HB0542 Enrolled LRB096 03750 DRJ 13780 b
1		AN ACT concerning public aid.
2		Be it enacted by the People of the State of Illinois,
3		represented in the General Assembly:
4		Section 5. The Excellence in Academic Medicine Act is
5		amended by changing Sections 25, 30, and 35 as follows:
6		(30 ILCS 775/25)
7		Sec. 25. Medical research and development challenge
8		program.
9		(a) The State shall provide the following financial
10		incentives to draw private and federal funding for biomedical
11		research, technology and programmatic development:
12		(1) Each qualified Chicago Medicare Metropolitan
13		Statistical Area academic medical center hospital shall
14		receive a percentage of the amount available for
15		distribution from the National Institutes of Health
16		Account, equal to that hospital's percentage of the total
17		contracts and grants from the National Institutes of Health
18		awarded to qualified Chicago Medicare Metropolitan
19		Statistical Area academic medical center hospitals and
20		their affiliated medical schools during the preceding
21		calendar year. These amounts shall be paid from the
22		National Institutes of Health Account.
23		(2) Each qualified Chicago Medicare Metropolitan

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1		Statistical Area academic medical center hospital shall
2		receive a payment from the State equal to 25% of all funded
3		grants (other than grants funded by the State of Illinois
4		or the National Institutes of Health) for biomedical
5		research, technology, or programmatic development received
6		by that qualified Chicago Medicare Metropolitan
7		Statistical Area academic medical center hospital during
8		the preceding calendar year. These amounts shall be paid
9		from the Philanthropic Medical Research Account.
10		(3) Each qualified Chicago Medicare Metropolitan
11		Statistical Area academic medical center hospital that (i)
12		contributes 40% of the funding for a biomedical research or
13		technology project or a programmatic development project
14		and (ii) obtains contributions from the private sector
15		equal to 40% of the funding for the project shall receive
16		from the State an amount equal to 20% of the funding for
17		the project upon submission of documentation demonstrating
18		those facts to the Comptroller; however, the State shall
19		not be required to make the payment unless the contribution
20		of the qualified Chicago Medicare Metropolitan Statistical
21		Area academic medical center hospital exceeds $100,000.
22		The documentation must be submitted within 180 days of the
23		beginning of the fiscal year. These amounts shall be paid
24		from the Market Medical Research Account.
25		(b) No hospital under the Medical Research and Development
26		Challenge Program shall receive more than 20% of the total

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1		amount appropriated to the Medical Research and Development
2		Fund.
3		The amounts received under the Medical Research and
4		Development Challenge Program by the Southern Illinois
5		University School of Medicine in Springfield and its affiliated
6		primary teaching hospitals, considered as a single entity,
7		shall not exceed an amount equal to one-sixth of the total
8		amount available for distribution from the Medical Research and
9		Development Fund, multiplied by a fraction, the numerator of
10		which is the amount awarded the Southern Illinois University
11		School of Medicine and its affiliated teaching hospitals in
12		grants or contracts by the National Institutes of Health and
13		the denominator of which is $8,000,000.
14		(c) On or after the 180th day of the fiscal year the
15		Comptroller may transfer unexpended funds in any account of the
16		Medical Research and Development Fund to pay appropriate claims
17		against another account.
18		(d) The amounts due each qualified Chicago Medicare
19		Metropolitan Statistical Area academic medical center hospital
20		under the Medical Research and Development Fund from the
21		National Institutes of Health Account, the Philanthropic
22		Medical Research Account, and the Market Medical Research
23		Account shall be combined and one quarter of the amount payable
24		to each qualified Chicago Medicare Metropolitan Statistical
25		Area academic medical center hospital shall be paid on the
26		fifteenth working day after July 1, October 1, January 1, and

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1		March 1 or on a schedule determined by the Department of
2		Healthcare and Family Services by rule that results in a more
3		expeditious payment of the amounts due.
4		(e) The Southern Illinois University School of Medicine in
5		Springfield and its affiliated primary teaching hospitals,
6		considered as a single entity, shall be deemed to be a
7		qualified Chicago Medicare Metropolitan Statistical Area
8		academic medical center hospital for the purposes of this
9		Section.
10		(f) In each State fiscal year, beginning in fiscal year
11		2008, the full amount appropriated for the Medical research and
12		development challenge program for that fiscal year shall be
13		distributed as described in this Section.
14		(Source: P.A. 95-744, eff. 7-18-08.)
15		(30 ILCS 775/30)
16		Sec. 30. Post-Tertiary Clinical Services Program. The
17		State shall provide incentives to develop and enhance
18		post-tertiary clinical services. Qualified academic medical
19		center hospitals as defined in Section 15 may receive funding
20		under the Post-Tertiary Clinical Services Program for up to 3
21		qualified programs as defined in Section 15 in any given year;
22		however, qualified academic medical center hospitals may
23		receive continued funding for previously funded qualified
24		programs rather than receive funding for a new program so long
25		as the number of qualified programs receiving funding does not

