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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, 2002 July 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.
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