Public Act 098-1166
 
SB3171 EnrolledLRB098 18157 KTG 53286 b


  
    AN ACT concerning public aid.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  

  
 
    Section 5. The Illinois Public Aid Code is amended  by 
changing Section 5-5e as follows:
 
    (305 ILCS 5/5-5e)
    Sec. 5-5e. Adjusted rates of reimbursement. 
    (a) Rates or payments for services in effect on June 30, 
2012 shall be adjusted and
services shall be affected as 
required by any other provision of this amendatory Act of
the 
97th General Assembly. In addition, the Department shall do the 
following: 
        (1) Delink the per diem rate paid for supportive living 
    facility services from the per diem rate paid for nursing 
    facility services, effective for services provided on or 
    after May 1, 2011.
        (2) Cease payment for bed reserves in nursing 
    facilities and specialized mental health rehabilitation 
    facilities; for purposes of therapeutic home visits for  
    individuals scoring as TBI on the MDS 3.0, beginning June 
    1, 2015, the Department shall approve payments for bed 
    reserves in nursing facilities and specialized mental 
    health rehabilitation facilities that have at least a 90% 
    occupancy level and at least 80% of their residents are 
    Medicaid eligible. Payment shall be at a daily rate of 75% 
    of an individual's current Medicaid per diem and shall not 
    exceed 10 days in a calendar month.
        (2.5) Cease payment for bed reserves for purposes of 
    inpatient hospitalizations to intermediate care facilities 
    for persons with development disabilities, except in the 
    instance of residents who are under 21 years of age. 
        (3) Cease payment of the $10 per day add-on payment to 
    nursing facilities for certain residents with 
    developmental disabilities.
    (b) After the application of subsection (a), 
notwithstanding any other provision of this
Code to the 
contrary and to the extent permitted by federal law, on and 
after July 1,
2012, the rates of reimbursement for services and 
other payments provided under this
Code shall further be 
reduced as follows: 
        (1) Rates or payments for physician services, dental 
    services, or community health center services reimbursed 
    through an encounter rate, and services provided under the 
    Medicaid Rehabilitation Option of the Illinois Title XIX 
    State Plan shall not be further reduced. 
        (2) Rates or payments, or the portion thereof, paid to 
    a provider that is operated by a  unit of local government 
    or State University that provides the non-federal share of 
    such services shall not be further reduced. 
        (3) Rates or payments for hospital services delivered 
    by a hospital defined as a Safety-Net Hospital under 
    Section 5-5e.1 of this Code shall not be further reduced. 
        (4) Rates or payments for hospital services delivered 
    by a Critical Access Hospital, which is an Illinois 
    hospital designated as a critical care hospital by the 
    Department of Public Health in accordance with 42 CFR 485, 
    Subpart F, shall not be further reduced. 
        (5) Rates or payments for Nursing Facility Services 
    shall only be further adjusted pursuant to Section 5-5.2 of 
    this Code. 
        (6) Rates or payments for services delivered by long 
    term care facilities licensed under the ID/DD Community 
    Care Act and developmental training services shall not be 
    further reduced. 
        (7) Rates or payments for services provided under 
    capitation rates shall be adjusted taking into 
    consideration the rates reduction and covered services 
    required by this amendatory Act of the 97th General 
    Assembly. 
        (8) For hospitals not previously described in this 
    subsection, the rates or payments for hospital services 
    shall be further reduced by 3.5%, except for payments 
    authorized under Section 5A-12.4 of this Code. 
        (9) For all other rates or payments for services 
    delivered by providers not specifically referenced in 
    paragraphs (1) through (8), rates or payments shall be 
    further reduced by 2.7%. 
    (c) Any assessment imposed by this Code shall continue and 
nothing in this Section shall be construed to cause it to 
cease. 

    (d) Notwithstanding any other provision of this Code to the 
contrary, subject to federal approval under Title XIX of the 
Social Security Act, for dates of service on and after July 1, 
2014, rates or payments for services provided for the purpose 
of transitioning children from a hospital to home placement or 
other appropriate setting by a children's community-based 
health care center authorized under the Alternative Health Care 
Delivery Act shall be $683 per day. 
    (e) Notwithstanding any other provision of this Code to the 
contrary, subject to federal approval under Title XIX of the 
Social Security Act, for dates of service on and after July 1, 
2014, rates or payments for home health visits shall be $72. 
    (f)  Notwithstanding any other provision of this Code to the 
contrary, subject to federal approval under Title XIX of the 
Social Security Act, for dates of service on and after July 1, 
2014, rates or payments for the certified nursing assistant 
component of the home health agency rate shall be $20. 
(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13; 
98-651, eff. 6-16-14.)
 
 
    Section 99. Effective date. This Act takes effect June 1, 
2015.