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1		exceed 3. Each qualified academic medical center hospital as
2		defined in Section 15 shall receive an equal percentage of the
3		Post-Tertiary Clinical Services Fund to be used in the funding
4		of qualified programs. In each State fiscal year, beginning in
5		fiscal year 2008, the full amount appropriated for the
6		Post-Tertiary Clinical Services Program for that fiscal year
7		shall be distributed as described in this Section. One quarter
8		of the amount payable to each qualified academic medical center
9		hospital shall be paid on the fifteenth working day after July
10		1, October 1, January 1, and March 1 or on a schedule
11		determined by the Department of Healthcare and Family Services
12		by rule that results in a more expeditious payment of the
13		amounts due.
14		(Source: P.A. 95-744, eff. 7-18-08.)
15		(30 ILCS 775/35)
16		Sec. 35. Independent Academic Medical Center Program.
17		There is created an Independent Academic Medical Center Program
18		to provide incentives to develop and enhance the independent
19		academic medical center hospital. In each State fiscal year,
20		beginning in fiscal year 2002, the independent academic medical
21		center hospital shall receive funding under the Program, equal
22		to the full amount appropriated for that purpose for that
23		fiscal year. In each fiscal year, one quarter of the amount
24		payable to the independent academic medical center hospital
25		shall be paid on the fifteenth working day after July 1,

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1		October 1, January 1, and March 1 or on a schedule determined
2		by the Department of Healthcare and Family Services by rule
3		that results in a more expeditious payment of the amounts due.
4		(Source: P.A. 92-10, eff. 6-11-01.)
5		Section 10. The Illinois Public Aid Code is amended by
6		changing Sections 5A-4, 5A-8, 5A-12.2, and 5A-14 and by adding
7		Section 5A-12.3 as follows:
8		(305 ILCS 5/5A-4) (from Ch. 23, par. 5A-4)
9		Sec. 5A-4. Payment of assessment; penalty.
10		(a) The annual assessment imposed by Section 5A-2 for State
11		fiscal year 2004 shall be due and payable on June 18 of the
12		year. The assessment imposed by Section 5A-2 for State fiscal
13		year 2005 shall be due and payable in quarterly installments,
14		each equalling one-fourth of the assessment for the year, on
15		July 19, October 19, January 18, and April 19 of the year. The
16		assessment imposed by Section 5A-2 for State fiscal years 2006
17		through 2008 shall be due and payable in quarterly
18		installments, each equaling one-fourth of the assessment for
19		the year, on the fourteenth State business day of September,
20		December, March, and May. Except as provided in subsection
21		(a-5) of this Section, the The assessment imposed by Section
22		5A-2 for State fiscal year 2009 and each subsequent State
23		fiscal year shall be due and payable in monthly installments,
24		each equaling one-twelfth of the assessment for the year, on

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1		the fourteenth State business day of each month. No installment
2		payment of an assessment imposed by Section 5A-2 shall be due
3		and payable, however, until after: (i) the Department notifies
4		the hospital provider, in writing, that the payment
5		methodologies to hospitals required under Section 5A-12,
6		Section 5A-12.1, or Section 5A-12.2, whichever is applicable
7		for that fiscal year, have been approved by the Centers for
8		Medicare and Medicaid Services of the U.S. Department of Health
9		and Human Services and the waiver under 42 CFR 433.68 for the
10		assessment imposed by Section 5A-2, if necessary, has been
11		granted by the Centers for Medicare and Medicaid Services of
12		the U.S. Department of Health and Human Services; and (ii) the
13		Comptroller has issued the payments required under Section
14		5A-12, Section 5A-12.1, or Section 5A-12.2, whichever is
15		applicable for that fiscal year. Upon notification to the
16		Department of approval of the payment methodologies required
17		under Section 5A-12, Section 5A-12.1, or Section 5A-12.2,
18		whichever is applicable for that fiscal year, and the waiver
19		granted under 42 CFR 433.68, all installments otherwise due
20		under Section 5A-2 prior to the date of notification shall be
21		due and payable to the Department upon written direction from
22		the Department and issuance by the Comptroller of the payments
23		required under Section 5A-12.1 or Section 5A-12.2, whichever is
24		applicable for that fiscal year.
25		(a-5) The Illinois Department may, for the purpose of
26		maximizing federal revenue, accelerate the schedule upon which

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1		assessment installments are due and payable by hospitals with a
2		payment ratio greater than or equal to one. Such acceleration
3		of due dates for payment of the assessment may be made only in
4		conjunction with a corresponding acceleration in access
5		payments identified in Section 5A-12.2 to the same hospitals.
6		For the purposes of this subsection (a-5), a hospital's payment
7		ratio is defined as the quotient obtained by dividing the total
8		payments for the State fiscal year, as authorized under Section
9		5A-12.2, by the total assessment for the State fiscal year
10		imposed under Section 5A-2.
11		(b) The Illinois Department is authorized to establish
12		delayed payment schedules for hospital providers that are
13		unable to make installment payments when due under this Section
14		due to financial difficulties, as determined by the Illinois
15		Department.
16		(c) If a hospital provider fails to pay the full amount of
17		an installment when due (including any extensions granted under
18		subsection (b)), there shall, unless waived by the Illinois
19		Department for reasonable cause, be added to the assessment
20		imposed by Section 5A-2 a penalty assessment equal to the
21		lesser of (i) 5% of the amount of the installment not paid on
22		or before the due date plus 5% of the portion thereof remaining
23		unpaid on the last day of each 30-day period thereafter or (ii)
24		100% of the installment amount not paid on or before the due
25		date. For purposes of this subsection, payments will be
26		credited first to unpaid installment amounts (rather than to

