Bill Text: IL SB2017 | 2019-2020 | 101st General Assembly | Introduced

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Bill Title: Amends the Covering ALL KIDS Health Insurance Act. Makes a technical change in a Section concerning the short title.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2021-01-13 - Session Sine Die [SB2017 Detail]

Download: Illinois-2019-SB2017-Introduced.html

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101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 SB2017 Introduced 2/15/2019, by Sen. Martin A. Sandoval SYNOPSIS AS INTRODUCED:
See Index
Amends the Covering ALL KIDS Health Insurance Act. Changes the short title of the Act to the Covering ALL KIDS and Young Adults Health Insurance Act and makes conforming changes in various Acts. Changes the name of the Covering ALL KIDS Health Insurance Program to the Covering ALL KIDS Young Adults Health Insurance Program and makes conforming changes. Provides that the Department of Healthcare and Family services shall purchase or provide healthcare benefits for eligible young adults that are identical to the benefits provided for individuals under the Medical Assistance Program established under the Illinois Public Aid Code. Defines young adult.
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A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Mental Health and Developmental
Disabilities Administrative Act is amended by changing Section
71a as follows:
(20 ILCS 1705/71a)
Sec. 71a. Community Behavioral Health Care.
(a) The Department shall strive to guarantee that persons,
including children, suffering from mental illness, substance
abuse, and other behavioral disorders have access to locally
accessible behavioral health care providers who have the
ability to treat the person's conditions in a cost effective,
outcome-based manner. To ensure continuity and quality of care
that is integrated with the person's overall medical care, the
Department shall:
(1) Designate as essential community behavioral health
care providers organizations that meet the qualifications
set forth in subsection (b) of this Section.
(2) Promote the co-location of primary and behavioral
health care services centers.
(3) Promote access to necessary behavioral health care
services in the State's Health Insurance Exchange

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policies.
(4) Promote continuity of care for persons moving
between Medicaid, SCHIP, and programs administered by the
Department that provide behavioral health care services.
(5) Promote continuity of care for persons not yet
eligible for Medicaid or who are without insurance coverage
for their conditions.
(6) Work toward improving access in Illinois'
underserved and health professional shortage areas.
(b) The Department shall designate certain community
behavioral health care providers as essential community
behavioral health care providers. To qualify for the
designation an organization must be a not-for-profit
organization under the Internal Revenue Code or a governmental
entity that:
(1) Demonstrates a commitment to serving low-income
and underserved populations.
(2) Provides outcome-based community behavioral health
care treatment or services.
(3) Does not restrict access or services because of a
client's financial limitation.
(4) Is a community behavioral health care provider
certified by the Department, or a licensed community
behavioral health care provider holding a purchase of care
contract with the State under the State's Medicaid program.
An organization that is licensed or certified by the

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Department may apply to the Department for designation as an
essential community behavioral health care provider. The
Department, through administrative rule, shall describe the
standards and process of designating an essential community
behavioral health care provider, establishing the community to
be served, other criteria for selection, and grounds for
termination.
(c) An organization designated as an essential community
behavioral health care provider under subsection (b) and all
members of the care treatment and service staff of the
essential community behavioral health care provider shall
agree to serve enrollees of all health insurers or health care
service contractors operating in the area that the designated
essential community behavioral health care provider serves.
Health insurers shall include State programs funded under Title
XIX and Title XXI of the federal Social Security Act, including
the State's Medicaid program and the Covering ALL KIDS and
Young Adults Health Insurance Program; other programs funded by
the Department of Healthcare and Family Services for non-public
employees; and programs for both the insured and uninsured
funded by the Department of Human Services.
(d) An essential community behavioral health care provider
shall be compensated on a fee-for-service basis within a global
budget or within a risk-based incentive contract in accordance
with the contracts and standards of the respective payors.
Staff members and other health care providers in the service

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area of the designated essential community behavioral health
care provider shall not be restricted from providing care,
treatment, or services through affiliation with any other
health insurer or health care service contractor.
(e) A designation of a community behavioral health care
provider as an essential community behavioral health care
provider shall end 5 years after the date the designation is
granted. The Department, however, may terminate the
designation for cause before the end of the 5-year period if
the essential community behavioral health care provider fails
to comply with the eligibility standards set forth in
subsection (b).
A designated essential community behavioral health care
provider may reapply for designation 6 months prior to the
designation ending and shall provide documented evidence that
the provider continues to meet all criteria for designation.
If the essential community behavioral health care provider
continues to meet all criteria for designation, the Department
shall continue the designation for an additional 5-year period.
(Source: P.A. 97-166, eff. 7-22-11.)
Section 10. The State Finance Act is amended by changing
Sections 6z-52, 6z-73, 6z-81, and 25 as follows:
(30 ILCS 105/6z-52)
Sec. 6z-52. Drug Rebate Fund.

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(a) There is created in the State Treasury a special fund
to be known as the Drug Rebate Fund.
(b) The Fund is created for the purpose of receiving and
disbursing moneys in accordance with this Section.
Disbursements from the Fund shall be made, subject to
appropriation, only as follows:
(1) For payments for reimbursement or coverage for
prescription drugs and other pharmacy products provided to
a recipient of medical assistance under the Illinois Public
Aid Code, the Children's Health Insurance Program Act, the
Covering ALL KIDS and Young Adults Health Insurance Act,
and the Veterans' Health Insurance Program Act of 2008.
(1.5) For payments to managed care organizations as
defined in Section 5-30.1 of the Illinois Public Aid Code.
(2) For reimbursement of moneys collected by the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) through error or
mistake.
(3) For payments of any amounts that are reimbursable
to the federal government resulting from a payment into
this Fund.
(4) For payments of operational and administrative
expenses related to providing and managing coverage for
prescription drugs and other pharmacy products provided to
a recipient of medical assistance under the Illinois Public
Aid Code, the Children's Health Insurance Program Act, the

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Covering ALL KIDS and Young Adults Health Insurance Act,
and the Veterans' Health Insurance Program Act of 2008.
(c) The Fund shall consist of the following:
(1) Upon notification from the Director of Healthcare
and Family Services, the Comptroller shall direct and the
Treasurer shall transfer the net State share (disregarding
the reduction in net State share attributable to the
American Recovery and Reinvestment Act of 2009 or any other
federal economic stimulus program) of all moneys received
by the Department of Healthcare and Family Services
(formerly Illinois Department of Public Aid) from drug
rebate agreements with pharmaceutical manufacturers
pursuant to Title XIX of the federal Social Security Act,
including any portion of the balance in the Public Aid
Recoveries Trust Fund on July 1, 2001 that is attributable
to such receipts.
(2) All federal matching funds received by the Illinois
Department as a result of expenditures made by the
Department that are attributable to moneys deposited in the
Fund.
(3) Any premium collected by the Illinois Department
from participants under a waiver approved by the federal
government relating to provision of pharmaceutical
services.
(4) All other moneys received for the Fund from any
other source, including interest earned thereon.

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(Source: P.A. 100-23, eff. 7-6-17.)
(30 ILCS 105/6z-73)
Sec. 6z-73. Financial Institutions Settlement of 2008
Fund. The Financial Institutions Settlement of 2008 Fund is
created as a nonappropriated trust fund to be held outside the
State treasury, with the State Treasurer as custodian. Moneys
in the Fund shall be used by the Comptroller solely for the
purpose of payment of outstanding vouchers as of the effective
date of this amendatory Act of the 95th General Assembly for
expenses related to medical assistance under the Illinois
Public Aid Code, the Children's Health Insurance Program Act,
the Covering ALL KIDS and Young Adults Health Insurance Act,
and the Senior Citizens and Disabled Persons Property Tax
Relief and Pharmaceutical Assistance Act. The Department of
Healthcare and Family Services must submit all necessary and
proper documentation to the Comptroller for administration of
this Fund.
(Source: P.A. 95-1047, eff. 4-6-09.)
(30 ILCS 105/6z-81)
Sec. 6z-81. Healthcare Provider Relief Fund.
(a) There is created in the State treasury a special fund
to be known as the Healthcare Provider Relief Fund.
(b) The Fund is created for the purpose of receiving and
disbursing moneys in accordance with this Section.

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Disbursements from the Fund shall be made only as follows:
(1) Subject to appropriation, for payment by the
Department of Healthcare and Family Services or by the
Department of Human Services of medical bills and related
expenses, including administrative expenses, for which the
State is responsible under Titles XIX and XXI of the Social
Security Act, the Illinois Public Aid Code, the Children's
Health Insurance Program Act, the Covering ALL KIDS and
Young Adults Health Insurance Act, and the Long Term Acute
Care Hospital Quality Improvement Transfer Program Act.
(2) For repayment of funds borrowed from other State
funds or from outside sources, including interest thereon.
(3) For State fiscal years 2017, 2018, and 2019, for
making payments to the human poison control center pursuant
to Section 12-4.105 of the Illinois Public Aid Code.
(c) The Fund shall consist of the following:
(1) Moneys received by the State from short-term
borrowing pursuant to the Short Term Borrowing Act on or
after the effective date of Public Act 96-820.
(2) All federal matching funds received by the Illinois
Department of Healthcare and Family Services as a result of
expenditures made by the Department that are attributable
to moneys deposited in the Fund.
(3) All federal matching funds received by the Illinois
Department of Healthcare and Family Services as a result of
federal approval of Title XIX State plan amendment

