Bill Text: IL SB1520 | 2017-2018 | 100th General Assembly | Introduced

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Bill Title: Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning an assessment on inpatient services that is imposed on hospital providers.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2019-01-09 - Session Sine Die [SB1520 Detail]

Download: Illinois-2017-SB1520-Introduced.html

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100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 SB1520 Introduced 2/9/2017, by Sen. Heather A. Steans SYNOPSIS AS INTRODUCED:
305 ILCS 5/5A-2 from Ch. 23, par. 5A-2
Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning an assessment on inpatient services that is imposed on hospital providers.
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A BILL FOR
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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 5A-2 as follows:
(305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
(Section scheduled to be repealed on July 1, 2018)
Sec. 5A-2. Assessment.
(a)(1) Subject to Sections 5A-3 and and 5A-10, for State
fiscal years 2009 through 2018, an annual assessment on
inpatient services is imposed on each hospital provider in an
amount equal to $218.38 multiplied by the difference of the
hospital's occupied bed days less the hospital's Medicare bed
days, provided, however, that the amount of $218.38 shall be
increased by a uniform percentage to generate an amount equal
to 75% of the State share of the payments authorized under
Section 5A-12.5, with such increase only taking effect upon the
date that a State share for such payments is required under
federal law. For the period of April through June 2015, the
amount of $218.38 used to calculate the assessment under this
paragraph shall, by emergency rule under subsection (s) of
Section 5-45 of the Illinois Administrative Procedure Act, be
increased by a uniform percentage to generate $20,250,000 in

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the aggregate for that period from all hospitals subject to the
annual assessment under this paragraph.
(2) In addition to any other assessments imposed under this
Article, effective July 1, 2016 and semi-annually thereafter
through June 2018, in addition to any federally required State
share as authorized under paragraph (1), the amount of $218.38
shall be increased by a uniform percentage to generate an
amount equal to 75% of the ACA Assessment Adjustment, as
defined in subsection (b-6) of this Section.
For State fiscal years 2009 through 2014 and after, a
hospital's occupied bed days and Medicare bed days shall be
determined using the most recent data available from each
hospital's 2005 Medicare cost report as contained in the
Healthcare Cost Report Information System file, for the quarter
ending on December 31, 2006, without regard to any subsequent
adjustments or changes to such data. If a hospital's 2005
Medicare cost report is not contained in the Healthcare Cost
Report Information System, then the Illinois Department may
obtain the hospital provider's occupied bed days and Medicare
bed days from any source available, including, but not limited
to, records maintained by the hospital provider, which may be
inspected at all times during business hours of the day by the
Illinois Department or its duly authorized agents and
employees.
(b) (Blank).
(b-5)(1) Subject to Sections 5A-3 and 5A-10, for the

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portion of State fiscal year 2012, beginning June 10, 2012
through June 30, 2012, and for State fiscal years 2013 through
2018, an annual assessment on outpatient services is imposed on
each hospital provider in an amount equal to .008766 multiplied
by the hospital's outpatient gross revenue, provided, however,
that the amount of .008766 shall be increased by a uniform
percentage to generate an amount equal to 25% of the State
share of the payments authorized under Section 5A-12.5, with
such increase only taking effect upon the date that a State
share for such payments is required under federal law. For the
period beginning June 10, 2012 through June 30, 2012, the
annual assessment on outpatient services shall be prorated by
multiplying the assessment amount by a fraction, the numerator
of which is 21 days and the denominator of which is 365 days.
For the period of April through June 2015, the amount of
.008766 used to calculate the assessment under this paragraph
shall, by emergency rule under subsection (s) of Section 5-45
of the Illinois Administrative Procedure Act, be increased by a
uniform percentage to generate $6,750,000 in the aggregate for
that period from all hospitals subject to the annual assessment
under this paragraph.
(2) In addition to any other assessments imposed under this
Article, effective July 1, 2016 and semi-annually thereafter
through June 2018, in addition to any federally required State
share as authorized under paragraph (1), the amount of .008766
shall be increased by a uniform percentage to generate an

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amount equal to 25% of the ACA Assessment Adjustment, as
defined in subsection (b-6) of this Section.
For the portion of State fiscal year 2012, beginning June
10, 2012 through June 30, 2012, and State fiscal years 2013
through 2018, a hospital's outpatient gross revenue shall be
determined using the most recent data available from each
hospital's 2009 Medicare cost report as contained in the
Healthcare Cost Report Information System file, for the quarter
ending on June 30, 2011, without regard to any subsequent
adjustments or changes to such data. If a hospital's 2009
Medicare cost report is not contained in the Healthcare Cost
Report Information System, then the Department may obtain the
hospital provider's outpatient gross revenue from any source
available, including, but not limited to, records maintained by
the hospital provider, which may be inspected at all times
during business hours of the day by the Department or its duly
authorized agents and employees.
(b-6)(1) As used in this Section, "ACA Assessment
Adjustment" means:
(A) For the period of July 1, 2016 through December 31,
2016, the product of .19125 multiplied by the sum of the
fee-for-service payments to hospitals as authorized under
Section 5A-12.5 and the adjustments authorized under
subsection (t) of Section 5A-12.2 to managed care
organizations for hospital services due and payable in the
month of April 2016 multiplied by 6.