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1		penalty or interest), beginning with the most delinquent
2		installments.
3		(d) Any assessment amount that is due and payable to the
4		Illinois Department more frequently than once per calendar
5		quarter shall be remitted to the Illinois Department by the
6		hospital provider by means of electronic funds transfer. The
7		Illinois Department may provide for remittance by other means
8		if (i) the amount due is less than $10,000 or (ii) electronic
9		funds transfer is unavailable for this purpose.
10		(Source: P.A. 94-242, eff. 7-18-05; 95-331, eff. 8-21-07;
11		95-859, eff. 8-19-08.)
12		(305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
13		Sec. 5A-8. Hospital Provider Fund.
14		(a) There is created in the State Treasury the Hospital
15		Provider Fund. Interest earned by the Fund shall be credited to
16		the Fund. The Fund shall not be used to replace any moneys
17		appropriated to the Medicaid program by the General Assembly.
18		(b) The Fund is created for the purpose of receiving moneys
19		in accordance with Section 5A-6 and disbursing moneys only for
20		the following purposes, notwithstanding any other provision of
21		law:
22		(1) For making payments to hospitals as required under
23		Articles V, V-A, VI, and XIV of this Code, under the
24		Children's Health Insurance Program Act, and under the
25		Covering ALL KIDS Health Insurance Act, and under the

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1		Senior Citizens and Disabled Persons Property Tax Relief
2		and Pharmaceutical Assistance Act.
3		(2) For the reimbursement of moneys collected by the
4		Illinois Department from hospitals or hospital providers
5		through error or mistake in performing the activities
6		authorized under this Article and Article V of this Code.
7		(3) For payment of administrative expenses incurred by
8		the Illinois Department or its agent in performing the
9		activities authorized by this Article.
10		(4) For payments of any amounts which are reimbursable
11		to the federal government for payments from this Fund which
12		are required to be paid by State warrant.
13		(5) For making transfers, as those transfers are
14		authorized in the proceedings authorizing debt under the
15		Short Term Borrowing Act, but transfers made under this
16		paragraph (5) shall not exceed the principal amount of debt
17		issued in anticipation of the receipt by the State of
18		moneys to be deposited into the Fund.
19		(6) For making transfers to any other fund in the State
20		treasury, but transfers made under this paragraph (6) shall
21		not exceed the amount transferred previously from that
22		other fund into the Hospital Provider Fund.
23		(6.5) For making transfers to the Healthcare Provider
24		Relief Fund, except that transfers made under this
25		paragraph (6.5) shall not exceed $60,000,000 in the
26		aggregate.

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1		(7) For State fiscal years 2004 and 2005 for making
2		transfers to the Health and Human Services Medicaid Trust
3		Fund, including 20% of the moneys received from hospital
4		providers under Section 5A-4 and transferred into the
5		Hospital Provider Fund under Section 5A-6. For State fiscal
6		year 2006 for making transfers to the Health and Human
7		Services Medicaid Trust Fund of up to $130,000,000 per year
8		of the moneys received from hospital providers under
9		Section 5A-4 and transferred into the Hospital Provider
10		Fund under Section 5A-6. Transfers under this paragraph
11		shall be made within 7 days after the payments have been
12		received pursuant to the schedule of payments provided in
13		subsection (a) of Section 5A-4.
14		(7.5) For State fiscal year 2007 for making transfers
15		of the moneys received from hospital providers under
16		Section 5A-4 and transferred into the Hospital Provider
17		Fund under Section 5A-6 to the designated funds not
18		exceeding the following amounts in that State fiscal year:
19		Health and Human Services
20		Medicaid Trust Fund................. $20,000,000
21		Long-Term Care Provider Fund............ $30,000,000
22		General Revenue Fund................... $80,000,000.
23		Transfers under this paragraph shall be made within 7
24		days after the payments have been received pursuant to the
25		schedule of payments provided in subsection (a) of Section
26		5A-4.