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transmittal number 07-09.
(4) All other moneys received for the Fund from any
other source, including interest earned thereon.
(5) All federal matching funds received by the Illinois
Department of Healthcare and Family Services as a result of
expenditures made by the Department for Medical Assistance
from the General Revenue Fund, the Tobacco Settlement
Recovery Fund, the Long-Term Care Provider Fund, and the
Drug Rebate Fund related to individuals eligible for
medical assistance pursuant to the Patient Protection and
Affordable Care Act (P.L. 111-148) and Section 5-2 of the
Illinois Public Aid Code.
(d) In addition to any other transfers that may be provided
for by law, on the effective date of Public Act 97-44, or as
soon thereafter as practical, the State Comptroller shall
direct and the State Treasurer shall transfer the sum of
$365,000,000 from the General Revenue Fund into the Healthcare
Provider Relief Fund.
(e) In addition to any other transfers that may be provided
for by law, on July 1, 2011, or as soon thereafter as
practical, the State Comptroller shall direct and the State
Treasurer shall transfer the sum of $160,000,000 from the
General Revenue Fund to the Healthcare Provider Relief Fund.
(f) Notwithstanding any other State law to the contrary,
and in addition to any other transfers that may be provided for
by law, the State Comptroller shall order transferred and the

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State Treasurer shall transfer $500,000,000 to the Healthcare
Provider Relief Fund from the General Revenue Fund in equal
monthly installments of $100,000,000, with the first transfer
to be made on July 1, 2012, or as soon thereafter as practical,
and with each of the remaining transfers to be made on August
1, 2012, September 1, 2012, October 1, 2012, and November 1,
2012, or as soon thereafter as practical. This transfer may
assist the Department of Healthcare and Family Services in
improving Medical Assistance bill processing timeframes or in
meeting the possible requirements of Senate Bill 3397, or other
similar legislation, of the 97th General Assembly should it
become law.
(g) Notwithstanding any other State law to the contrary,
and in addition to any other transfers that may be provided for
by law, on July 1, 2013, or as soon thereafter as may be
practical, the State Comptroller shall direct and the State
Treasurer shall transfer the sum of $601,000,000 from the
General Revenue Fund to the Healthcare Provider Relief Fund.
(Source: P.A. 99-516, eff. 6-30-16; 100-587, eff. 6-4-18.)
(30 ILCS 105/25) (from Ch. 127, par. 161)
Sec. 25. Fiscal year limitations.
(a) All appropriations shall be available for expenditure
for the fiscal year or for a lesser period if the Act making
that appropriation so specifies. A deficiency or emergency
appropriation shall be available for expenditure only through

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June 30 of the year when the Act making that appropriation is
enacted unless that Act otherwise provides.
(b) Outstanding liabilities as of June 30, payable from
appropriations which have otherwise expired, may be paid out of
the expiring appropriations during the 2-month period ending at
the close of business on August 31. Any service involving
professional or artistic skills or any personal services by an
employee whose compensation is subject to income tax
withholding must be performed as of June 30 of the fiscal year
in order to be considered an "outstanding liability as of June
30" that is thereby eligible for payment out of the expiring
appropriation.
(b-1) However, payment of tuition reimbursement claims
under Section 14-7.03 or 18-3 of the School Code may be made by
the State Board of Education from its appropriations for those
respective purposes for any fiscal year, even though the claims
reimbursed by the payment may be claims attributable to a prior
fiscal year, and payments may be made at the direction of the
State Superintendent of Education from the fund from which the
appropriation is made without regard to any fiscal year
limitations, except as required by subsection (j) of this
Section. Beginning on June 30, 2021, payment of tuition
reimbursement claims under Section 14-7.03 or 18-3 of the
School Code as of June 30, payable from appropriations that
have otherwise expired, may be paid out of the expiring
appropriation during the 4-month period ending at the close of

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business on October 31.
(b-2) All outstanding liabilities as of June 30, 2010,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2010, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2010, without regard to the
fiscal year in which the payment is made, as long as vouchers
for the liabilities are received by the Comptroller no later
than August 31, 2010.
(b-2.5) All outstanding liabilities as of June 30, 2011,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2011, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2011, without regard to the
fiscal year in which the payment is made, as long as vouchers
for the liabilities are received by the Comptroller no later
than August 31, 2011.
(b-2.6) All outstanding liabilities as of June 30, 2012,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2012, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2012, without regard to the
fiscal year in which the payment is made, as long as vouchers

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for the liabilities are received by the Comptroller no later
than August 31, 2012.
(b-2.6a) All outstanding liabilities as of June 30, 2017,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2017, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2017, without regard to the
fiscal year in which the payment is made, as long as vouchers
for the liabilities are received by the Comptroller no later
than September 30, 2017.
(b-2.6b) All outstanding liabilities as of June 30, 2018,
payable from appropriations that would otherwise expire at the
conclusion of the lapse period for fiscal year 2018, and
interest penalties payable on those liabilities under the State
Prompt Payment Act, may be paid out of the expiring
appropriations until December 31, 2018, without regard to the
fiscal year in which the payment is made, as long as vouchers
for the liabilities are received by the Comptroller no later
than October 31, 2018.
(b-2.7) For fiscal years 2012, 2013, and 2014, interest
penalties payable under the State Prompt Payment Act associated
with a voucher for which payment is issued after June 30 may be
paid out of the next fiscal year's appropriation. The future
year appropriation must be for the same purpose and from the
same fund as the original payment. An interest penalty voucher

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submitted against a future year appropriation must be submitted
within 60 days after the issuance of the associated voucher,
and the Comptroller must issue the interest payment within 60
days after acceptance of the interest voucher.
(b-3) Medical payments may be made by the Department of
Veterans' Affairs from its appropriations for those purposes
for any fiscal year, without regard to the fact that the
medical services being compensated for by such payment may have
been rendered in a prior fiscal year, except as required by
subsection (j) of this Section. Beginning on June 30, 2021,
medical payments payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
(b-4) Medical payments and child care payments may be made
by the Department of Human Services (as successor to the
Department of Public Aid) from appropriations for those
purposes for any fiscal year, without regard to the fact that
the medical or child care services being compensated for by
such payment may have been rendered in a prior fiscal year; and
payments may be made at the direction of the Department of
Healthcare and Family Services (or successor agency) from the
Health Insurance Reserve Fund without regard to any fiscal year
limitations, except as required by subsection (j) of this
Section. Beginning on June 30, 2021, medical and child care
payments made by the Department of Human Services and payments

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made at the discretion of the Department of Healthcare and
Family Services (or successor agency) from the Health Insurance
Reserve Fund and payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
(b-5) Medical payments may be made by the Department of
Human Services from its appropriations relating to substance
abuse treatment services for any fiscal year, without regard to
the fact that the medical services being compensated for by
such payment may have been rendered in a prior fiscal year,
provided the payments are made on a fee-for-service basis
consistent with requirements established for Medicaid
reimbursement by the Department of Healthcare and Family
Services, except as required by subsection (j) of this Section.
Beginning on June 30, 2021, medical payments made by the
Department of Human Services relating to substance abuse
treatment services payable from appropriations that have
otherwise expired may be paid out of the expiring appropriation
during the 4-month period ending at the close of business on
October 31.
(b-6) Additionally, payments may be made by the Department
of Human Services from its appropriations, or any other State
agency from its appropriations with the approval of the
Department of Human Services, from the Immigration Reform and
Control Fund for purposes authorized pursuant to the

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Immigration Reform and Control Act of 1986, without regard to
any fiscal year limitations, except as required by subsection
(j) of this Section. Beginning on June 30, 2021, payments made
by the Department of Human Services from the Immigration Reform
and Control Fund for purposes authorized pursuant to the
Immigration Reform and Control Act of 1986 payable from
appropriations that have otherwise expired may be paid out of
the expiring appropriation during the 4-month period ending at
the close of business on October 31.
(b-7) Payments may be made in accordance with a plan
authorized by paragraph (11) or (12) of Section 405-105 of the
Department of Central Management Services Law from
appropriations for those payments without regard to fiscal year
limitations.
(b-8) Reimbursements to eligible airport sponsors for the
construction or upgrading of Automated Weather Observation
Systems may be made by the Department of Transportation from
appropriations for those purposes for any fiscal year, without
regard to the fact that the qualification or obligation may
have occurred in a prior fiscal year, provided that at the time
the expenditure was made the project had been approved by the
Department of Transportation prior to June 1, 2012 and, as a
result of recent changes in federal funding formulas, can no
longer receive federal reimbursement.
(b-9) Medical payments not exceeding $150,000,000 may be
made by the Department on Aging from its appropriations

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relating to the Community Care Program for fiscal year 2014,
without regard to the fact that the medical services being
compensated for by such payment may have been rendered in a
prior fiscal year, provided the payments are made on a
fee-for-service basis consistent with requirements established
for Medicaid reimbursement by the Department of Healthcare and
Family Services, except as required by subsection (j) of this
Section.
(c) Further, payments may be made by the Department of
Public Health and the Department of Human Services (acting as
successor to the Department of Public Health under the
Department of Human Services Act) from their respective
appropriations for grants for medical care to or on behalf of
premature and high-mortality risk infants and their mothers and
for grants for supplemental food supplies provided under the
United States Department of Agriculture Women, Infants and
Children Nutrition Program, for any fiscal year without regard
to the fact that the services being compensated for by such
payment may have been rendered in a prior fiscal year, except
as required by subsection (j) of this Section. Beginning on
June 30, 2021, payments made by the Department of Public Health
and the Department of Human Services from their respective
appropriations for grants for medical care to or on behalf of
premature and high-mortality risk infants and their mothers and
for grants for supplemental food supplies provided under the
United States Department of Agriculture Women, Infants and

