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| [ Introduced ] | [ Engrossed ] | [ House Amendment 002 ] |
91_SB1660ham001
LRB9109396WHcdam
1 AMENDMENT TO SENATE BILL 1660
2 AMENDMENT NO. . Amend Senate Bill 1660 on page 1,
3 line 2 by inserting after "5-16.3" the following:
4 "and changing Section 5-5.4"; and
5 on page 1, by inserting after line 7 the following:
6 "Section 10. 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
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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 and before July 1, 2000, unless
8 specifically provided for in this Section.
9 For all facilities that (i) are licensed by the
10 Department of Public Health under the Nursing Home Care Act
11 as Intermediate Care for the Developmentally Disabled
12 facilities, (ii) have a capacity of 100 or more beds, and
13 (iii) received a permit required under Sections 5 and 13.1 of
14 the Illinois Health Facilities Planning Act after July 1,
15 1994, the capital cost element of the rates shall be
16 increased to reimburse 100% of the permit amount set forth in
17 the permit issued by the Illinois Health Facilities Planning
18 Board and actually incurred. Subject to appropriation, the
19 increase shall take effect on the date the permitted
20 structure is licensed or the permitted equipment is
21 installed. If that date is before the effective date of this
22 amendatory Act of the 91st General Assembly, the increase
23 shall be retroactive to that date of licensure or
24 installation and the total rate shall be adjusted to
25 incorporate all rate increases taking effect after that date.
26 For facilities licensed by the Department of Public
27 Health under the Nursing Home Care Act as Intermediate Care
28 for the Developmentally Disabled facilities or Long Term Care
29 for Under Age 22 facilities, the rates taking effect on July
30 1, 1998 shall include an increase of 3%. For facilities
31 licensed by the Department of Public Health under the Nursing
32 Home Care Act as Skilled Nursing facilities or Intermediate
33 Care facilities, the rates taking effect on July 1, 1998
34 shall include an increase of 3% plus $1.10 per resident-day,
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1 as defined by the Department.
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, 1999 shall include an increase of 1.6% plus $3.00 per
7 resident-day, as defined by the Department. For facilities
8 licensed by the Department of Public Health under the Nursing
9 Home Care Act as Skilled Nursing facilities or Intermediate
10 Care facilities, the rates taking effect on July 1, 1999
11 shall include an increase of 1.6% and, for services provided
12 on or after October 1, 1999, shall be increased by $4.00 per
13 resident-day, as defined by the Department.
14 Rates established effective each July 1 shall govern
15 payment for services rendered throughout that fiscal year,
16 except that rates established on July 1, 1996 shall be
17 increased by 6.8% for services provided on or after January
18 1, 1997. 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.
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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. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24,
23 eff. 7-1-99.)
24 Section 99. Effective date. Section 10 and this Section
25 take effect on July 1, 2000.".