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1		(7.8) For State fiscal year 2008, for making transfers
2		of the moneys received from hospital providers under
3		Section 5A-4 and transferred into the Hospital Provider
4		Fund under Section 5A-6 to the designated funds not
5		exceeding the following amounts in that State fiscal year:
6		Health and Human Services
7		Medicaid Trust Fund..................$40,000,000
8		Long-Term Care Provider Fund..............$60,000,000
9		General Revenue Fund...................$160,000,000.
10		Transfers under this paragraph shall be made within 7
11		days after the payments have been received pursuant to the
12		schedule of payments provided in subsection (a) of Section
13		5A-4.
14		(7.9) For State fiscal years 2009 through 2013, for
15		making transfers of the moneys received from hospital
16		providers under Section 5A-4 and transferred into the
17		Hospital Provider Fund under Section 5A-6 to the designated
18		funds not exceeding the following amounts in that State
19		fiscal year:
20		Health and Human Services
21		Medicaid Trust Fund...................$20,000,000
22		Long Term Care Provider Fund..............$30,000,000
23		General Revenue Fund.....................$80,000,000.
24		Except as provided under this paragraph, transfers
25		under this paragraph shall be made within 7 business days
26		after the payments have been received pursuant to the

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1		schedule of payments provided in subsection (a) of Section
2		5A-4. For State fiscal year 2009, transfers to the General
3		Revenue Fund under this paragraph shall be made on or
4		before June 30, 2009, as sufficient funds become available
5		in the Hospital Provider Fund to both make the transfers
6		and continue hospital payments.
7		(8) For making refunds to hospital providers pursuant
8		to Section 5A-10.
9		Disbursements from the Fund, other than transfers
10		authorized under paragraphs (5) and (6) of this subsection,
11		shall be by warrants drawn by the State Comptroller upon
12		receipt of vouchers duly executed and certified by the Illinois
13		Department.
14		(c) The Fund shall consist of the following:
15		(1) All moneys collected or received by the Illinois
16		Department from the hospital provider assessment imposed
17		by this Article.
18		(2) All federal matching funds received by the Illinois
19		Department as a result of expenditures made by the Illinois
20		Department that are attributable to moneys deposited in the
21		Fund.
22		(3) Any interest or penalty levied in conjunction with
23		the administration of this Article.
24		(4) Moneys transferred from another fund in the State
25		treasury.
26		(5) All other moneys received for the Fund from any

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1		other source, including interest earned thereon.
2		(d) (Blank).
3		(Source: P.A. 95-707, eff. 1-11-08; 95-859, eff. 8-19-08; 96-3,
4		eff. 2-27-09; 96-45, eff. 7-15-09.)
5		(305 ILCS 5/5A-12.2)
6		(Section scheduled to be repealed on July 1, 2013)
7		Sec. 5A-12.2. Hospital access payments on or after July 1,
8		2008.
9		(a) To preserve and improve access to hospital services,
10		for hospital services rendered on or after July 1, 2008, the
11		Illinois Department shall, except for hospitals described in
12		subsection (b) of Section 5A-3, make payments to hospitals as
13		set forth in this Section. These payments shall be paid in 12
14		equal installments on or before the seventh State business day
15		of each month, except that no payment shall be due within 100
16		days after the later of the date of notification of federal
17		approval of the payment methodologies required under this
18		Section or any waiver required under 42 CFR 433.68, at which
19		time the sum of amounts required under this Section prior to
20		the date of notification is due and payable. Payments under
21		this Section are not due and payable, however, until (i) the
22		methodologies described in this Section are approved by the
23		federal government in an appropriate State Plan amendment and
24		(ii) the assessment imposed under this Article is determined to
25		be a permissible tax under Title XIX of the Social Security

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1		Act.
2		(a-5) The Illinois Department may, when practicable,
3		accelerate the schedule upon which payments authorized under
4		this Section are made.
5		(b) Across-the-board inpatient adjustment.
6		(1) In addition to rates paid for inpatient hospital
7		services, the Department shall pay to each Illinois general
8		acute care hospital an amount equal to 40% of the total
9		base inpatient payments paid to the hospital for services
10		provided in State fiscal year 2005.
11		(2) In addition to rates paid for inpatient hospital
12		services, the Department shall pay to each freestanding
13		Illinois specialty care hospital as defined in 89 Ill. Adm.
14		Code 149.50(c)(1), (2), or (4) an amount equal to 60% of
15		the total base inpatient payments paid to the hospital for
16		services provided in State fiscal year 2005.
17		(3) In addition to rates paid for inpatient hospital
18		services, the Department shall pay to each freestanding
19		Illinois rehabilitation or psychiatric hospital an amount
20		equal to $1,000 per Medicaid inpatient day multiplied by
21		the increase in the hospital's Medicaid inpatient
22		utilization ratio (determined using the positive
23		percentage change from the rate year 2005 Medicaid
24		inpatient utilization ratio to the rate year 2007 Medicaid
25		inpatient utilization ratio, as calculated by the
26		Department for the disproportionate share determination).