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Children Nutrition Program payable from appropriations that
have otherwise expired may be paid out of the expiring
appropriations during the 4-month period ending at the close of
business on October 31.
(d) The Department of Public Health and the Department of
Human Services (acting as successor to the Department of Public
Health under the Department of Human Services Act) shall each
annually submit to the State Comptroller, Senate President,
Senate Minority Leader, Speaker of the House, House Minority
Leader, and the respective Chairmen and Minority Spokesmen of
the Appropriations Committees of the Senate and the House, on
or before December 31, a report of fiscal year funds used to
pay for services provided in any prior fiscal year. This report
shall document by program or service category those
expenditures from the most recently completed fiscal year used
to pay for services provided in prior fiscal years.
(e) The Department of Healthcare and Family Services, the
Department of Human Services (acting as successor to the
Department of Public Aid), and the Department of Human Services
making fee-for-service payments relating to substance abuse
treatment services provided during a previous fiscal year shall
each annually submit to the State Comptroller, Senate
President, Senate Minority Leader, Speaker of the House, House
Minority Leader, the respective Chairmen and Minority
Spokesmen of the Appropriations Committees of the Senate and
the House, on or before November 30, a report that shall

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document by program or service category those expenditures from
the most recently completed fiscal year used to pay for (i)
services provided in prior fiscal years and (ii) services for
which claims were received in prior fiscal years.
(f) The Department of Human Services (as successor to the
Department of Public Aid) shall annually submit to the State
Comptroller, Senate President, Senate Minority Leader, Speaker
of the House, House Minority Leader, and the respective
Chairmen and Minority Spokesmen of the Appropriations
Committees of the Senate and the House, on or before December
31, a report of fiscal year funds used to pay for services
(other than medical care) provided in any prior fiscal year.
This report shall document by program or service category those
expenditures from the most recently completed fiscal year used
to pay for services provided in prior fiscal years.
(g) In addition, each annual report required to be
submitted by the Department of Healthcare and Family Services
under subsection (e) shall include the following information
with respect to the State's Medicaid program:
(1) Explanations of the exact causes of the variance
between the previous year's estimated and actual
liabilities.
(2) Factors affecting the Department of Healthcare and
Family Services' liabilities, including but not limited to
numbers of aid recipients, levels of medical service
utilization by aid recipients, and inflation in the cost of

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medical services.
(3) The results of the Department's efforts to combat
fraud and abuse.
(h) As provided in Section 4 of the General Assembly
Compensation Act, any utility bill for service provided to a
General Assembly member's district office for a period
including portions of 2 consecutive fiscal years may be paid
from funds appropriated for such expenditure in either fiscal
year.
(i) An agency which administers a fund classified by the
Comptroller as an internal service fund may issue rules for:
(1) billing user agencies in advance for payments or
authorized inter-fund transfers based on estimated charges
for goods or services;
(2) issuing credits, refunding through inter-fund
transfers, or reducing future inter-fund transfers during
the subsequent fiscal year for all user agency payments or
authorized inter-fund transfers received during the prior
fiscal year which were in excess of the final amounts owed
by the user agency for that period; and
(3) issuing catch-up billings to user agencies during
the subsequent fiscal year for amounts remaining due when
payments or authorized inter-fund transfers received from
the user agency during the prior fiscal year were less than
the total amount owed for that period.
User agencies are authorized to reimburse internal service

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funds for catch-up billings by vouchers drawn against their
respective appropriations for the fiscal year in which the
catch-up billing was issued or by increasing an authorized
inter-fund transfer during the current fiscal year. For the
purposes of this Act, "inter-fund transfers" means transfers
without the use of the voucher-warrant process, as authorized
by Section 9.01 of the State Comptroller Act.
(i-1) Beginning on July 1, 2021, all outstanding
liabilities, not payable during the 4-month lapse period as
described in subsections (b-1), (b-3), (b-4), (b-5), (b-6), and
(c) of this Section, that are made from appropriations for that
purpose for any fiscal year, without regard to the fact that
the services being compensated for by those payments may have
been rendered in a prior fiscal year, are limited to only those
claims that have been incurred but for which a proper bill or
invoice as defined by the State Prompt Payment Act has not been
received by September 30th following the end of the fiscal year
in which the service was rendered.
(j) Notwithstanding any other provision of this Act, the
aggregate amount of payments to be made without regard for
fiscal year limitations as contained in subsections (b-1),
(b-3), (b-4), (b-5), (b-6), and (c) of this Section, and
determined by using Generally Accepted Accounting Principles,
shall not exceed the following amounts:
(1) $6,000,000,000 for outstanding liabilities related
to fiscal year 2012;

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(2) $5,300,000,000 for outstanding liabilities related
to fiscal year 2013;
(3) $4,600,000,000 for outstanding liabilities related
to fiscal year 2014;
(4) $4,000,000,000 for outstanding liabilities related
to fiscal year 2015;
(5) $3,300,000,000 for outstanding liabilities related
to fiscal year 2016;
(6) $2,600,000,000 for outstanding liabilities related
to fiscal year 2017;
(7) $2,000,000,000 for outstanding liabilities related
to fiscal year 2018;
(8) $1,300,000,000 for outstanding liabilities related
to fiscal year 2019;
(9) $600,000,000 for outstanding liabilities related
to fiscal year 2020; and
(10) $0 for outstanding liabilities related to fiscal
year 2021 and fiscal years thereafter.
(k) Department of Healthcare and Family Services Medical
Assistance Payments.
(1) Definition of Medical Assistance.
For purposes of this subsection, the term "Medical
Assistance" shall include, but not necessarily be
limited to, medical programs and services authorized
under Titles XIX and XXI of the Social Security Act,
the Illinois Public Aid Code, the Children's Health

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Insurance Program Act, the Covering ALL KIDS and Young
Adults Health Insurance Act, the Long Term Acute Care
Hospital Quality Improvement Transfer Program Act, and
medical care to or on behalf of persons suffering from
chronic renal disease, persons suffering from
hemophilia, and victims of sexual assault.
(2) Limitations on Medical Assistance payments that
may be paid from future fiscal year appropriations.
(A) The maximum amounts of annual unpaid Medical
Assistance bills received and recorded by the
Department of Healthcare and Family Services on or
before June 30th of a particular fiscal year
attributable in aggregate to the General Revenue Fund,
Healthcare Provider Relief Fund, Tobacco Settlement
Recovery Fund, Long-Term Care Provider Fund, and the
Drug Rebate Fund that may be paid in total by the
Department from future fiscal year Medical Assistance
appropriations to those funds are: $700,000,000 for
fiscal year 2013 and $100,000,000 for fiscal year 2014
and each fiscal year thereafter.
(B) Bills for Medical Assistance services rendered
in a particular fiscal year, but received and recorded
by the Department of Healthcare and Family Services
after June 30th of that fiscal year, may be paid from
either appropriations for that fiscal year or future
fiscal year appropriations for Medical Assistance.

SB2017 - 24 - LRB101 09603 RAB 54701 b
Such payments shall not be subject to the requirements
of subparagraph (A).
(C) Medical Assistance bills received by the
Department of Healthcare and Family Services in a
particular fiscal year, but subject to payment amount
adjustments in a future fiscal year may be paid from a
future fiscal year's appropriation for Medical
Assistance. Such payments shall not be subject to the
requirements of subparagraph (A).
(D) Medical Assistance payments made by the
Department of Healthcare and Family Services from
funds other than those specifically referenced in
subparagraph (A) may be made from appropriations for
those purposes for any fiscal year without regard to
the fact that the Medical Assistance services being
compensated for by such payment may have been rendered
in a prior fiscal year. Such payments shall not be
subject to the requirements of subparagraph (A).
(3) Extended lapse period for Department of Healthcare
and Family Services Medical Assistance payments.
Notwithstanding any other State law to the contrary,
outstanding Department of Healthcare and Family Services
Medical Assistance liabilities, as of June 30th, payable
from appropriations which have otherwise expired, may be
paid out of the expiring appropriations during the 6-month
period ending at the close of business on December 31st.

SB2017 - 25 - LRB101 09603 RAB 54701 b
(l) The changes to this Section made by Public Act 97-691
shall be effective for payment of Medical Assistance bills
incurred in fiscal year 2013 and future fiscal years. The
changes to this Section made by Public Act 97-691 shall not be
applied to Medical Assistance bills incurred in fiscal year
2012 or prior fiscal years.
(m) The Comptroller must issue payments against
outstanding liabilities that were received prior to the lapse
period deadlines set forth in this Section as soon thereafter
as practical, but no payment may be issued after the 4 months
following the lapse period deadline without the signed
authorization of the Comptroller and the Governor.
(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18.)
Section 15. The State Prompt Payment Act is amended by
changing Section 3-2 as follows:
(30 ILCS 540/3-2)
Sec. 3-2. Beginning July 1, 1993, in any instance where a
State official or agency is late in payment of a vendor's bill
or invoice for goods or services furnished to the State, as
defined in Section 1, properly approved in accordance with
rules promulgated under Section 3-3, the State official or
agency shall pay interest to the vendor in accordance with the
following:
(1) Any bill, except a bill submitted under Article V

SB2017 - 26 - LRB101 09603 RAB 54701 b
of the Illinois Public Aid Code and except as provided
under paragraph (1.05) of this Section, approved for
payment under this Section must be paid or the payment
issued to the payee within 60 days of receipt of a proper
bill or invoice. If payment is not issued to the payee
within this 60-day period, an interest penalty of 1.0% of
any amount approved and unpaid shall be added for each
month or fraction thereof after the end of this 60-day
period, until final payment is made. Any bill, except a
bill for pharmacy or nursing facility services or goods,
and except as provided under paragraph (1.05) of this
Section, submitted under Article V of the Illinois Public
Aid Code approved for payment under this Section must be
paid or the payment issued to the payee within 60 days
after receipt of a proper bill or invoice, and, if payment
is not issued to the payee within this 60-day period, an
interest penalty of 2.0% of any amount approved and unpaid
shall be added for each month or fraction thereof after the
end of this 60-day period, until final payment is made. Any
bill for pharmacy or nursing facility services or goods
submitted under Article V of the Illinois Public Aid Code,
except as provided under paragraph (1.05) of this Section,
and approved for payment under this Section must be paid or
the payment issued to the payee within 60 days of receipt
of a proper bill or invoice. If payment is not issued to
the payee within this 60-day period, an interest penalty of

