume payments, and outpatient indigent volume
10 payments. On or before April 1, 1995, the Illinois
11 Department shall issue recommendations regarding (i)
12 reimbursement mechanisms or adjustment payments to reflect
13 these costs and services, including methods by which the
14 payments may be calculated and the method by which the
15 payments may be financed, and (ii) reimbursement mechanisms
16 or adjustment payments to reflect costs and services of
17 federally qualified health centers with respect to recipients
18 of medical assistance.
19 (g) If one or more hospitals file suit in any court
20 challenging any part of this Article XIV, payments to
21 hospitals under this Article XIV shall be made only to the
22 extent that sufficient monies are available in the Fund and
23 only to the extent that any monies in the Fund are not
24 prohibited from disbursement under any order of the court.
25 (h) Payments under the disbursement methodology
26 described in this Section are subject to approval by the
27 federal government in an appropriate State plan amendment.
28 (i) The Illinois Department may by rule establish
29 criteria for and develop methodologies for adjustment
30 payments to hospitals participating under this Article.
31 (j) Hospital Residing Long Term Care Services. In
32 addition to any other payments made under this Code, the
33 Illinois Department may by rule establish criteria and
34 develop methodologies for payments to hospitals for Hospital
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1 Residing Long Term Care Services.
2 (Source: P.A. 89-21, eff. 7-1-95; 89-499, eff. 6-28-96;
3 89-507, eff. 7-1-97; 90-9, eff. 7-1-97; 90-14, eff. 7-1-97;
4 90-588, eff. 7-1-98.)
5 (305 ILCS 5/15-5) (from Ch. 23, par. 15-5)
6 Sec. 15-5. Disbursements from the Fund.
7 (a) The monies in the Fund shall be disbursed only as
8 provided in Section 15-2 of this Code and as follows:
9 (1) To pay the county hospitals' inpatient
10 reimbursement rate based on actual costs, trended forward
11 annually by an inflation index and supplemented by
12 teaching, capital, and other direct and indirect costs,
13 according to a State plan approved by the federal
14 government. Effective October 1, 1992, the inpatient
15 reimbursement rate (including any disproportionate or
16 supplemental disproportionate share payments) for
17 hospital services provided by county operated facilities
18 within the County shall be no less than the reimbursement
19 rates in effect on June 1, 1992, except that this minimum
20 shall be adjusted as of July 1, 1992 and each July 1
21 thereafter through July 1, 2002 by the annual percentage
22 change in the per diem cost of inpatient hospital
23 services as reported in the most recent annual Medicaid
24 cost report. Effective July 1, 2003, the rate for
25 hospital inpatient services provided by county hospitals
26 shall be the rate in effect on January 1, 2003, except
27 that this minimum may be adjusted by the Illinois
28 Department to ensure compliance with aggregate and
29 hospital-specific federal payment limitations.
30 (2) To pay county hospitals and county operated
31 outpatient facilities for outpatient services based on a
32 federally approved methodology to cover the maximum
33 allowable costs per patient visit. Effective October 1,
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1 1992, the outpatient reimbursement rate for outpatient
2 services provided by county hospitals and county operated
3 outpatient facilities shall be no less than the
4 reimbursement rates in effect on June 1, 1992, except
5 that this minimum shall be adjusted as of July 1, 1992
6 and each July 1 thereafter through July 1, 2002 by the
7 annual percentage change in the per diem cost of
8 inpatient hospital services as reported in the most
9 recent annual Medicaid cost report. Effective July 1,
10 2003, the Illinois Department shall by rule establish
11 rates for outpatient services provided by county
12 hospitals and other county-operated facilities within the
13 County that are in compliance with aggregate and
14 hospital-specific federal payment limitations.
15 (3) To pay the county hospitals' disproportionate
16 share payments as established by the Illinois Department
17 under Section 5-5.02 of this Code. Effective October 1,
18 1992, the disproportionate share payments for hospital
19 services provided by county operated facilities within
20 the County shall be no less than the reimbursement rates
21 in effect on June 1, 1992, except that this minimum shall
22 be adjusted as of July 1, 1992 and each July 1 thereafter
23 through July 1, 2002 by the annual percentage change in
24 the per diem cost of inpatient hospital services as
25 reported in the most recent annual Medicaid cost report.
26 Effective July 1, 2003, the Illinois Department may by
27 rule establish rates for disproportionate share payments
28 to county hospitals that are in compliance with aggregate
29 and hospital-specific federal payment limitations.
30 (3.5) To pay county providers for services provided
31 pursuant to Section 5-11 of this Code.
32 (4) To reimburse the county providers for expenses
33 contractually assumed pursuant to Section 15-4 of this
34 Code.
SB742 Enrolled -32- LRB093 03019 RCE 03036 b
1 (5) To pay the Illinois Department its necessary
2 administrative expenses relative to the Fund and other
3 amounts agreed to, if any, by the county providers in the
4 agreement provided for in subsection (c).