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1		(4) In addition to rates paid for inpatient hospital
2		services, the Department shall pay to each Illinois
3		children's hospital an amount equal to 20% of the total
4		base inpatient payments paid to the hospital for services
5		provided in State fiscal year 2005 and an additional amount
6		equal to 20% of the base inpatient payments paid to the
7		hospital for psychiatric services provided in State fiscal
8		year 2005.
9		(5) In addition to rates paid for inpatient hospital
10		services, the Department shall pay to each Illinois
11		hospital eligible for a pediatric inpatient adjustment
12		payment under 89 Ill. Adm. Code 148.298, as in effect for
13		State fiscal year 2007, a supplemental pediatric inpatient
14		adjustment payment equal to:
15		(i) For freestanding children's hospitals as
16		defined in 89 Ill. Adm. Code 149.50(c)(3)(A), 2.5
17		multiplied by the hospital's pediatric inpatient
18		adjustment payment required under 89 Ill. Adm. Code
19		148.298, as in effect for State fiscal year 2008.
20		(ii) For hospitals other than freestanding
21		children's hospitals as defined in 89 Ill. Adm. Code
22		149.50(c)(3)(B), 1.0 multiplied by the hospital's
23		pediatric inpatient adjustment payment required under
24		89 Ill. Adm. Code 148.298, as in effect for State
25		fiscal year 2008.
26		(c) Outpatient adjustment.

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1		(1) In addition to the rates paid for outpatient
2		hospital services, the Department shall pay each Illinois
3		hospital an amount equal to 2.2 multiplied by the
4		hospital's ambulatory procedure listing payments for
5		categories 1, 2, 3, and 4, as defined in 89 Ill. Adm. Code
6		148.140(b), for State fiscal year 2005.
7		(2) In addition to the rates paid for outpatient
8		hospital services, the Department shall pay each Illinois
9		freestanding psychiatric hospital an amount equal to 3.25
10		multiplied by the hospital's ambulatory procedure listing
11		payments for category 5b, as defined in 89 Ill. Adm. Code
12		148.140(b)(1)(E), for State fiscal year 2005.
13		(d) Medicaid high volume adjustment. In addition to rates
14		paid for inpatient hospital services, the Department shall pay
15		to each Illinois general acute care hospital that provided more
16		than 20,500 Medicaid inpatient days of care in State fiscal
17		year 2005 amounts as follows:
18		(1) For hospitals with a case mix index equal to or
19		greater than the 85th percentile of hospital case mix
20		indices, $350 for each Medicaid inpatient day of care
21		provided during that period; and
22		(2) For hospitals with a case mix index less than the
23		85th percentile of hospital case mix indices, $100 for each
24		Medicaid inpatient day of care provided during that period.
25		(e) Capital adjustment. In addition to rates paid for
26		inpatient hospital services, the Department shall pay an

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1		additional payment to each Illinois general acute care hospital
2		that has a Medicaid inpatient utilization rate of at least 10%
3		(as calculated by the Department for the rate year 2007
4		disproportionate share determination) amounts as follows:
5		(1) For each Illinois general acute care hospital that
6		has a Medicaid inpatient utilization rate of at least 10%
7		and less than 36.94% and whose capital cost is less than
8		the 60th percentile of the capital costs of all Illinois
9		hospitals, the amount of such payment shall equal the
10		hospital's Medicaid inpatient days multiplied by the
11		difference between the capital costs at the 60th percentile
12		of the capital costs of all Illinois hospitals and the
13		hospital's capital costs.
14		(2) For each Illinois general acute care hospital that
15		has a Medicaid inpatient utilization rate of at least
16		36.94% and whose capital cost is less than the 75th
17		percentile of the capital costs of all Illinois hospitals,
18		the amount of such payment shall equal the hospital's
19		Medicaid inpatient days multiplied by the difference
20		between the capital costs at the 75th percentile of the
21		capital costs of all Illinois hospitals and the hospital's
22		capital costs.
23		(f) Obstetrical care adjustment.
24		(1) In addition to rates paid for inpatient hospital
25		services, the Department shall pay $1,500 for each Medicaid
26		obstetrical day of care provided in State fiscal year 2005

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1		by each Illinois rural hospital that had a Medicaid
2		obstetrical percentage (Medicaid obstetrical days divided
3		by Medicaid inpatient days) greater than 15% for State
4		fiscal year 2005.
5		(2) In addition to rates paid for inpatient hospital
6		services, the Department shall pay $1,350 for each Medicaid
7		obstetrical day of care provided in State fiscal year 2005
8		by each Illinois general acute care hospital that was
9		designated a level III perinatal center as of December 31,
10		2006, and that had a case mix index equal to or greater
11		than the 45th percentile of the case mix indices for all
12		level III perinatal centers.
13		(3) In addition to rates paid for inpatient hospital
14		services, the Department shall pay $900 for each Medicaid
15		obstetrical day of care provided in State fiscal year 2005
16		by each Illinois general acute care hospital that was
17		designated a level II or II+ perinatal center as of
18		December 31, 2006, and that had a case mix index equal to
19		or greater than the 35th percentile of the case mix indices
20		for all level II and II+ perinatal centers.
21		(g) Trauma adjustment.
22		(1) In addition to rates paid for inpatient hospital
23		services, the Department shall pay each Illinois general
24		acute care hospital designated as a trauma center as of
25		July 1, 2007, a payment equal to 3.75 multiplied by the
26		hospital's State fiscal year 2005 Medicaid capital