SB2017 - 27 - LRB101 09603 RAB 54701 b
1.0% of any amount approved and unpaid shall be added for
each month or fraction thereof after the end of this 60-day
period, until final payment is made.
(1.05) For State fiscal year 2012 and future fiscal
years, any bill approved for payment under this Section
must be paid or the payment issued to the payee within 90
days of receipt of a proper bill or invoice. If payment is
not issued to the payee within this 90-day period, an
interest penalty of 1.0% of any amount approved and unpaid
shall be added for each month, or 0.033% (one-thirtieth of
one percent) of any amount approved and unpaid for each
day, after the end of this 90-day period, until final
payment is made.
(1.1) A State agency shall review in a timely manner
each bill or invoice after its receipt. If the State agency
determines that the bill or invoice contains a defect
making it unable to process the payment request, the agency
shall notify the vendor requesting payment as soon as
possible after discovering the defect pursuant to rules
promulgated under Section 3-3; provided, however, that the
notice for construction related bills or invoices must be
given not later than 30 days after the bill or invoice was
first submitted. The notice shall identify the defect and
any additional information necessary to correct the
defect. If one or more items on a construction related bill
or invoice are disapproved, but not the entire bill or

SB2017 - 28 - LRB101 09603 RAB 54701 b
invoice, then the portion that is not disapproved shall be
paid.
(2) Where a State official or agency is late in payment
of a vendor's bill or invoice properly approved in
accordance with this Act, and different late payment terms
are not reduced to writing as a contractual agreement, the
State official or agency shall automatically pay interest
penalties required by this Section amounting to $50 or more
to the appropriate vendor. Each agency shall be responsible
for determining whether an interest penalty is owed and for
paying the interest to the vendor. Except as provided in
paragraph (4), an individual interest payment amounting to
$5 or less shall not be paid by the State. Interest due to
a vendor that amounts to greater than $5 and less than $50
shall not be paid but shall be accrued until all interest
due the vendor for all similar warrants exceeds $50, at
which time the accrued interest shall be payable and
interest will begin accruing again, except that interest
accrued as of the end of the fiscal year that does not
exceed $50 shall be payable at that time. In the event an
individual has paid a vendor for services in advance, the
provisions of this Section shall apply until payment is
made to that individual.
(3) The provisions of Public Act 96-1501 reducing the
interest rate on pharmacy claims under Article V of the
Illinois Public Aid Code to 1.0% per month shall apply to

SB2017 - 29 - LRB101 09603 RAB 54701 b
any pharmacy bills for services and goods under Article V
of the Illinois Public Aid Code received on or after the
date 60 days before January 25, 2011 (the effective date of
Public Act 96-1501) except as provided under paragraph
(1.05) of this Section.
(4) Interest amounting to less than $5 shall not be
paid by the State, except for claims (i) to the Department
of Healthcare and Family Services or the Department of
Human Services, (ii) pursuant to Article V of the Illinois
Public Aid Code, the Covering ALL KIDS and Young Adults
Health Insurance Act, or the Children's Health Insurance
Program Act, and (iii) made (A) by pharmacies for
prescriptive services or (B) by any federally qualified
health center for prescriptive services or any other
services.
Notwithstanding any provision to the contrary, interest
may not be paid under this Act when: (1) a Chief Procurement
Officer has voided the underlying contract for goods or
services under Article 50 of the Illinois Procurement Code; or
(2) the Auditor General is conducting a performance or program
audit and the Comptroller has held or is holding for review a
related contract or vouchers for payment of goods or services
in the exercise of duties under Section 9 of the State
Comptroller Act. In such event, interest shall not accrue
during the pendency of the Auditor General's review.
(Source: P.A. 100-1064, eff. 8-24-18.)

SB2017 - 30 - LRB101 09603 RAB 54701 b
Section 20. The Use Tax Act is amended by changing Section
3-8 as follows:
(35 ILCS 105/3-8)
Sec. 3-8. Hospital exemption.
(a) Tangible personal property sold to or used by a
hospital owner that owns one or more hospitals licensed under
the Hospital Licensing Act or operated under the University of
Illinois Hospital Act, or a hospital affiliate that is not
already exempt under another provision of this Act and meets
the criteria for an exemption under this Section, is exempt
from taxation under this Act.
(b) A hospital owner or hospital affiliate satisfies the
conditions for an exemption under this Section if the value of
qualified services or activities listed in subsection (c) of
this Section for the hospital year equals or exceeds the
relevant hospital entity's estimated property tax liability,
without regard to any property tax exemption granted under
Section 15-86 of the Property Tax Code, for the calendar year
in which exemption or renewal of exemption is sought. For
purposes of making the calculations required by this subsection
(b), if the relevant hospital entity is a hospital owner that
owns more than one hospital, the value of the services or
activities listed in subsection (c) shall be calculated on the
basis of only those services and activities relating to the

SB2017 - 31 - LRB101 09603 RAB 54701 b
hospital that includes the subject property, and the relevant
hospital entity's estimated property tax liability shall be
calculated only with respect to the properties comprising that
hospital. In the case of a multi-state hospital system or
hospital affiliate, the value of the services or activities
listed in subsection (c) shall be calculated on the basis of
only those services and activities that occur in Illinois and
the relevant hospital entity's estimated property tax
liability shall be calculated only with respect to its property
located in Illinois.
(c) The following services and activities shall be
considered for purposes of making the calculations required by
subsection (b):
(1) Charity care. Free or discounted services provided
pursuant to the relevant hospital entity's financial
assistance policy, measured at cost, including discounts
provided under the Hospital Uninsured Patient Discount
Act.
(2) Health services to low-income and underserved
individuals. Other unreimbursed costs of the relevant
hospital entity for providing without charge, paying for,
or subsidizing goods, activities, or services for the
purpose of addressing the health of low-income or
underserved individuals. Those activities or services may
include, but are not limited to: financial or in-kind
support to affiliated or unaffiliated hospitals, hospital

SB2017 - 32 - LRB101 09603 RAB 54701 b
affiliates, community clinics, or programs that treat
low-income or underserved individuals; paying for or
subsidizing health care professionals who care for
low-income or underserved individuals; providing or
subsidizing outreach or educational services to low-income
or underserved individuals for disease management and
prevention; free or subsidized goods, supplies, or
services needed by low-income or underserved individuals
because of their medical condition; and prenatal or
childbirth outreach to low-income or underserved persons.
(3) Subsidy of State or local governments. Direct or
indirect financial or in-kind subsidies of State or local
governments by the relevant hospital entity that pay for or
subsidize activities or programs related to health care for
low-income or underserved individuals.
(4) Support for State health care programs for
low-income individuals. At the election of the hospital
applicant for each applicable year, either (A) 10% of
payments to the relevant hospital entity and any hospital
affiliate designated by the relevant hospital entity
(provided that such hospital affiliate's operations
provide financial or operational support for or receive
financial or operational support from the relevant
hospital entity) under Medicaid or other means-tested
programs, including, but not limited to, General
Assistance, the Covering ALL KIDS and Young Adults Health

SB2017 - 33 - LRB101 09603 RAB 54701 b
Insurance Act, and the State Children's Health Insurance
Program or (B) the amount of subsidy provided by the
relevant hospital entity and any hospital affiliate
designated by the relevant hospital entity (provided that
such hospital affiliate's operations provide financial or
operational support for or receive financial or
operational support from the relevant hospital entity) to
State or local government in treating Medicaid recipients
and recipients of means-tested programs, including but not
limited to General Assistance, the Covering ALL KIDS and
Young Adults Health Insurance Act, and the State Children's
Health Insurance Program. The amount of subsidy for purpose
of this item (4) is calculated in the same manner as
unreimbursed costs are calculated for Medicaid and other
means-tested government programs in the Schedule H of IRS
Form 990 in effect on the effective date of this amendatory
Act of the 97th General Assembly.
(5) Dual-eligible subsidy. The amount of subsidy
provided to government by treating dual-eligible
Medicare/Medicaid patients. The amount of subsidy for
purposes of this item (5) is calculated by multiplying the
relevant hospital entity's unreimbursed costs for
Medicare, calculated in the same manner as determined in
the Schedule H of IRS Form 990 in effect on the effective
date of this amendatory Act of the 97th General Assembly,
by the relevant hospital entity's ratio of dual-eligible

SB2017 - 34 - LRB101 09603 RAB 54701 b
patients to total Medicare patients.
(6) Relief of the burden of government related to
health care. Except to the extent otherwise taken into
account in this subsection, the portion of unreimbursed
costs of the relevant hospital entity attributable to
providing, paying for, or subsidizing goods, activities,
or services that relieve the burden of government related
to health care for low-income individuals. Such activities
or services shall include, but are not limited to,
providing emergency, trauma, burn, neonatal, psychiatric,
rehabilitation, or other special services; providing
medical education; and conducting medical research or
training of health care professionals. The portion of those
unreimbursed costs attributable to benefiting low-income
individuals shall be determined using the ratio calculated
by adding the relevant hospital entity's costs
attributable to charity care, Medicaid, other means-tested
government programs, Medicare patients with disabilities
under age 65, and dual-eligible Medicare/Medicaid patients
and dividing that total by the relevant hospital entity's
total costs. Such costs for the numerator and denominator
shall be determined by multiplying gross charges by the
cost to charge ratio taken from the hospital's most
recently filed Medicare cost report (CMS 2252-10
Worksheet, Part I). In the case of emergency services, the
ratio shall be calculated using costs (gross charges

