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92_SB0608eng SB608 Engrossed LRB9203291DJgc 1 AN ACT in relation to public aid. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Illinois Public Aid Code is amended by 5 changing Section 5-5.4 as follows: 6 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4) 7 Sec. 5-5.4. Standards of Payment - Department of Public 8 Aid. The Department of Public Aid shall develop standards of 9 payment of skilled nursing and intermediate care services in 10 facilities providing such services under this Article which: 11 (1) Provides for the determination of a facility's 12 payment for skilled nursing and intermediate care services on 13 a prospective basis. The amount of the payment rate for all 14 nursing facilities certified under the medical assistance 15 program shall be prospectively established annually on the 16 basis of historical, financial, and statistical data 17 reflecting actual costs from prior years, which shall be 18 applied to the current rate year and updated for inflation, 19 except that the capital cost element for newly constructed 20 facilities shall be based upon projected budgets. The 21 annually established payment rate shall take effect on July 1 22 in 1984 and subsequent years. Rate increases shall be 23 provided annually thereafter on July 1 in 1984 and on each 24 subsequent July 1 in the following years, except that no rate 25 increase and no update for inflation shall be provided on or 26 after July 1, 1994 and before July 1, 2002July 1, 2001, 27 unless specifically provided for in this Section. 28 For facilities licensed by the Department of Public 29 Health under the Nursing Home Care Act as Intermediate Care 30 for the Developmentally Disabled facilities or Long Term Care 31 for Under Age 22 facilities, the rates taking effect on July SB608 Engrossed -2- LRB9203291DJgc 1 1, 1998 shall include an increase of 3%. For facilities 2 licensed by the Department of Public Health under the Nursing 3 Home Care Act as Skilled Nursing facilities or Intermediate 4 Care facilities, the rates taking effect on July 1, 1998 5 shall include an increase of 3% plus $1.10 per resident-day, 6 as defined by the Department. 7 For facilities licensed by the Department of Public 8 Health under the Nursing Home Care Act as Intermediate Care 9 for the Developmentally Disabled facilities or Long Term Care 10 for Under Age 22 facilities, the rates taking effect on July 11 1, 1999 shall include an increase of 1.6% plus $3.00 per 12 resident-day, as defined by the Department. For facilities 13 licensed by the Department of Public Health under the Nursing 14 Home Care Act as Skilled Nursing facilities or Intermediate 15 Care facilities, the rates taking effect on July 1, 1999 16 shall include an increase of 1.6% and, for services provided 17 on or after October 1, 1999, shall be increased by $4.00 per 18 resident-day, as defined by the Department. 19 For facilities licensed by the Department of Public 20 Health under the Nursing Home Care Act as Intermediate Care 21 for the Developmentally Disabled facilities or Long Term Care 22 for Under Age 22 facilities, the rates taking effect on July 23 1, 2000 shall include an increase of 2.5% per resident-day, 24 as defined by the Department. For facilities licensed by the 25 Department of Public Health under the Nursing Home Care Act 26 as Skilled Nursing facilities or Intermediate Care 27 facilities, the rates taking effect on July 1, 2000 shall 28 include an increase of 2.5% per resident-day, as defined by 29 the Department. 30 For facilities licensed by the Department of Public 31 Health under the Nursing Home Care Act as skilled nursing 32 facilities or intermediate care facilities, the rates taking 33 effect on July 1, 2001, and each subsequent year thereafter, 34 shall be computed using the most recent cost reports on file SB608 Engrossed -3- LRB9203291DJgc 1 with the Department of Public Aid no later than April 1, 2000 2 updated for inflation to January 1, 2001. For rates 3 effective July 1, 2001 only, rates shall be the greater of 4 the rate computed for July 1, 2001 or the rate effective on 5 June 30, 2001. 6 Rates established effective each July 1 shall govern 7 payment for services rendered throughout that fiscal year, 8 except that rates established on July 1, 1996 shall be 9 increased by 6.8% for services provided on or after January 10 1, 1997. Such rates will be based upon the rates calculated 11 for the year beginning July 1, 1990, and for subsequent years 12 thereafter until June 30, 2001 shall be based on the facility 13 cost reports for the facility fiscal year ending at any point 14 in time during the previous calendar year, updated to the 15 midpoint of the rate year. The cost report shall be on file 16 with the Department no later than April 1 of the current rate 17 year. Should the cost report not be on file by April 1, the 18 Department shall base the rate on the latest cost report 19 filed by each skilled care facility and intermediate care 20 facility, updated to the midpoint of the current rate year. 21 In determining rates for services rendered on and after July 22 1, 1985, fixed time shall not be computed at less than zero. 23 The Department shall not make any alterations of regulations 24 which would reduce any component of the Medicaid rate to a 25 level below what that component would have been utilizing in 26 the rate effective on July 1, 1984. 27 (2) Shall take into account the actual costs incurred by 28 facilities in providing services for recipients of skilled 29 nursing and intermediate care services under the medical 30 assistance program. 31 (3) Shall take into account the medical and 32 psycho-social characteristics and needs of the patients. 33 (4) Shall take into account the actual costs incurred by 34 facilities in meeting licensing and certification standards SB608 Engrossed -4- LRB9203291DJgc 1 imposed and prescribed by the State of Illinois, any of its 2 political subdivisions or municipalities and by the U.S. 3 Department of Health and Human Services pursuant to Title XIX 4 of the Social Security Act. 5 The Department of Public Aid shall develop precise 6 standards for payments to reimburse nursing facilities for 7 any utilization of appropriate rehabilitative personnel for 8 the provision of rehabilitative services which is authorized 9 by federal regulations, including reimbursement for services 10 provided by qualified therapists or qualified assistants, and 11 which is in accordance with accepted professional practices. 12 Reimbursement also may be made for utilization of other 13 supportive personnel under appropriate supervision. 14 (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24, 15 eff. 7-1-99; 91-712, eff. 7-1-00.) 16 Section 99. Effective date. This Act takes effect upon 17 becoming law.