Bill Text: IL HB2451 | 2013-2014 | 98th General Assembly | Introduced

---

Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Restores a provision that was previously repealed by Public Act 97-689 and that requires the Department of Healthcare and Family Services to promulgate rules that establish a policy of bed reserve payments to intermediate care facilities for the developmentally disabled (ICF/DDs) which address the needs of residents of ICF/DDs and their families. Restores a provision that was previously repealed by Public Act 97-689 and that requires the Department to approve bed reserves at a daily rate of 75% of an individual's current Medicaid per diem, for nursing facilities 90% or more of whose residents are Medicaid recipients and that have occupancy levels of at least 93% for resident bed reserves not exceeding 10 days. Removes a provision requiring the Department to cease payment for bed reserves in nursing facilities, specialized mental health rehabilitation facilities, and, except in the instance of residents who are under 21 years of age, intermediate care facilities for persons with developmental disabilities.

Spectrum: Partisan Bill (Democrat 29-1)

Status: (Failed) 2014-12-03 - Session Sine Die [HB2451 Detail]

Download: Illinois-2013-HB2451-Introduced.html

---

98TH GENERAL ASSEMBLY State of Illinois 2013 and 2014 HB2451 Introduced , by Rep. Lawrence M. Walsh, Jr. SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-5.4h new
305 ILCS 5/5-5.4i new
305 ILCS 5/5-5e
Amends the Medical Assistance Article of the Illinois Public Aid Code. Restores a provision that was previously repealed by Public Act 97-689 and that requires the Department of Healthcare and Family Services to promulgate rules that establish a policy of bed reserve payments to intermediate care facilities for the developmentally disabled (ICF/DDs) which address the needs of residents of ICF/DDs and their families. Restores a provision that was previously repealed by Public Act 97-689 and that requires the Department to approve bed reserves at a daily rate of 75% of an individual's current Medicaid per diem, for nursing facilities 90% or more of whose residents are Medicaid recipients and that have occupancy levels of at least 93% for resident bed reserves not exceeding 10 days. Removes a provision requiring the Department to cease payment for bed reserves in nursing facilities, specialized mental health rehabilitation facilities, and, except in the instance of residents who are under 21 years of age, intermediate care facilities for persons with developmental disabilities.
LRB098 09092 KTG 39229 b
FISCAL NOTE ACT MAY APPLY
A BILL FOR
HB2451 LRB098 09092 KTG 39229 b
AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5-5e and by adding Sections 5-5.4h and 5-5.4i
as follows:
(305 ILCS 5/5-5.4h new)
Sec. 5-5.4h. Intermediate Care Facility for the
Developmentally Disabled; bed reserve payments. The Department
shall promulgate rules that establish a policy of bed reserve
payments to ICF/DDs which addresses the needs of residents of
ICF/DDs and their families.
(a) When a resident of an ICF/DD is absent from the
facility in which he or she is a resident for purposes of
physician authorized in-patient admission to a hospital, the
Department's rules shall, at a minimum, provide (1) bed reserve
payments at a daily rate which is 100% of the client's current
per diem rate, for a period not exceeding 10 consecutive days;
(2) bed reserve payments at a daily rate which is 75% of the
client's current per diem rate, for a period which exceeds 10
consecutive days but does not exceed 30 consecutive days; and
(3) bed reserve payments at a daily rate which is 50% of the
client's current per diem rate for a period which exceeds 30

HB2451 - 2 - LRB098 09092 KTG 39229 b
consecutive days but does not exceed 45 consecutive days.
(b) When a resident of an ICF/DD is absent from the
facility in which he or she is a resident for purposes of a
home visit with a family member, the Department's rules shall,
at a minimum, provide (1) bed reserve payments at a rate which
is 100% of the client's current per diem rate, for a period not
exceeding 10 days per State fiscal year; and (2) bed reserve
payments at a rate which is 75% of the client's current per
diem rate, for a period which exceeds 10 days per State fiscal
year but does not exceed 30 days per State fiscal year.
(c) No Department rule regarding bed reserve payments shall
require an ICF/DD to have a specified percentage of total
facility occupancy as a requirement for receiving bed reserve
payments.
(d) This Section 5-5.4h shall not apply to any State
operated facilities.
(305 ILCS 5/5-5.4i new)
Sec. 5-5.4i. Bed reserves; approval. The Department of
Healthcare and Family Services shall approve bed reserves at a
daily rate of 75% of an individual's current Medicaid per diem,
for nursing facilities 90% or more of whose residents are
Medicaid recipients and that have occupancy levels of at least
93% for resident bed reserves not exceeding 10 days.
(305 ILCS 5/5-5e)

HB2451 - 3 - LRB098 09092 KTG 39229 b
Sec. 5-5e. Adjusted rates of reimbursement.
(a) Rates or payments for services in effect on June 30,
2012 shall be adjusted and services shall be affected as
required by any other provision of this amendatory Act of the
97th General Assembly. In addition, the Department shall do the
following:
(1) Delink the per diem rate paid for supportive living
facility services from the per diem rate paid for nursing
facility services, effective for services provided on or
after May 1, 2011.
(2) (Blank). Cease payment for bed reserves in nursing
facilities, specialized mental health rehabilitation
facilities, and, except in the instance of residents who
are under 21 years of age, intermediate care facilities for
persons with developmental disabilities.
(3) Cease payment of the $10 per day add-on payment to
nursing facilities for certain residents with
developmental disabilities.
(b) After the application of subsection (a),
notwithstanding any other provision of this Code to the
contrary and to the extent permitted by federal law, on and
after July 1, 2012, the rates of reimbursement for services and
other payments provided under this Code shall further be
reduced as follows:
(1) Rates or payments for physician services, dental
services, or community health center services reimbursed

HB2451 - 4 - LRB098 09092 KTG 39229 b
through an encounter rate, and services provided under the
Medicaid Rehabilitation Option of the Illinois Title XIX
State Plan shall not be further reduced.
(2) Rates or payments, or the portion thereof, paid to
a provider that is operated by a unit of local government
or State University that provides the non-federal share of
such services shall not be further reduced.
(3) Rates or payments for hospital services delivered
by a hospital defined as a Safety-Net Hospital under
Section 5-5e.1 of this Code shall not be further reduced.
(4) Rates or payments for hospital services delivered
by a Critical Access Hospital, which is an Illinois
hospital designated as a critical care hospital by the
Department of Public Health in accordance with 42 CFR 485,
Subpart F, shall not be further reduced.
(5) Rates or payments for Nursing Facility Services
shall only be further adjusted pursuant to Section 5-5.2 of
this Code.
(6) Rates or payments for services delivered by long
term care facilities licensed under the ID/DD Community
Care Act and developmental training services shall not be
further reduced.
(7) Rates or payments for services provided under
capitation rates shall be adjusted taking into
consideration the rates reduction and covered services
required by this amendatory Act of the 97th General

HB2451 - 5 - LRB098 09092 KTG 39229 b
Assembly.
(8) For hospitals not previously described in this
subsection, the rates or payments for hospital services
shall be further reduced by 3.5%, except for payments
authorized under Section 5A-12.4 of this Code.
(9) For all other rates or payments for services
delivered by providers not specifically referenced in
paragraphs (1) through (8), rates or payments shall be
further reduced by 2.7%.
(c) Any assessment imposed by this Code shall continue and
nothing in this Section shall be construed to cause it to
cease.
(Source: P.A. 97-689, eff. 6-14-12.)