SB2017 - 35 - LRB101 09603 RAB 54701 b
multiplied by the cost to charge ratio taken from the
hospital's most recently filed Medicare cost report (CMS
2252-10 Worksheet, Part I)) of patients treated in the
relevant hospital entity's emergency department.
(7) Any other activity by the relevant hospital entity
that the Department determines relieves the burden of
government or addresses the health of low-income or
underserved individuals.
(d) The hospital applicant shall include information in its
exemption application establishing that it satisfies the
requirements of subsection (b). For purposes of making the
calculations required by subsection (b), the hospital
applicant may for each year elect to use either (1) the value
of the services or activities listed in subsection (e) for the
hospital year or (2) the average value of those services or
activities for the 3 fiscal years ending with the hospital
year. If the relevant hospital entity has been in operation for
less than 3 completed fiscal years, then the latter
calculation, if elected, shall be performed on a pro rata
basis.
(e) For purposes of making the calculations required by
this Section:
(1) particular services or activities eligible for
consideration under any of the paragraphs (1) through (7)
of subsection (c) may not be counted under more than one of
those paragraphs; and

SB2017 - 36 - LRB101 09603 RAB 54701 b
(2) the amount of unreimbursed costs and the amount of
subsidy shall not be reduced by restricted or unrestricted
payments received by the relevant hospital entity as
contributions deductible under Section 170(a) of the
Internal Revenue Code.
(f) (Blank).
(g) Estimation of Exempt Property Tax Liability. The
estimated property tax liability used for the determination in
subsection (b) shall be calculated as follows:
(1) "Estimated property tax liability" means the
estimated dollar amount of property tax that would be owed,
with respect to the exempt portion of each of the relevant
hospital entity's properties that are already fully or
partially exempt, or for which an exemption in whole or in
part is currently being sought, and then aggregated as
applicable, as if the exempt portion of those properties
were subject to tax, calculated with respect to each such
property by multiplying:
(A) the lesser of (i) the actual assessed value, if
any, of the portion of the property for which an
exemption is sought or (ii) an estimated assessed value
of the exempt portion of such property as determined in
item (2) of this subsection (g), by
(B) the applicable State equalization rate
(yielding the equalized assessed value), by
(C) the applicable tax rate.

SB2017 - 37 - LRB101 09603 RAB 54701 b
(2) The estimated assessed value of the exempt portion
of the property equals the sum of (i) the estimated fair
market value of buildings on the property, as determined in
accordance with subparagraphs (A) and (B) of this item (2),
multiplied by the applicable assessment factor, and (ii)
the estimated assessed value of the land portion of the
property, as determined in accordance with subparagraph
(C).
(A) The "estimated fair market value of buildings
on the property" means the replacement value of any
exempt portion of buildings on the property, minus
depreciation, determined utilizing the cost
replacement method whereby the exempt square footage
of all such buildings is multiplied by the replacement
cost per square foot for Class A Average building found
in the most recent edition of the Marshall & Swift
Valuation Services Manual, adjusted by any appropriate
current cost and local multipliers.
(B) Depreciation, for purposes of calculating the
estimated fair market value of buildings on the
property, is applied by utilizing a weighted mean life
for the buildings based on original construction and
assuming a 40-year life for hospital buildings and the
applicable life for other types of buildings as
specified in the American Hospital Association
publication "Estimated Useful Lives of Depreciable

SB2017 - 38 - LRB101 09603 RAB 54701 b
Hospital Assets". In the case of hospital buildings,
the remaining life is divided by 40 and this ratio is
multiplied by the replacement cost of the buildings to
obtain an estimated fair market value of buildings. If
a hospital building is older than 35 years, a remaining
life of 5 years for residual value is assumed; and if a
building is less than 8 years old, a remaining life of
32 years is assumed.
(C) The estimated assessed value of the land
portion of the property shall be determined by
multiplying (i) the per square foot average of the
assessed values of three parcels of land (not including
farm land, and excluding the assessed value of the
improvements thereon) reasonably comparable to the
property, by (ii) the number of square feet comprising
the exempt portion of the property's land square
footage.
(3) The assessment factor, State equalization rate,
and tax rate (including any special factors such as
Enterprise Zones) used in calculating the estimated
property tax liability shall be for the most recent year
that is publicly available from the applicable chief county
assessment officer or officers at least 90 days before the
end of the hospital year.
(4) The method utilized to calculate estimated
property tax liability for purposes of this Section 15-86

SB2017 - 39 - LRB101 09603 RAB 54701 b
shall not be utilized for the actual valuation, assessment,
or taxation of property pursuant to the Property Tax Code.
(h) For the purpose of this Section, the following terms
shall have the meanings set forth below:
(1) "Hospital" means any institution, place, building,
buildings on a campus, or other health care facility
located in Illinois that is licensed under the Hospital
Licensing Act and has a hospital owner.
(2) "Hospital owner" means a not-for-profit
corporation that is the titleholder of a hospital, or the
owner of the beneficial interest in an Illinois land trust
that is the titleholder of a hospital.
(3) "Hospital affiliate" means any corporation,
partnership, limited partnership, joint venture, limited
liability company, association or other organization,
other than a hospital owner, that directly or indirectly
controls, is controlled by, or is under common control with
one or more hospital owners and that supports, is supported
by, or acts in furtherance of the exempt health care
purposes of at least one of those hospital owners'
hospitals.
(4) "Hospital system" means a hospital and one or more
other hospitals or hospital affiliates related by common
control or ownership.
(5) "Control" relating to hospital owners, hospital
affiliates, or hospital systems means possession, direct

SB2017 - 40 - LRB101 09603 RAB 54701 b
or indirect, of the power to direct or cause the direction
of the management and policies of the entity, whether
through ownership of assets, membership interest, other
voting or governance rights, by contract or otherwise.
(6) "Hospital applicant" means a hospital owner or
hospital affiliate that files an application for an
exemption or renewal of exemption under this Section.
(7) "Relevant hospital entity" means (A) the hospital
owner, in the case of a hospital applicant that is a
hospital owner, and (B) at the election of a hospital
applicant that is a hospital affiliate, either (i) the
hospital affiliate or (ii) the hospital system to which the
hospital applicant belongs, including any hospitals or
hospital affiliates that are related by common control or
ownership.
(8) "Subject property" means property used for the
calculation under subsection (b) of this Section.
(9) "Hospital year" means the fiscal year of the
relevant hospital entity, or the fiscal year of one of the
hospital owners in the hospital system if the relevant
hospital entity is a hospital system with members with
different fiscal years, that ends in the year for which the
exemption is sought.
(Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.)
Section 25. The Retailers' Occupation Tax Act is amended by

SB2017 - 41 - LRB101 09603 RAB 54701 b
changing Section 2-9 as follows:
(35 ILCS 120/2-9)
Sec. 2-9. Hospital exemption.
(a) Tangible personal property sold to or used by a
hospital owner that owns one or more hospitals licensed under
the Hospital Licensing Act or operated under the University of
Illinois Hospital Act, or a hospital affiliate that is not
already exempt under another provision of this Act and meets
the criteria for an exemption under this Section, is exempt
from taxation under this Act.
(b) A hospital owner or hospital affiliate satisfies the
conditions for an exemption under this Section if the value of
qualified services or activities listed in subsection (c) of
this Section for the hospital year equals or exceeds the
relevant hospital entity's estimated property tax liability,
without regard to any property tax exemption granted under
Section 15-86 of the Property Tax Code, for the calendar year
in which exemption or renewal of exemption is sought. For
purposes of making the calculations required by this subsection
(b), if the relevant hospital entity is a hospital owner that
owns more than one hospital, the value of the services or
activities listed in subsection (c) shall be calculated on the
basis of only those services and activities relating to the
hospital that includes the subject property, and the relevant
hospital entity's estimated property tax liability shall be

SB2017 - 42 - LRB101 09603 RAB 54701 b
calculated only with respect to the properties comprising that
hospital. In the case of a multi-state hospital system or
hospital affiliate, the value of the services or activities
listed in subsection (c) shall be calculated on the basis of
only those services and activities that occur in Illinois and
the relevant hospital entity's estimated property tax
liability shall be calculated only with respect to its property
located in Illinois.
(c) The following services and activities shall be
considered for purposes of making the calculations required by
subsection (b):
(1) Charity care. Free or discounted services provided
pursuant to the relevant hospital entity's financial
assistance policy, measured at cost, including discounts
provided under the Hospital Uninsured Patient Discount
Act.
(2) Health services to low-income and underserved
individuals. Other unreimbursed costs of the relevant
hospital entity for providing without charge, paying for,
or subsidizing goods, activities, or services for the
purpose of addressing the health of low-income or
underserved individuals. Those activities or services may
include, but are not limited to: financial or in-kind
support to affiliated or unaffiliated hospitals, hospital
affiliates, community clinics, or programs that treat
low-income or underserved individuals; paying for or

