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90_SB1420ham002
LRB9009801DJcdam03
1 AMENDMENT TO SENATE BILL 1420
2 AMENDMENT NO. . Amend Senate Bill 1420, AS AMENDED,
3 as follows:
4 by replacing everything after the enacting clause with the
5 following:
6 "Section 5. The Illinois Public Aid Code is amended by
7 changing Section 5-5.4 as follows:
8 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
9 Sec. 5-5.4. Standards of Payment - Department of Public
10 Aid. The Department of Public Aid shall develop standards of
11 payment of skilled nursing and intermediate care services in
12 facilities providing such services under this Article which:
13 (1) Provides for the determination of a facility's
14 payment for skilled nursing and intermediate care services on
15 a prospective basis. The amount of the payment rate for all
16 nursing facilities certified under the medical assistance
17 program shall be prospectively established annually on the
18 basis of historical, financial, and statistical data
19 reflecting actual costs from prior years, which shall be
20 applied to the current rate year and updated for inflation,
21 except that the capital cost element for newly constructed
-2- LRB9009801DJcdam03
1 facilities shall be based upon projected budgets. The
2 annually established payment rate shall take effect on July 1
3 in 1984 and subsequent years. Rate increases shall be
4 provided annually thereafter on July 1 in 1984 and on each
5 subsequent July 1 in the following years, except that no rate
6 increase and no update for inflation shall be provided on or
7 after July 1, 1994 except as otherwise may be provided for
8 herein. Rates established effective each July 1 shall govern
9 payment for services rendered throughout that fiscal year,
10 except that rates established on July 1, 1996 shall be
11 increased by 6.8% for services provided on or after January
12 1, 1997. Such rates will be based upon the rates calculated
13 for the year beginning July 1, 1990, and for subsequent years
14 thereafter shall be based on the facility cost reports for
15 the facility fiscal year ending at any point in time during
16 the previous calendar year, updated to the midpoint of the
17 rate year, except that rates established on July 1, 1998
18 shall be based on the facility cost reports on file with the
19 Department on April 1, 1997, updated to the midpoint of the
20 rate year, and reimbursement based upon those rates shall be
21 payable for services provided on or after October 1, 1998.
22 Effective October 1, 1998 the Department shall reimburse for
23 the actual cost of real estate taxes paid by the facility,
24 prorated for the facility's Medicaid census. The cost report
25 shall be on file with the Department no later than April 1 of
26 the current rate year. Should the cost report not be on file
27 by April 1, the Department shall base the rate on the latest
28 cost report filed by each skilled care facility and
29 intermediate care facility, updated to the midpoint of the
30 current rate year. In determining rates for services
31 rendered on and after July 1, 1985, fixed time shall not be
32 computed at less than zero. The Department shall not make
33 any alterations of regulations which would reduce any
34 component of the Medicaid rate to a level below what that
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1 component would have been utilizing in the rate effective on
2 July 1, 1984.
3 (2) Shall take into account the actual costs incurred by
4 facilities in providing services for recipients of skilled
5 nursing and intermediate care services under the medical
6 assistance program.
7 (3) Shall take into account the medical and
8 psycho-social characteristics and needs of the patients.
9 (4) Shall take into account the actual costs incurred by
10 facilities in meeting, licensing and certification standards
11 imposed and prescribed by the State of Illinois, any of its
12 political subdivisions or municipalities and by the United
13 States Department of Health, Education and Welfare pursuant
14 to Title XIX of the Social Security Act.
15 The Department of Public Aid shall develop precise
16 standards for payments to reimburse nursing facilities for
17 any utilization of appropriate rehabilitative personnel for
18 the provision of rehabilitative services which is authorized
19 by federal regulations, including reimbursement for services
20 provided by qualified therapists or qualified assistants, and
21 which is in accordance with accepted professional practices.
22 Reimbursement also may be made for utilization of other
23 supportive personnel under appropriate supervision.
24 (Source: P.A. 89-21, eff. 7-1-95; 89-499, eff. 6-28-96; 90-9,
25 eff. 7-1-97.)
26 Section 99. Effective date. This Act takes effect upon
27 becoming law.".