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| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB0772 Introduced 2/8/2011, by Sen. John J. Cullerton SYNOPSIS AS INTRODUCED:
| | 305 ILCS 5/5-5.5 | from Ch. 23, par. 5-5.5 |
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Amends the Illinois Public Aid Code. Makes a technical change in a Section
concerning Medicaid payment rates for skilled nursing and intermediate care services in nursing facilities.
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| | A BILL FOR |
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| | SB0772 | | LRB097 04505 KTG 44544 b |
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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 | | changing Section 5-5.5 as follows:
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| 6 | | (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
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| 7 | | Sec. 5-5.5. Elements of Payment Rate.
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| 8 | | (a) The
The Department of Healthcare and Family Services |
| 9 | | shall develop a prospective method for
determining payment |
| 10 | | rates for skilled nursing and intermediate care
services in |
| 11 | | nursing facilities composed of the following cost elements:
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| 12 | | (1) Standard Services, with the cost of this component |
| 13 | | being determined
by taking into account the actual costs to |
| 14 | | the facilities of these services
subject to cost ceilings |
| 15 | | to be defined in the Department's rules.
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| 16 | | (2) Resident Services, with the cost of this component |
| 17 | | being
determined by taking into account the actual costs, |
| 18 | | needs and utilization
of these services, as derived from an |
| 19 | | assessment of the resident needs in
the nursing facilities.
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| 20 | | (3) Ancillary Services, with the payment rate being |
| 21 | | developed for
each individual type of service. Payment |
| 22 | | shall be made only when
authorized under procedures |
| 23 | | developed by the Department of Healthcare and Family |
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| 1 | | Services.
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| 2 | | (4) Nurse's Aide Training, with the cost of this |
| 3 | | component being
determined by taking into account the |
| 4 | | actual cost to the facilities of
such training.
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| 5 | | (5) Real Estate Taxes, with the cost of this component |
| 6 | | being
determined by taking into account the figures |
| 7 | | contained in the most
currently available cost reports |
| 8 | | (with no imposition of maximums) updated
to the midpoint of |
| 9 | | the current rate year for long term care services
rendered |
| 10 | | between July 1, 1984 and June 30, 1985, and with the cost |
| 11 | | of this
component being determined by taking into account |
| 12 | | the actual 1983 taxes for
which the nursing homes were |
| 13 | | assessed (with no imposition of maximums)
updated to the |
| 14 | | midpoint of the current rate year for long term care
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| 15 | | services rendered between July 1, 1985 and June 30, 1986.
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| 16 | | (b) In developing a prospective method for determining |
| 17 | | payment rates
for skilled nursing and intermediate care |
| 18 | | services in nursing facilities,
the Department of Healthcare |
| 19 | | and Family Services shall consider the following cost elements:
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| 20 | | (1) Reasonable capital cost determined by utilizing |
| 21 | | incurred interest
rate and the current value of the |
| 22 | | investment, including land, utilizing
composite rates, or |
| 23 | | by utilizing such other reasonable cost related methods
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| 24 | | determined by the Department. However, beginning with the |
| 25 | | rate
reimbursement period effective July 1, 1987, the |
| 26 | | Department shall be
prohibited from establishing, |
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| 1 | | including, and implementing any depreciation
factor in |
| 2 | | calculating the capital cost element.
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| 3 | | (2) Profit, with the actual amount being produced and |
| 4 | | accruing to
the providers in the form of a return on their |
| 5 | | total investment, on the
basis of their ability to |
| 6 | | economically and efficiently deliver a type
of service. The |
| 7 | | method of payment may assure the opportunity for a
profit, |
| 8 | | but shall not guarantee or establish a specific amount as a |
| 9 | | cost.
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| 10 | | (c) The Illinois Department may implement the amendatory |
| 11 | | changes to
this Section made by this amendatory Act of 1991 |
| 12 | | through the use of
emergency rules in accordance with the |
| 13 | | provisions of Section 5.02 of the
Illinois Administrative |
| 14 | | Procedure Act. For purposes of the Illinois
Administrative |
| 15 | | Procedure Act, the adoption of rules to implement the
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| 16 | | amendatory changes to this Section made by this amendatory
Act |
| 17 | | of 1991 shall be deemed an emergency and necessary for the |
| 18 | | public
interest, safety and welfare.
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| 19 | | (d) No later than January 1, 2001, the Department of Public |
| 20 | | Aid shall file
with the Joint Committee on Administrative |
| 21 | | Rules, pursuant to the Illinois
Administrative Procedure
Act,
a |
| 22 | | proposed rule, or a proposed amendment to an existing rule, |
| 23 | | regarding payment
for appropriate services, including |
| 24 | | assessment, care planning, discharge
planning, and treatment
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| 25 | | provided by nursing facilities to residents who have a serious |
| 26 | | mental
illness.
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