SB2017 - 43 - LRB101 09603 RAB 54701 b
subsidizing health care professionals who care for
low-income or underserved individuals; providing or
subsidizing outreach or educational services to low-income
or underserved individuals for disease management and
prevention; free or subsidized goods, supplies, or
services needed by low-income or underserved individuals
because of their medical condition; and prenatal or
childbirth outreach to low-income or underserved persons.
(3) Subsidy of State or local governments. Direct or
indirect financial or in-kind subsidies of State or local
governments by the relevant hospital entity that pay for or
subsidize activities or programs related to health care for
low-income or underserved individuals.
(4) Support for State health care programs for
low-income individuals. At the election of the hospital
applicant for each applicable year, either (A) 10% of
payments to the relevant hospital entity and any hospital
affiliate designated by the relevant hospital entity
(provided that such hospital affiliate's operations
provide financial or operational support for or receive
financial or operational support from the relevant
hospital entity) under Medicaid or other means-tested
programs, including, but not limited to, General
Assistance, the Covering ALL KIDS and Young Adults Health
Insurance Act, and the State Children's Health Insurance
Program or (B) the amount of subsidy provided by the

SB2017 - 44 - LRB101 09603 RAB 54701 b
relevant hospital entity and any hospital affiliate
designated by the relevant hospital entity (provided that
such hospital affiliate's operations provide financial or
operational support for or receive financial or
operational support from the relevant hospital entity) to
State or local government in treating Medicaid recipients
and recipients of means-tested programs, including but not
limited to General Assistance, the Covering ALL KIDS Health
Insurance Act, and the State Children's Health Insurance
Program. The amount of subsidy for purposes of this item
(4) is calculated in the same manner as unreimbursed costs
are calculated for Medicaid and other means-tested
government programs in the Schedule H of IRS Form 990 in
effect on the effective date of this amendatory Act of the
97th General Assembly.
(5) Dual-eligible subsidy. The amount of subsidy
provided to government by treating dual-eligible
Medicare/Medicaid patients. The amount of subsidy for
purposes of this item (5) is calculated by multiplying the
relevant hospital entity's unreimbursed costs for
Medicare, calculated in the same manner as determined in
the Schedule H of IRS Form 990 in effect on the effective
date of this amendatory Act of the 97th General Assembly,
by the relevant hospital entity's ratio of dual-eligible
patients to total Medicare patients.
(6) Relief of the burden of government related to

SB2017 - 45 - LRB101 09603 RAB 54701 b
health care. Except to the extent otherwise taken into
account in this subsection, the portion of unreimbursed
costs of the relevant hospital entity attributable to
providing, paying for, or subsidizing goods, activities,
or services that relieve the burden of government related
to health care for low-income individuals. Such activities
or services shall include, but are not limited to,
providing emergency, trauma, burn, neonatal, psychiatric,
rehabilitation, or other special services; providing
medical education; and conducting medical research or
training of health care professionals. The portion of those
unreimbursed costs attributable to benefiting low-income
individuals shall be determined using the ratio calculated
by adding the relevant hospital entity's costs
attributable to charity care, Medicaid, other means-tested
government programs, Medicare patients with disabilities
under age 65, and dual-eligible Medicare/Medicaid patients
and dividing that total by the relevant hospital entity's
total costs. Such costs for the numerator and denominator
shall be determined by multiplying gross charges by the
cost to charge ratio taken from the hospital's most
recently filed Medicare cost report (CMS 2252-10
Worksheet, Part I). In the case of emergency services, the
ratio shall be calculated using costs (gross charges
multiplied by the cost to charge ratio taken from the
hospital's most recently filed Medicare cost report (CMS

SB2017 - 46 - LRB101 09603 RAB 54701 b
2252-10 Worksheet, Part I)) of patients treated in the
relevant hospital entity's emergency department.
(7) Any other activity by the relevant hospital entity
that the Department determines relieves the burden of
government or addresses the health of low-income or
underserved individuals.
(d) The hospital applicant shall include information in its
exemption application establishing that it satisfies the
requirements of subsection (b). For purposes of making the
calculations required by subsection (b), the hospital
applicant may for each year elect to use either (1) the value
of the services or activities listed in subsection (e) for the
hospital year or (2) the average value of those services or
activities for the 3 fiscal years ending with the hospital
year. If the relevant hospital entity has been in operation for
less than 3 completed fiscal years, then the latter
calculation, if elected, shall be performed on a pro rata
basis.
(e) For purposes of making the calculations required by
this Section:
(1) particular services or activities eligible for
consideration under any of the paragraphs (1) through (7)
of subsection (c) may not be counted under more than one of
those paragraphs; and
(2) the amount of unreimbursed costs and the amount of
subsidy shall not be reduced by restricted or unrestricted

SB2017 - 47 - LRB101 09603 RAB 54701 b
payments received by the relevant hospital entity as
contributions deductible under Section 170(a) of the
Internal Revenue Code.
(f) (Blank).
(g) Estimation of Exempt Property Tax Liability. The
estimated property tax liability used for the determination in
subsection (b) shall be calculated as follows:
(1) "Estimated property tax liability" means the
estimated dollar amount of property tax that would be owed,
with respect to the exempt portion of each of the relevant
hospital entity's properties that are already fully or
partially exempt, or for which an exemption in whole or in
part is currently being sought, and then aggregated as
applicable, as if the exempt portion of those properties
were subject to tax, calculated with respect to each such
property by multiplying:
(A) the lesser of (i) the actual assessed value, if
any, of the portion of the property for which an
exemption is sought or (ii) an estimated assessed value
of the exempt portion of such property as determined in
item (2) of this subsection (g), by
(B) the applicable State equalization rate
(yielding the equalized assessed value), by
(C) the applicable tax rate.
(2) The estimated assessed value of the exempt portion
of the property equals the sum of (i) the estimated fair

SB2017 - 48 - LRB101 09603 RAB 54701 b
market value of buildings on the property, as determined in
accordance with subparagraphs (A) and (B) of this item (2),
multiplied by the applicable assessment factor, and (ii)
the estimated assessed value of the land portion of the
property, as determined in accordance with subparagraph
(C).
(A) The "estimated fair market value of buildings
on the property" means the replacement value of any
exempt portion of buildings on the property, minus
depreciation, determined utilizing the cost
replacement method whereby the exempt square footage
of all such buildings is multiplied by the replacement
cost per square foot for Class A Average building found
in the most recent edition of the Marshall & Swift
Valuation Services Manual, adjusted by any appropriate
current cost and local multipliers.
(B) Depreciation, for purposes of calculating the
estimated fair market value of buildings on the
property, is applied by utilizing a weighted mean life
for the buildings based on original construction and
assuming a 40-year life for hospital buildings and the
applicable life for other types of buildings as
specified in the American Hospital Association
publication "Estimated Useful Lives of Depreciable
Hospital Assets". In the case of hospital buildings,
the remaining life is divided by 40 and this ratio is

SB2017 - 49 - LRB101 09603 RAB 54701 b
multiplied by the replacement cost of the buildings to
obtain an estimated fair market value of buildings. If
a hospital building is older than 35 years, a remaining
life of 5 years for residual value is assumed; and if a
building is less than 8 years old, a remaining life of
32 years is assumed.
(C) The estimated assessed value of the land
portion of the property shall be determined by
multiplying (i) the per square foot average of the
assessed values of three parcels of land (not including
farm land, and excluding the assessed value of the
improvements thereon) reasonably comparable to the
property, by (ii) the number of square feet comprising
the exempt portion of the property's land square
footage.
(3) The assessment factor, State equalization rate,
and tax rate (including any special factors such as
Enterprise Zones) used in calculating the estimated
property tax liability shall be for the most recent year
that is publicly available from the applicable chief county
assessment officer or officers at least 90 days before the
end of the hospital year.
(4) The method utilized to calculate estimated
property tax liability for purposes of this Section 15-86
shall not be utilized for the actual valuation, assessment,
or taxation of property pursuant to the Property Tax Code.

SB2017 - 50 - LRB101 09603 RAB 54701 b
(h) For the purpose of this Section, the following terms
shall have the meanings set forth below:
(1) "Hospital" means any institution, place, building,
buildings on a campus, or other health care facility
located in Illinois that is licensed under the Hospital
Licensing Act and has a hospital owner.
(2) "Hospital owner" means a not-for-profit
corporation that is the titleholder of a hospital, or the
owner of the beneficial interest in an Illinois land trust
that is the titleholder of a hospital.
(3) "Hospital affiliate" means any corporation,
partnership, limited partnership, joint venture, limited
liability company, association or other organization,
other than a hospital owner, that directly or indirectly
controls, is controlled by, or is under common control with
one or more hospital owners and that supports, is supported
by, or acts in furtherance of the exempt health care
purposes of at least one of those hospital owners'
hospitals.
(4) "Hospital system" means a hospital and one or more
other hospitals or hospital affiliates related by common
control or ownership.
(5) "Control" relating to hospital owners, hospital
affiliates, or hospital systems means possession, direct
or indirect, of the power to direct or cause the direction
of the management and policies of the entity, whether

SB2017 - 51 - LRB101 09603 RAB 54701 b
through ownership of assets, membership interest, other
voting or governance rights, by contract or otherwise.
(6) "Hospital applicant" means a hospital owner or
hospital affiliate that files an application for an
exemption or renewal of exemption under this Section.
(7) "Relevant hospital entity" means (A) the hospital
owner, in the case of a hospital applicant that is a
hospital owner, and (B) at the election of a hospital
applicant that is a hospital affiliate, either (i) the
hospital affiliate or (ii) the hospital system to which the
hospital applicant belongs, including any hospitals or
hospital affiliates that are related by common control or
ownership.
(8) "Subject property" means property used for the
calculation under subsection (b) of this Section.
(9) "Hospital year" means the fiscal year of the
relevant hospital entity, or the fiscal year of one of the
hospital owners in the hospital system if the relevant
hospital entity is a hospital system with members with
different fiscal years, that ends in the year for which the
exemption is sought.
(Source: P.A. 98-463, eff. 8-16-13; 99-143, eff. 7-27-15.)
Section 30. The Property Tax Code is amended by changing
Section 15-86 as follows:

SB2017 - 52 - LRB101 09603 RAB 54701 b
(35 ILCS 200/15-86)
Sec. 15-86. Exemptions related to access to hospital and
health care services by low-income and underserved
individuals.
(a) The General Assembly finds:
(1) Despite the Supreme Court's decision in Provena
Covenant Medical Center v. Dept. of Revenue, 236 Ill.2d
368, there is considerable uncertainty surrounding the
test for charitable property tax exemption, especially
regarding the application of a quantitative or monetary
threshold. In Provena, the Department stated that the
primary basis for its decision was the hospital's
inadequate amount of charitable activity, but the
Department has not articulated what constitutes an
adequate amount of charitable activity. After Provena, the
Department denied property tax exemption applications of 3
more hospitals, and, on the effective date of this
amendatory Act of the 97th General Assembly, at least 20
other hospitals are awaiting rulings on applications for
property tax exemption.
(2) In Provena, two Illinois Supreme Court justices
opined that "setting a monetary or quantum standard is a
complex decision which should be left to our legislature,
should it so choose". The Appellate Court in Provena
stated: "The language we use in the State of Illinois to
determine whether real property is used for a charitable

SB2017 - 53 - LRB101 09603 RAB 54701 b
purpose has its genesis in our 1870 Constitution. It is
obvious that such language may be difficult to apply to the
modern face of our nation's health care delivery systems".
The court noted the many significant changes in the health
care system since that time, but concluded that taking
these changes into account is a matter of public policy,
and "it is the legislature's job, not ours, to make public
policy".
(3) It is essential to ensure that tax exemption law
relating to hospitals accounts for the complexities of the
modern health care delivery system. Health care is moving
beyond the walls of the hospital. In addition to treating
individual patients, hospitals are assuming responsibility
for improving the health status of communities and
populations. Low-income and underserved communities
benefit disproportionately by these activities.
(4) The Supreme Court has explained that: "the
fundamental ground upon which all exemptions in favor of
charitable institutions are based is the benefit conferred
upon the public by them, and a consequent relief, to some
extent, of the burden upon the state to care for and
advance the interests of its citizens". Hospitals relieve
the burden of government in many ways, but most
significantly through their participation in and
substantial financial subsidization of the Illinois
Medicaid program, which could not operate without the

SB2017 - 54 - LRB101 09603 RAB 54701 b
participation and partnership of Illinois hospitals.
(5) Working with the Illinois hospital community and
other interested parties, the General Assembly has
developed a comprehensive combination of related
legislation that addresses hospital property tax
exemption, significantly increases access to free health
care for indigent persons, and strengthens the Medical
Assistance program. It is the intent of the General
Assembly to establish a new category of ownership for
charitable property tax exemption to be applied to
not-for-profit hospitals and hospital affiliates in lieu
of the existing ownership category of "institutions of
public charity". It is also the intent of the General
Assembly to establish quantifiable standards for the
issuance of charitable exemptions for such property. It is
not the intent of the General Assembly to declare any
property exempt ipso facto, but rather to establish
criteria to be applied to the facts on a case-by-case
basis.
(b) For the purpose of this Section and Section 15-10, the
following terms shall have the meanings set forth below:
(1) "Hospital" means any institution, place, building,
buildings on a campus, or other health care facility
located in Illinois that is licensed under the Hospital
Licensing Act and has a hospital owner.
(2) "Hospital owner" means a not-for-profit

SB2017 - 55 - LRB101 09603 RAB 54701 b
corporation that is the titleholder of a hospital, or the
owner of the beneficial interest in an Illinois land trust
that is the titleholder of a hospital.
(3) "Hospital affiliate" means any corporation,
partnership, limited partnership, joint venture, limited
liability company, association or other organization,
other than a hospital owner, that directly or indirectly
controls, is controlled by, or is under common control with
one or more hospital owners and that supports, is supported
by, or acts in furtherance of the exempt health care
purposes of at least one of those hospital owners'
hospitals.
(4) "Hospital system" means a hospital and one or more
other hospitals or hospital affiliates related by common
control or ownership.
(5) "Control" relating to hospital owners, hospital
affiliates, or hospital systems means possession, direct
or indirect, of the power to direct or cause the direction
of the management and policies of the entity, whether
through ownership of assets, membership interest, other
voting or governance rights, by contract or otherwise.
(6) "Hospital applicant" means a hospital owner or
hospital affiliate that files an application for a property
tax exemption pursuant to Section 15-5 and this Section.
(7) "Relevant hospital entity" means (A) the hospital
owner, in the case of a hospital applicant that is a

SB2017 - 56 - LRB101 09603 RAB 54701 b
hospital owner, and (B) at the election of a hospital
applicant that is a hospital affiliate, either (i) the
hospital affiliate or (ii) the hospital system to which the
hospital applicant belongs, including any hospitals or
hospital affiliates that are related by common control or
ownership.
(8) "Subject property" means property for which a
hospital applicant files an application for an exemption
pursuant to Section 15-5 and this Section.
(9) "Hospital year" means the fiscal year of the
relevant hospital entity, or the fiscal year of one of the
hospital owners in the hospital system if the relevant
hospital entity is a hospital system with members with
different fiscal years, that ends in the year for which the
exemption is sought.
(c) A hospital applicant satisfies the conditions for an
exemption under this Section with respect to the subject
property, and shall be issued a charitable exemption for that
property, if the value of services or activities listed in
subsection (e) for the hospital year equals or exceeds the
relevant hospital entity's estimated property tax liability,
as determined under subsection (g), for the year for which
exemption is sought. For purposes of making the calculations
required by this subsection (c), if the relevant hospital
entity is a hospital owner that owns more than one hospital,
the value of the services or activities listed in subsection

SB2017 - 57 - LRB101 09603 RAB 54701 b
(e) shall be calculated on the basis of only those services and
activities relating to the hospital that includes the subject
property, and the relevant hospital entity's estimated
property tax liability shall be calculated only with respect to
the properties comprising that hospital. In the case of a
multi-state hospital system or hospital affiliate, the value of
the services or activities listed in subsection (e) shall be
calculated on the basis of only those services and activities
that occur in Illinois and the relevant hospital entity's
estimated property tax liability shall be calculated only with
respect to its property located in Illinois.
Notwithstanding any other provisions of this Act, any
parcel or portion thereof, that is owned by a for-profit entity
whether part of the hospital system or not, or that is leased,
licensed or operated by a for-profit entity regardless of
whether healthcare services are provided on that parcel shall
not qualify for exemption. If a parcel has both exempt and
non-exempt uses, an exemption may be granted for the qualifying
portion of that parcel. In the case of parking lots and common
areas serving both exempt and non-exempt uses those parcels or
portions thereof may qualify for an exemption in proportion to
the amount of qualifying use.
(d) The hospital applicant shall include information in its
exemption application establishing that it satisfies the
requirements of subsection (c). For purposes of making the
calculations required by subsection (c), the hospital

SB2017 - 58 - LRB101 09603 RAB 54701 b
applicant may for each year elect to use either (1) the value
of the services or activities listed in subsection (e) for the
hospital year or (2) the average value of those services or
activities for the 3 fiscal years ending with the hospital
year. If the relevant hospital entity has been in operation for
less than 3 completed fiscal years, then the latter
calculation, if elected, shall be performed on a pro rata
basis.
(e) Services that address the health care needs of
low-income or underserved individuals or relieve the burden of
government with regard to health care services. The following
services and activities shall be considered for purposes of
making the calculations required by subsection (c):
(1) Charity care. Free or discounted services provided
pursuant to the relevant hospital entity's financial
assistance policy, measured at cost, including discounts
provided under the Hospital Uninsured Patient Discount
Act.
(2) Health services to low-income and underserved
individuals. Other unreimbursed costs of the relevant
hospital entity for providing without charge, paying for,
or subsidizing goods, activities, or services for the
purpose of addressing the health of low-income or
underserved individuals. Those activities or services may
include, but are not limited to: financial or in-kind
support to affiliated or unaffiliated hospitals, hospital

SB2017 - 59 - LRB101 09603 RAB 54701 b
affiliates, community clinics, or programs that treat
low-income or underserved individuals; paying for or
subsidizing health care professionals who care for
low-income or underserved individuals; providing or
subsidizing outreach or educational services to low-income
or underserved individuals for disease management and
prevention; free or subsidized goods, supplies, or
services needed by low-income or underserved individuals
because of their medical condition; and prenatal or
childbirth outreach to low-income or underserved persons.
(3) Subsidy of State or local governments. Direct or
indirect financial or in-kind subsidies of State or local
governments by the relevant hospital entity that pay for or
subsidize activities or programs related to health care for
low-income or underserved individuals.
(4) Support for State health care programs for
low-income individuals. At the election of the hospital
applicant for each applicable year, either (A) 10% of
payments to the relevant hospital entity and any hospital
affiliate designated by the relevant hospital entity
(provided that such hospital affiliate's operations
provide financial or operational support for or receive
financial or operational support from the relevant
hospital entity) under Medicaid or other means-tested
programs, including, but not limited to, General
Assistance, the Covering ALL KIDS and Young Adults Health