5 (6) To pay the county providers any other amount
6 duehospitals' supplemental disproportionate share
7 payments, hereby authorized, as specified in the
8 agreement provided for in subsection (c) and according to
9 a federally approved State plan, including but not
10 limited to payments made under the provisions of Section
11 701(d)(3)(B) of the federal Medicare, Medicaid, and SCHIP
12 Benefits Improvement and Protection Act of 2000.
13 Intergovernmental transfers supporting payments under
14 this paragraph (6) shall not be subject to the
15 computation described in subsection (a) of Section 15-3
16 of this Code, but shall be computed as the difference
17 between the total of such payments made by the Illinois
18 Department to county providers less any amount of federal
19 financial participation due the Illinois Department under
20 Titles XIX and XXI of the Social Security Act as a result
21 of such payments to county providers. Effective October
22 1, 1992, the supplemental disproportionate share payments
23 for hospital services provided by county operated
24 facilities within the County shall be no less than the
25 reimbursement rates in effect on June 1, 1992, except
26 that this minimum shall be adjusted as of July 1, 1992
27 and each July 1 thereafter by the annual percentage
28 change in the per diem cost of inpatient hospital
29 services as reported in the most recent annual Medicaid
30 cost report.
31 (b) The Illinois Department shall promptly seek all
32 appropriate amendments to the Illinois State Plan to effect
33 the foregoing payment methodology.
34 (c) The Illinois Department shall implement the changes
SB742 Enrolled -33- LRB093 03019 RCE 03036 b
1 made by Article 3 of this amendatory Act of 1992 beginning
2 October 1, 1992. All terms and conditions of the
3 disbursement of monies from the Fund not set forth expressly
4 in this Article shall be set forth in the agreement executed
5 under the Intergovernmental Cooperation Act so long as those
6 terms and conditions are not inconsistent with this Article
7 or applicable federal law. The Illinois Department shall
8 report in writing to the Hospital Service Procurement
9 Advisory Board and the Health Care Cost Containment Council
10 by October 15, 1992, the terms and conditions of all such
11 initial agreements and, where no such initial agreement has
12 yet been executed with a qualifying county, the Illinois
13 Department's reasons that each such initial agreement has not
14 been executed. Copies and reports of amended agreements
15 following the initial agreements shall likewise be filed by
16 the Illinois Department with the Hospital Service Procurement
17 Advisory Board and the Health Care Cost Containment Council
18 within 30 days following their execution. The foregoing
19 filing obligations of the Illinois Department are
20 informational only, to allow the Board and Council,
21 respectively, to better perform their public roles, except
22 that the Board or Council may, at its discretion, advise the
23 Illinois Department in the case of the failure of the
24 Illinois Department to reach agreement with any qualifying
25 county by the required date.
26 (d) The payments provided for herein are intended to
27 cover services rendered on and after July 1, 1991, and any
28 agreement executed between a qualifying county and the
29 Illinois Department pursuant to this Section may relate back
30 to that date, provided the Illinois Department obtains
31 federal approval. Any changes in payment rates resulting
32 from the provisions of Article 3 of this amendatory Act of
33 1992 are intended to apply to services rendered on or after
34 October 1, 1992, and any agreement executed between a
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1 qualifying county and the Illinois Department pursuant to
2 this Section may be effective as of that date.
3 (e) If one or more hospitals file suit in any court
4 challenging any part of this Article XV, payments to
5 hospitals from the Fund under this Article XV shall be made
6 only to the extent that sufficient monies are available in
7 the Fund and only to the extent that any monies in the Fund
8 are not prohibited from disbursement and may be disbursed
9 under any order of the court.
10 (f) All payments under this Section are contingent upon
11 federal approval of changes to the State plan, if that
12 approval is required.
13 (Source: P.A. 92-370, eff. 8-15-01.)
14 (305 ILCS 5/5-7 rep.)
15 Section 15-6. The Illinois Public Aid Code is amended by
16 repealing Section 5-7.
17 ARTICLE 20.
18 Section 20-5. The Alzheimer's Disease Assistance Act is
19 amended by changing Section 7 as follows:
20 (410 ILCS 405/7) (from Ch. 111 1/2, par. 6957)
21 Sec. 7. Regional ADA center fundinggrants-in-aid.
22 Pursuant to appropriations enacted by the General Assembly,
23 the Department shall provide fundsgrants-in-aid to hospitals
24 affiliated with each Regional ADA Center for necessary
25 research and for the development and maintenance of services
26 for victims of Alzheimer's disease and related disorders and
27 their families. For the fiscal year beginning July 1, 2003,
28 and each year thereafter, the Department shall effect
29 payments under this Section to hospitals affiliated with each
30 Regional ADA Center through the Illinois Department of Public
SB742 Enrolled -35- LRB093 03019 RCE 03036 b
1 Aid. The Department shall include the annual expenditures
2 for this purpose in the plan required by Section 5 of this
3 Act.in accordance with the State Alzheimer's Assistance
4 Plan. The first $2,000,000 of any grants-in-aid appropriated
5 by the General Assembly for Regional ADA Centers in any State
6 fiscal year shall be distributed in equal portions to those
7 Regional ADA Centers receiving the appropriated grants-in-aid
8 for the State fiscal year beginning July 1, 1996. The first
9 $400,000 appropriated by the General Assembly in excess of
10 $2,000,000 in any State fiscal year beginning on or after
11 July 1, 1997 shall be distributed in equal portions to those
12 Regional ADA Centers receiving the appropriated grants-in-aid
13 for the State fiscal year beginning July 1, 1996. Any monies
14 appropriated by the General Assembly in excess of $2,400,000
15 for any State fiscal year beginning on or after July 1, 1997
16 shall be distributed in equal portions to each Regional ADA
17 Center. The Department shall promulgate rules and procedures
18 governing the distribution and specific purposes for such
19 grants, including any contributions of recipients of services
20 toward the cost of care.
21 (Source: P.A. 90-404, eff. 8-15-97.)
22 ARTICLE 99.
23 Section 99-99. Effective date. This Act takes effect
24 upon becoming law.
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