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(B) For the period of January 1, 2017 through June 30,
2017, the product of .19125 multiplied by the sum of the
fee-for-service payments to hospitals as authorized under
Section 5A-12.5 and the adjustments authorized under
subsection (t) of Section 5A-12.2 to managed care
organizations for hospital services due and payable in the
month of October 2016 multiplied by 6, except that the
amount calculated under this subparagraph (B) shall be
adjusted, either positively or negatively, to account for
the difference between the actual payments issued under
Section 5A-12.5 for the period beginning July 1, 2016
through December 31, 2016 and the estimated payments due
and payable in the month of April 2016 multiplied by 6 as
described in subparagraph (A).
(C) For the period of July 1, 2017 through December 31,
2017, the product of .19125 multiplied by the sum of the
fee-for-service payments to hospitals as authorized under
Section 5A-12.5 and the adjustments authorized under
subsection (t) of Section 5A-12.2 to managed care
organizations for hospital services due and payable in the
month of April 2017 multiplied by 6, except that the amount
calculated under this subparagraph (C) shall be adjusted,
either positively or negatively, to account for the
difference between the actual payments issued under
Section 5A-12.5 for the period beginning January 1, 2017
through June 30, 2017 and the estimated payments due and

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payable in the month of October 2016 multiplied by 6 as
described in subparagraph (B).
(D) For the period of January 1, 2018 through June 30,
2018, the product of .19125 multiplied by the sum of the
fee-for-service payments to hospitals as authorized under
Section 5A-12.5 and the adjustments authorized under
subsection (t) of Section 5A-12.2 to managed care
organizations for hospital services due and payable in the
month of October 2017 multiplied by 6, except that:
(i) the amount calculated under this subparagraph
(D) shall be adjusted, either positively or
negatively, to account for the difference between the
actual payments issued under Section 5A-12.5 for the
period of July 1, 2017 through December 31, 2017 and
the estimated payments due and payable in the month of
April 2017 multiplied by 6 as described in subparagraph
(C); and
(ii) the amount calculated under this subparagraph
(D) shall be adjusted to include the product of .19125
multiplied by the sum of the fee-for-service payments,
if any, estimated to be paid to hospitals under
subsection (b) of Section 5A-12.5.
(2) The Department shall complete and apply a final
reconciliation of the ACA Assessment Adjustment prior to June
30, 2018 to account for:
(A) any differences between the actual payments issued

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or scheduled to be issued prior to June 30, 2018 as
authorized in Section 5A-12.5 for the period of January 1,
2018 through June 30, 2018 and the estimated payments due
and payable in the month of October 2017 multiplied by 6 as
described in subparagraph (D); and
(B) any difference between the estimated
fee-for-service payments under subsection (b) of Section
5A-12.5 and the amount of such payments that are actually
scheduled to be paid.
The Department shall notify hospitals of any additional
amounts owed or reduction credits to be applied to the June
2018 ACA Assessment Adjustment. This is to be considered the
final reconciliation for the ACA Assessment Adjustment.
(3) Notwithstanding any other provision of this Section, if
for any reason the scheduled payments under subsection (b) of
Section 5A-12.5 are not issued in full by the final day of the
period authorized under subsection (b) of Section 5A-12.5,
funds collected from each hospital pursuant to subparagraph (D)
of paragraph (1) and pursuant to paragraph (2), attributable to
the scheduled payments authorized under subsection (b) of
Section 5A-12.5 that are not issued in full by the final day of
the period attributable to each payment authorized under
subsection (b) of Section 5A-12.5, shall be refunded.
(4) The increases authorized under paragraph (2) of
subsection (a) and paragraph (2) of subsection (b-5) shall be
limited to the federally required State share of the total

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payments authorized under Section 5A-12.5 if the sum of such
payments yields an annualized amount equal to or less than
$450,000,000, or if the adjustments authorized under
subsection (t) of Section 5A-12.2 are found not to be
actuarially sound; however, this limitation shall not apply to
the fee-for-service payments described in subsection (b) of
Section 5A-12.5.
(c) (Blank).
(d) Notwithstanding any of the other provisions of this
Section, the Department is authorized to adopt rules to reduce
the rate of any annual assessment imposed under this Section,
as authorized by Section 5-46.2 of the Illinois Administrative
Procedure Act.
(e) Notwithstanding any other provision of this Section,
any plan providing for an assessment on a hospital provider as
a permissible tax under Title XIX of the federal Social
Security Act and Medicaid-eligible payments to hospital
providers from the revenues derived from that assessment shall
be reviewed by the Illinois Department of Healthcare and Family
Services, as the Single State Medicaid Agency required by
federal law, to determine whether those assessments and
hospital provider payments meet federal Medicaid standards. If
the Department determines that the elements of the plan may
meet federal Medicaid standards and a related State Medicaid
Plan Amendment is prepared in a manner and form suitable for
submission, that State Plan Amendment shall be submitted in a

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timely manner for review by the Centers for Medicare and
Medicaid Services of the United States Department of Health and
Human Services and subject to approval by the Centers for
Medicare and Medicaid Services of the United States Department
of Health and Human Services. No such plan shall become
effective without approval by the Illinois General Assembly by
the enactment into law of related legislation. Notwithstanding
any other provision of this Section, the Department is
authorized to adopt rules to reduce the rate of any annual
assessment imposed under this Section. Any such rules may be
adopted by the Department under Section 5-50 of the Illinois
Administrative Procedure Act.
(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14; 99-2,
eff. 3-26-15; 99-516, eff. 6-30-16.)