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1		payments.
2		(2) In addition to rates paid for inpatient hospital
3		services, the Department shall pay $400 for each Medicaid
4		acute inpatient day of care provided in State fiscal year
5		2005 by each Illinois general acute care hospital that was
6		designated a level II trauma center, as defined in 89 Ill.
7		Adm. Code 148.295(a)(3) and 148.295(a)(4), as of July 1,
8		2007.
9		(3) In addition to rates paid for inpatient hospital
10		services, the Department shall pay $235 for each Illinois
11		Medicaid acute inpatient day of care provided in State
12		fiscal year 2005 by each level I pediatric trauma center
13		located outside of Illinois that had more than 8,000
14		Illinois Medicaid inpatient days in State fiscal year 2005.
15		(h) Supplemental tertiary care adjustment. In addition to
16		rates paid for inpatient services, the Department shall pay to
17		each Illinois hospital eligible for tertiary care adjustment
18		payments under 89 Ill. Adm. Code 148.296, as in effect for
19		State fiscal year 2007, a supplemental tertiary care adjustment
20		payment equal to the tertiary care adjustment payment required
21		under 89 Ill. Adm. Code 148.296, as in effect for State fiscal
22		year 2007.
23		(i) Crossover adjustment. In addition to rates paid for
24		inpatient services, the Department shall pay each Illinois
25		general acute care hospital that had a ratio of crossover days
26		to total inpatient days for medical assistance programs

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1		administered by the Department (utilizing information from
2		2005 paid claims) greater than 50%, and a case mix index
3		greater than the 65th percentile of case mix indices for all
4		Illinois hospitals, a rate of $1,125 for each Medicaid
5		inpatient day including crossover days.
6		(j) Magnet hospital adjustment. In addition to rates paid
7		for inpatient hospital services, the Department shall pay to
8		each Illinois general acute care hospital and each Illinois
9		freestanding children's hospital that, as of February 1, 2008,
10		was recognized as a Magnet hospital by the American Nurses
11		Credentialing Center and that had a case mix index greater than
12		the 75th percentile of case mix indices for all Illinois
13		hospitals amounts as follows:
14		(1) For hospitals located in a county whose eligibility
15		growth factor is greater than the mean, $450 multiplied by
16		the eligibility growth factor for the county in which the
17		hospital is located for each Medicaid inpatient day of care
18		provided by the hospital during State fiscal year 2005.
19		(2) For hospitals located in a county whose eligibility
20		growth factor is less than or equal to the mean, $225
21		multiplied by the eligibility growth factor for the county
22		in which the hospital is located for each Medicaid
23		inpatient day of care provided by the hospital during State
24		fiscal year 2005.
25		For purposes of this subsection, "eligibility growth
26		factor" means the percentage by which the number of Medicaid

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1		recipients in the county increased from State fiscal year 1998
2		to State fiscal year 2005.
3		(k) For purposes of this Section, a hospital that is
4		enrolled to provide Medicaid services during State fiscal year
5		2005 shall have its utilization and associated reimbursements
6		annualized prior to the payment calculations being performed
7		under this Section.
8		(l) For purposes of this Section, the terms "Medicaid
9		days", "ambulatory procedure listing services", and
10		"ambulatory procedure listing payments" do not include any
11		days, charges, or services for which Medicare or a managed care
12		organization reimbursed on a capitated basis was liable for
13		payment, except where explicitly stated otherwise in this
14		Section.
15		(m) For purposes of this Section, in determining the
16		percentile ranking of an Illinois hospital's case mix index or
17		capital costs, hospitals described in subsection (b) of Section
18		5A-3 shall be excluded from the ranking.
19		(n) Definitions. Unless the context requires otherwise or
20		unless provided otherwise in this Section, the terms used in
21		this Section for qualifying criteria and payment calculations
22		shall have the same meanings as those terms have been given in
23		the Illinois Department's administrative rules as in effect on
24		March 1, 2008. Other terms shall be defined by the Illinois
25		Department by rule.
26		As used in this Section, unless the context requires

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1		otherwise:
2		"Base inpatient payments" means, for a given hospital, the
3		sum of base payments for inpatient services made on a per diem
4		or per admission (DRG) basis, excluding those portions of per
5		admission payments that are classified as capital payments.
6		Disproportionate share hospital adjustment payments, Medicaid
7		Percentage Adjustments, Medicaid High Volume Adjustments, and
8		outlier payments, as defined by rule by the Department as of
9		January 1, 2008, are not base payments.
10		"Capital costs" means, for a given hospital, the total
11		capital costs determined using the most recent 2005 Medicare
12		cost report as contained in the Healthcare Cost Report
13		Information System file, for the quarter ending on December 31,
14		2006, divided by the total inpatient days from the same cost
15		report to calculate a capital cost per day. The resulting
16		capital cost per day is inflated to the midpoint of State
17		fiscal year 2009 utilizing the national hospital market price
18		proxies (DRI) hospital cost index. If a hospital's 2005
19		Medicare cost report is not contained in the Healthcare Cost
20		Report Information System, the Department may obtain the data
21		necessary to compute the hospital's capital costs from any
22		source available, including, but not limited to, records
23		maintained by the hospital provider, which may be inspected at
24		all times during business hours of the day by the Illinois
25		Department or its duly authorized agents and employees.
26		"Case mix index" means, for a given hospital, the sum of

