State of Illinois
91st General Assembly

   [ Search ]   [ Legislation ]
[ Home ]   [ Back ]   [ Bottom ]

[ Introduced ]


SB668 Engrossed                                LRB9104110DJcd

 1        AN  ACT to amend the Illinois Public Aid Code by changing
 2    Section 5-5.4.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section   5.   The Illinois Public Aid Code is amended by
 6    changing Section 5-5.4 as follows:

 7        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 8        Sec. 5-5.4.  Standards of Payment - Department of  Public
 9    Aid.  The Department of Public Aid shall develop standards of
10    payment  of skilled nursing and intermediate care services in
11    facilities providing such services under this Article which:
12        (1)  Provides  for  the  determination  of  a  facility's
13    payment for skilled nursing and intermediate care services on
14    a prospective basis.  The amount of the payment rate for  all
15    nursing  facilities  certified  under  the medical assistance
16    program shall be prospectively established  annually  on  the
17    basis   of   historical,   financial,  and  statistical  data
18    reflecting actual costs from  prior  years,  which  shall  be
19    applied  to  the current rate year and updated for inflation,
20    except that the capital cost element  for  newly  constructed
21    facilities  shall  be  based  upon  projected  budgets.   The
22    annually established payment rate shall take effect on July 1
23    in  1984  and  subsequent  years.   Rate  increases  shall be
24    provided annually thereafter on July 1 in 1984  and  on  each
25    subsequent July 1 in the following years, except that no rate
26    increase  and no update for inflation shall be provided on or
27    after  July  1,  1994  and  before  July  1,   1999,   unless
28    specifically  provided  for  in this Section.  For facilities
29    licensed by the Department of Public Health under the Nursing
30    Home Care Act as Intermediate Care  for  the  Developmentally
31    Disabled  facilities  or  Long  Term  Care  for  Under Age 22
SB668 Engrossed             -2-                LRB9104110DJcd
 1    facilities, the rates taking effect on  July  1,  1998  shall
 2    include  an  increase  of 3%.  For facilities licensed by the
 3    Department of Public Health under the Nursing Home  Care  Act
 4    as   Skilled   Nursing   facilities   or   Intermediate  Care
 5    facilities, the rates taking effect on  July  1,  1998  shall
 6    include  an  increase  of  3% plus $1.10 per resident-day, as
 7    defined by the Department.  Rates established effective  each
 8    July  1 shall govern payment for services rendered throughout
 9    that fiscal year, except that rates established  on  July  1,
10    1996  shall  be increased by 6.8% for services provided on or
11    after January 1, 1997, and except that for  those  facilities
12    with  rates  less  than  the  actual,  audited  costs,  rates
13    established  on  July  1,  1999 shall be increased to no less
14    than the  lower  of  the  average  costs  in  the  facility's
15    geographic   area   as  defined  by  the  Department  or  the
16    facility's actual audited, adjusted costs.  In no case  shall
17    a  facility's  July  1, 1999 rate be less than its January 1,
18    1998 rate. Such rates will be based upon the rates calculated
19    for the year beginning July 1, 1990, and for subsequent years
20    thereafter shall be based on the facility  cost  reports  for
21    the  facility  fiscal year ending at any point in time during
22    the previous calendar year, updated to the  midpoint  of  the
23    rate  year.   The  cost  report  shall  be  on  file with the
24    Department no later than April 1 of the  current  rate  year.
25    Should  the  cost  report  not  be  on  file  by April 1, the
26    Department shall base the rate  on  the  latest  cost  report
27    filed  by  each  skilled  care facility and intermediate care
28    facility, updated to the midpoint of the current  rate  year.
29    In  determining rates for services rendered on and after July
30    1, 1985, fixed time shall not be computed at less than  zero.
31    The  Department shall not make any alterations of regulations
32    which would reduce any component of the Medicaid  rate  to  a
33    level  below what that component would have been utilizing in
34    the rate effective on July 1, 1984.
SB668 Engrossed             -3-                LRB9104110DJcd
 1        (2)  Shall take into account the actual costs incurred by
 2    facilities in providing services for  recipients  of  skilled
 3    nursing  and  intermediate  care  services  under the medical
 4    assistance program.
 5        (3)  Shall   take   into   account   the   medical    and
 6    psycho-social characteristics and needs of the patients.
 7        (4)  Shall take into account the actual costs incurred by
 8    facilities  in  meeting licensing and certification standards
 9    imposed and prescribed by the State of Illinois, any  of  its
10    political  subdivisions  or  municipalities and by the United
11    States Department of Health, Education and  Welfare  pursuant
12    to Title XIX of the Social Security Act.
13        The  Department  of  Public  Aid  shall  develop  precise
14    standards  for  payments  to reimburse nursing facilities for
15    any utilization of appropriate rehabilitative  personnel  for
16    the  provision of rehabilitative services which is authorized
17    by federal regulations, including reimbursement for  services
18    provided by qualified therapists or qualified assistants, and
19    which  is in accordance with accepted professional practices.
20    Reimbursement also may  be  made  for  utilization  of  other
21    supportive personnel under appropriate supervision.
22    (Source: P.A. 89-21, eff. 7-1-95; 89-499, eff. 6-28-96; 90-9,
23    eff. 7-1-97; 90-588, eff. 7-1-98.)

24        Section  99.  Effective date.  This Act takes effect July
25    1, 1999.

[ Top ]