Public Act 0691 103RD GENERAL ASSEMBLY

 


 
Public Act 103-0691
 
HB5095 EnrolledLRB103 39315 CES 69469 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Nursing Home Care Act is amended by
changing Section 3-401.1 as follows:
 
    (210 ILCS 45/3-401.1)  (from Ch. 111 1/2, par. 4153-401.1)
    Sec. 3-401.1. (a) A facility participating in the Medical
Assistance Program is prohibited from failing or refusing to
retain as a resident any person because he or she is a
recipient of or an applicant for the Medical Assistance
Program.
    (a-5) A After the effective date of this amendatory Act of
1997, a facility of which only a distinct part is certified to
participate in the Medical Assistance Program may refuse to
retain as a resident any person who resides in a part of the
facility that does not participate in the Medical Assistance
Program and who is unable to pay for his or her care in the
facility without Medical Assistance only if:
        (1) the facility, no later than at the time of
    admission and at the time of the resident's contract
    renewal, explains to the resident (unless he or she is
    incompetent), and to the resident's representative, and to
    the person making payment on behalf of the resident for
    the resident's stay, in writing, that the facility may
    discharge the resident if the resident is no longer able
    to pay for his or her care in the facility without Medical
    Assistance;
        (2) the resident (unless he or she is incompetent),
    the resident's representative, and the person making
    payment on behalf of the resident for the resident's stay,
    acknowledge in writing that they have received the written
    explanation; .
        (3) in circumstances where the Medicare coverage is
    ending prior to the full 100-day benefit period, the
    facility provides notice to the resident and to the
    resident's representative that the resident's Medicare
    coverage will likely end in 5 days. This notification
    shall specify that the resident shall not be required to
    move under this Section until these 5 days are up. In cases
    where the facility is notified in a shorter time frame
    than 5 days by a managed care organization or the time
    frame is shorter than 5 days due to inaccurate reporting
    by an outside entity, the facility must provide a minimum
    of 2 days' notification.
    (a-10) For the purposes of this Section, a recipient or
applicant shall be considered a resident in the facility
during any hospital stay totaling 10 days or less following a
hospital admission. The Department of Healthcare and Family
Services shall recoup funds from a facility when, as a result
of the facility's refusal to readmit a recipient after
hospitalization for 10 days or less, the recipient incurs
hospital bills in an amount greater than the amount that would
have been paid by that Department (formerly the Illinois
Department of Public Aid) for care of the recipient in the
facility. The amount of the recoupment shall be the difference
between the Department of Healthcare and Family Services'
(formerly the Illinois Department of Public Aid's) payment for
hospital care and the amount that Department would have paid
for care in the facility.
    (b) A facility which violates this Section shall be guilty
of a business offense and fined not less than $500 nor more
than $1,000 for the first offense and not less than $1,000 nor
more than $5,000 for each subsequent offense.
(Source: P.A. 95-331, eff. 8-21-07.)