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1		the DRG relative weighting factors in effect on January 1,
2		2005, for all general acute care admissions for State fiscal
3		year 2005, excluding Medicare crossover admissions and
4		transplant admissions reimbursed under 89 Ill. Adm. Code
5		148.82, divided by the total number of general acute care
6		admissions for State fiscal year 2005, excluding Medicare
7		crossover admissions and transplant admissions reimbursed
8		under 89 Ill. Adm. Code 148.82.
9		"Medicaid inpatient day" means, for a given hospital, the
10		sum of days of inpatient hospital days provided to recipients
11		of medical assistance under Title XIX of the federal Social
12		Security Act, excluding days for individuals eligible for
13		Medicare under Title XVIII of that Act (Medicaid/Medicare
14		crossover days), as tabulated from the Department's paid claims
15		data for admissions occurring during State fiscal year 2005
16		that was adjudicated by the Department through March 23, 2007.
17		"Medicaid obstetrical day" means, for a given hospital, the
18		sum of days of inpatient hospital days grouped by the
19		Department to DRGs of 370 through 375 provided to recipients of
20		medical assistance under Title XIX of the federal Social
21		Security Act, excluding days for individuals eligible for
22		Medicare under Title XVIII of that Act (Medicaid/Medicare
23		crossover days), as tabulated from the Department's paid claims
24		data for admissions occurring during State fiscal year 2005
25		that was adjudicated by the Department through March 23, 2007.
26		"Outpatient ambulatory procedure listing payments" means,

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1		for a given hospital, the sum of payments for ambulatory
2		procedure listing services, as described in 89 Ill. Adm. Code
3		148.140(b), provided to recipients of medical assistance under
4		Title XIX of the federal Social Security Act, excluding
5		payments for individuals eligible for Medicare under Title
6		XVIII of the Act (Medicaid/Medicare crossover days), as
7		tabulated from the Department's paid claims data for services
8		occurring in State fiscal year 2005 that were adjudicated by
9		the Department through March 23, 2007.
10		(o) The Department may adjust payments made under this
11		Section 12.2 to comply with federal law or regulations
12		regarding hospital-specific payment limitations on
13		government-owned or government-operated hospitals.
14		(p) Notwithstanding any of the other provisions of this
15		Section, the Department is authorized to adopt rules that
16		change the hospital access improvement payments specified in
17		this Section, but only to the extent necessary to conform to
18		any federally approved amendment to the Title XIX State plan.
19		Any such rules shall be adopted by the Department as authorized
20		by Section 5-50 of the Illinois Administrative Procedure Act.
21		Notwithstanding any other provision of law, any changes
22		implemented as a result of this subsection (p) shall be given
23		retroactive effect so that they shall be deemed to have taken
24		effect as of the effective date of this Section.
25		(q) For State fiscal years 2012 and 2013, the Department
26		may make recommendations to the General Assembly regarding the

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1		use of more recent data for purposes of calculating the
2		assessment authorized under Section 5A-2 and the payments
3		authorized under this Section 5A-12.2.
4		(Source: P.A. 95-859, eff. 8-19-08.)
5		(305 ILCS 5/5A-12.3 new)
6		Sec. 5A-12.3. Hospital Medicaid Stimulus Payments.
7		(a) Supplemental payments. Subject to federal approval and
8		as soon as practicable after the effective date of this
9		amendatory Act of the 96th General Assembly, the Department
10		shall make a one-time Medicaid supplemental payment to
11		hospitals for inpatient and outpatient Medicaid services. This
12		payment shall be the sum of the following payment
13		methodologies:
14		(1) In addition to the rates paid for outpatient
15		hospital services, the Department shall pay all rural
16		hospitals a supplemental outpatient payment in an amount
17		equal to the hospital's outpatient ambulatory procedure
18		listing payments for Group 3 as defined in 89 Ill. Adm.
19		Code 148.140(b)(1)(C), for State fiscal year 2005. For a
20		hospital qualified as a critical access hospital, as
21		designated by the Illinois Department of Public Health in
22		accordance with 42 CFR 485, Subpart F (2001), the payment
23		amount under this paragraph (1) shall be multiplied by 3.5.
24		In order to qualify for payments under this Section a
25		hospital must:

