Bill Text: IL HB4510 | 2023-2024 | 103rd General Assembly | Introduced
Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning January 1, 2025, renal dialysis services provided within a skilled nursing facility by a certified home dialysis provider shall receive a per-claim add-on payment of $95 per treatment. Defines "certified home dialysis provider" to mean an end stage renal disease facility that (i) provides dialysis treatment or dialysis training to caregivers or individuals with end stage renal disease and (ii) has been approved to provide dialysis home training support services by the federal Centers for Medicare and Medicaid Services. Effective January 1, 2025.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2024-05-31 - Rule 19(a) / Re-referred to Rules Committee [HB4510 Detail]
Download: Illinois-2023-HB4510-Introduced.html
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| 1 | AN ACT concerning public aid.
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| 2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||
| 3 | represented in the General Assembly:
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| 4 | Section 5. The Illinois Public Aid Code is amended by | |||||||||||||||||||
| 5 | adding Section 5-5.08a as follows:
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| 6 | (305 ILCS 5/5-5.08a new) | |||||||||||||||||||
| 7 | Sec. 5-5.08a. Renal dialysis; add-on payments for skilled | |||||||||||||||||||
| 8 | nursing facilities. | |||||||||||||||||||
| 9 | (a) Findings. The General Assembly finds the following: | |||||||||||||||||||
| 10 | (1) Home dialysis services provided on-site at skilled | |||||||||||||||||||
| 11 | nursing facilities are beneficial to nursing home | |||||||||||||||||||
| 12 | residents by permitting more time for other health and | |||||||||||||||||||
| 13 | wellness activities, and nullifying burdensome off-site | |||||||||||||||||||
| 14 | travel which carries various healthcare risks and | |||||||||||||||||||
| 15 | increased costs. | |||||||||||||||||||
| 16 | (2) Home dialysis for nursing home residents provides | |||||||||||||||||||
| 17 | an on-site venue for high-acuity residents to receive | |||||||||||||||||||
| 18 | dialysis services, effectively creating downstream care | |||||||||||||||||||
| 19 | opportunities for hospital patients in need of post-acute | |||||||||||||||||||
| 20 | care and dialysis, and reducing the total cost of dialysis | |||||||||||||||||||
| 21 | care. | |||||||||||||||||||
| 22 | (3) On-site home dialysis in nursing homes is costlier | |||||||||||||||||||
| 23 | for the provider than conventional outpatient dialysis, as | |||||||||||||||||||
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| 1 | labor costs are greater per treatment and such patients | ||||||
| 2 | typically have higher acuities, necessitating more | ||||||
| 3 | medication and greater staff involvement to promote | ||||||
| 4 | patient compliance. | ||||||
| 5 | (b) For home renal dialysis provided to residents of | ||||||
| 6 | skilled nursing facilities, the Department shall reimburse a | ||||||
| 7 | per-claim add-on payment in accordance with this Section. | ||||||
| 8 | Beginning January 1, 2025, renal dialysis services provided | ||||||
| 9 | within a skilled nursing facility by a certified home dialysis | ||||||
| 10 | provider shall receive a per-claim add-on payment of $95 per | ||||||
| 11 | treatment. As used in this Section, "certified home dialysis | ||||||
| 12 | provider" means an end stage renal disease facility that (i) | ||||||
| 13 | provides dialysis treatment or dialysis training to caregivers | ||||||
| 14 | or individuals with end stage renal disease and (ii) has been | ||||||
| 15 | approved to provide dialysis home training support services by | ||||||
| 16 | the federal Centers for Medicare and Medicaid Services.
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