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1		(A) Be a hospital that is licensed by the
2		Department of Public Health under the Hospital
3		Licensing Act, certified by that Department to
4		participate in the Illinois Medicaid Program, and
5		enrolled with the Department of Healthcare and Family
6		Services to participate in the Illinois Medicaid
7		Program;
8		(B) Provide services as required under 77 Ill. Adm.
9		Code 250.710 in an emergency room subject to the
10		requirements under either 77 Ill. Adm. Code
11		250.2440(k) or 77 Ill. Adm. Code 250.2630(k); and
12		(C) Be a rural Illinois hospital, as defined at 89
13		Ill. Adm. Code 148.25(g)(3).
14		(2) In addition to the rates paid for inpatient
15		hospital services, the Department shall pay $175 for each
16		Medicaid obstetrical day of care by each Illinois general
17		acute care hospital that was designated a level III
18		perinatal center as of July 1, 2009 and provided more than
19		2,000 Medicaid obstetrical days of service.
20		(3) In addition to the rates paid for inpatient
21		hospital services, the Department shall pay $22 for each
22		Medicaid inpatient day to each hospital designated as a
23		Level I Trauma Center. For the purpose of this Section, a
24		Level I Trauma Center is a hospital designated by the
25		Department of Public Health using the criteria under 77
26		Ill. Adm. Code 515.2030 or 77 Ill. Adm. Code 515.2035 as of

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1		July 1, 2009. For the purposes of this payment, hospitals
2		located in the same city that alternate their Level I
3		Trauma Center designation as defined in 89 Ill. Adm. Code
4		148.295(a)(2) shall both be eligible to receive this
5		payment.
6		(4) In addition to the rates paid for inpatient
7		hospital services, the Department shall pay $37 for each
8		Medicaid inpatient day.
9		(5) In addition to the rates paid for inpatient
10		hospital services, the Department shall pay an additional
11		$35 for each Medicaid inpatient day to each hospital
12		qualifying for a payment in paragraph (4) of this
13		subsection (a) that also qualifies for payments under 89
14		Ill. Adm. Code 148.120 or 89 Ill. Adm. Code 148.122 for the
15		rate period beginning October 1, 2009.
16		(b) Exclusions from payments under this Section.
17		(1) A hospital that is operated by a State agency, a
18		State university, or a county with a population of
19		3,000,000 or more is not eligible for any payment under
20		this Section.
21		(2) A hospital as defined in 89 Ill. Adm. Code
22		149.50(c)(4) is not eligible for any payment under
23		paragraph (4) or (5) of subsection (a) of this Section.
24		(3) A hospital as defined in 89 Ill. Adm. Code
25		149.50(c)(1) or 89 Ill. Adm. Code 149.50(c)(2) is not
26		eligible for any payment under paragraph (5) of subsection

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1		(a) of this Section.
2		(4) A hospital that ceases operations prior to federal
3		approval of, and adoption of administrative rules
4		necessary to effect, payments under this Section is not
5		eligible for any payment under this Section.
6		(5) A hospital that has filed for bankruptcy or is
7		operating under bankruptcy protection under any Chapter of
8		Title 11 of the United States Code (Bankruptcy) is not
9		eligible for any payment under this Section.
10		(c) Definitions. Unless the context requires otherwise or
11		unless provided otherwise in this Section, the terms used in
12		this Section for qualifying criteria and payment calculations
13		shall have the same meanings as those terms have been given in
14		the Department's administrative rules as in effect on March 1,
15		2008. As used in this Section, unless the context requires
16		otherwise:
17		(1) “Medicaid inpatient day” has the same meaning as
18		defined in subsection (n) of Section 5A-12.2.
19		(2) “Hospital” means any facility located in Illinois
20		that is required to submit cost reports as mandated under
21		89 Ill. Adm. Code 148.210.
22		(3) “Medicaid obstetrical day” has the same meaning
23		ascribed to it in subsection (n) of Section 5A-12.2.
24		(4) "Outpatient ambulatory procedure listing payments"
25		means, for a given hospital, the sum of payments for
26		ambulatory procedure listing services, as described in 89

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1		Ill. Adm. Code 148.140(b)(1)(C), provided to recipients of
2		medical assistance under Title XIX of the federal Social
3		Security Act, excluding payments for individuals eligible
4		for Medicare under Title XVIII of the Act
5		(Medicaid/Medicare crossover days), as tabulated from the
6		Department's paid claims data for services occurring in
7		State fiscal year 2005 that were adjudicated by the
8		Department through March 23, 2007.
9		(d) Funding sources. Payments under this Section shall be
10		made from the Healthcare Provider Relief Fund.
11		(e) Adjustments. The Department may pay a portion of
12		payments made under this Section in a subsequent State fiscal
13		year to comply with federal law or regulations regarding
14		hospital-specific payment limitations.
15		(305 ILCS 5/5A-14)
16		Sec. 5A-14. Repeal of assessments and disbursements.
17		(a) Section 5A-2 is repealed on July 1, 2013.
18		(b) Section 5A-12 is repealed on July 1, 2005.
19		(c) Section 5A-12.1 is repealed on July 1, 2008.
20		(d) Section 5A-12.2 is repealed on July 1, 2013.
21		(e) Section 5A-12.3 is repealed on July 1, 2011.
22		(Source: P.A. 94-242, eff. 7-18-05; 95-859, eff. 8-19-08.)
23		Section 99. Effective date. This Act takes effect upon
24