SB2017 - 60 - LRB101 09603 RAB 54701 b
Insurance Act, and the State Children's Health Insurance
Program or (B) the amount of subsidy provided by the
relevant hospital entity and any hospital affiliate
designated by the relevant hospital entity (provided that
such hospital affiliate's operations provide financial or
operational support for or receive financial or
operational support from the relevant hospital entity) to
State or local government in treating Medicaid recipients
and recipients of means-tested programs, including but not
limited to General Assistance, the Covering ALL KIDS Health
Insurance Act, and the State Children's Health Insurance
Program. The amount of subsidy for purposes of this item
(4) is calculated in the same manner as unreimbursed costs
are calculated for Medicaid and other means-tested
government programs in the Schedule H of IRS Form 990 in
effect on the effective date of this amendatory Act of the
97th General Assembly; provided, however, that in any event
unreimbursed costs shall be net of fee-for-services
payments, payments pursuant to an assessment, quarterly
payments, and all other payments included on the schedule H
of the IRS form 990.
(5) Dual-eligible subsidy. The amount of subsidy
provided to government by treating dual-eligible
Medicare/Medicaid patients. The amount of subsidy for
purposes of this item (5) is calculated by multiplying the
relevant hospital entity's unreimbursed costs for

SB2017 - 61 - LRB101 09603 RAB 54701 b
Medicare, calculated in the same manner as determined in
the Schedule H of IRS Form 990 in effect on the effective
date of this amendatory Act of the 97th General Assembly,
by the relevant hospital entity's ratio of dual-eligible
patients to total Medicare patients.
(6) Relief of the burden of government related to
health care of low-income individuals. Except to the extent
otherwise taken into account in this subsection, the
portion of unreimbursed costs of the relevant hospital
entity attributable to providing, paying for, or
subsidizing goods, activities, or services that relieve
the burden of government related to health care for
low-income individuals. Such activities or services shall
include, but are not limited to, providing emergency,
trauma, burn, neonatal, psychiatric, rehabilitation, or
other special services; providing medical education; and
conducting medical research or training of health care
professionals. The portion of those unreimbursed costs
attributable to benefiting low-income individuals shall be
determined using the ratio calculated by adding the
relevant hospital entity's costs attributable to charity
care, Medicaid, other means-tested government programs,
Medicare patients with disabilities under age 65, and
dual-eligible Medicare/Medicaid patients and dividing that
total by the relevant hospital entity's total costs. Such
costs for the numerator and denominator shall be determined

SB2017 - 62 - LRB101 09603 RAB 54701 b
by multiplying gross charges by the cost to charge ratio
taken from the hospitals' most recently filed Medicare cost
report (CMS 2252-10 Worksheet C, Part I). In the case of
emergency services, the ratio shall be calculated using
costs (gross charges multiplied by the cost to charge ratio
taken from the hospitals' most recently filed Medicare cost
report (CMS 2252-10 Worksheet C, Part I)) of patients
treated in the relevant hospital entity's emergency
department.
(7) Any other activity by the relevant hospital entity
that the Department determines relieves the burden of
government or addresses the health of low-income or
underserved individuals.
(f) For purposes of making the calculations required by
subsections (c) and (e):
(1) particular services or activities eligible for
consideration under any of the paragraphs (1) through (7)
of subsection (e) may not be counted under more than one of
those paragraphs; and
(2) the amount of unreimbursed costs and the amount of
subsidy shall not be reduced by restricted or unrestricted
payments received by the relevant hospital entity as
contributions deductible under Section 170(a) of the
Internal Revenue Code.
(g) Estimation of Exempt Property Tax Liability. The
estimated property tax liability used for the determination in

SB2017 - 63 - LRB101 09603 RAB 54701 b
subsection (c) shall be calculated as follows:
(1) "Estimated property tax liability" means the
estimated dollar amount of property tax that would be owed,
with respect to the exempt portion of each of the relevant
hospital entity's properties that are already fully or
partially exempt, or for which an exemption in whole or in
part is currently being sought, and then aggregated as
applicable, as if the exempt portion of those properties
were subject to tax, calculated with respect to each such
property by multiplying:
(A) the lesser of (i) the actual assessed value, if
any, of the portion of the property for which an
exemption is sought or (ii) an estimated assessed value
of the exempt portion of such property as determined in
item (2) of this subsection (g), by:
(B) the applicable State equalization rate
(yielding the equalized assessed value), by
(C) the applicable tax rate.
(2) The estimated assessed value of the exempt portion
of the property equals the sum of (i) the estimated fair
market value of buildings on the property, as determined in
accordance with subparagraphs (A) and (B) of this item (2),
multiplied by the applicable assessment factor, and (ii)
the estimated assessed value of the land portion of the
property, as determined in accordance with subparagraph
(C).

SB2017 - 64 - LRB101 09603 RAB 54701 b
(A) The "estimated fair market value of buildings
on the property" means the replacement value of any
exempt portion of buildings on the property, minus
depreciation, determined utilizing the cost
replacement method whereby the exempt square footage
of all such buildings is multiplied by the replacement
cost per square foot for Class A Average building found
in the most recent edition of the Marshall & Swift
Valuation Services Manual, adjusted by any appropriate
current cost and local multipliers.
(B) Depreciation, for purposes of calculating the
estimated fair market value of buildings on the
property, is applied by utilizing a weighted mean life
for the buildings based on original construction and
assuming a 40-year life for hospital buildings and the
applicable life for other types of buildings as
specified in the American Hospital Association
publication "Estimated Useful Lives of Depreciable
Hospital Assets". In the case of hospital buildings,
the remaining life is divided by 40 and this ratio is
multiplied by the replacement cost of the buildings to
obtain an estimated fair market value of buildings. If
a hospital building is older than 35 years, a remaining
life of 5 years for residual value is assumed; and if a
building is less than 8 years old, a remaining life of
32 years is assumed.

SB2017 - 65 - LRB101 09603 RAB 54701 b
(C) The estimated assessed value of the land
portion of the property shall be determined by
multiplying (i) the per square foot average of the
assessed values of three parcels of land (not including
farm land, and excluding the assessed value of the
improvements thereon) reasonably comparable to the
property, by (ii) the number of square feet comprising
the exempt portion of the property's land square
footage.
(3) The assessment factor, State equalization rate,
and tax rate (including any special factors such as
Enterprise Zones) used in calculating the estimated
property tax liability shall be for the most recent year
that is publicly available from the applicable chief county
assessment officer or officers at least 90 days before the
end of the hospital year.
(4) The method utilized to calculate estimated
property tax liability for purposes of this Section 15-86
shall not be utilized for the actual valuation, assessment,
or taxation of property pursuant to the Property Tax Code.
(h) Application. Each hospital applicant applying for a
property tax exemption pursuant to Section 15-5 and this
Section shall use an application form provided by the
Department. The application form shall specify the records
required in support of the application and those records shall
be submitted to the Department with the application form. Each

SB2017 - 66 - LRB101 09603 RAB 54701 b
application or affidavit shall contain a verification by the
Chief Executive Officer of the hospital applicant under oath or
affirmation stating that each statement in the application or
affidavit and each document submitted with the application or
affidavit are true and correct. The records submitted with the
application pursuant to this Section shall include an exhibit
prepared by the relevant hospital entity showing (A) the value
of the relevant hospital entity's services and activities, if
any, under paragraphs (1) through (7) of subsection (e) of this
Section stated separately for each paragraph, and (B) the value
relating to the relevant hospital entity's estimated property
tax liability under subsections (g)(1)(A), (B), and (C),
subsections (g)(2)(A), (B), and (C), and subsection (g)(3) of
this Section stated separately for each item. Such exhibit will
be made available to the public by the chief county assessment
officer. Nothing in this Section shall be construed as limiting
the Attorney General's authority under the Illinois False
Claims Act.
(i) Nothing in this Section shall be construed to limit the
ability of otherwise eligible hospitals, hospital owners,
hospital affiliates, or hospital systems to obtain or maintain
property tax exemptions pursuant to a provision of the Property
Tax Code other than this Section.
(Source: P.A. 99-143, eff. 7-27-15.)
Section 35. The Illinois Pension Code is amended by

SB2017 - 67 - LRB101 09603 RAB 54701 b
changing Section 24-102 as follows:
(40 ILCS 5/24-102) (from Ch. 108 1/2, par. 24-102)
Sec. 24-102. As used in this Article, "employee" means any
person, including a person elected, appointed or under
contract, receiving compensation from the State or a unit of
local government or school district for personal services
rendered, including salaried persons. A health care provider
who elects to participate in the State Employees Deferred
Compensation Plan established under Section 24-104 of this Code
shall, for purposes of that participation, be deemed an
"employee" as defined in this Section.
As used in this Article, "health care provider" means a
dentist, physician, optometrist, pharmacist, or podiatric
physician that participates and receives compensation as a
provider under the Illinois Public Aid Code, the Children's
Health Insurance Act, or the Covering ALL KIDS and Young Adults
Health Insurance Act.
As used in this Article, "compensation" includes
compensation received in a lump sum for accumulated unused
vacation, personal leave or sick leave, with the exception of
health care providers. "Compensation" with respect to health
care providers is defined under the Illinois Public Aid Code,
the Children's Health Insurance Act, or the Covering ALL KIDS
Health Insurance Act.
Where applicable, in no event shall the total of the amount

SB2017 - 68 - LRB101 09603 RAB 54701 b
of deferred compensation of an employee set aside in relation
to a particular year under the Illinois State Employees
Deferred Compensation Plan and the employee's nondeferred
compensation for that year exceed the total annual salary or
compensation under the existing salary schedule or
classification plan applicable to such employee in such year;
except that any compensation received in a lump sum for
accumulated unused vacation, personal leave or sick leave shall
not be included in the calculation of such totals.
(Source: P.A. 98-214, eff. 8-9-13.)
Section 40. The Loan Repayment Assistance for Dentists Act
is amended by changing Section 10, 25, and 30 as follows:
(110 ILCS 948/10)
Sec. 10. Definitions. In this Act, unless the context
otherwise requires:
"Dental hygienist" means a person who holds a license under
the Illinois Dental Practice Act to perform dental services as
authorized by Section 18 of the Illinois Dental Practice Act.
"Dental payments" means compensation provided to dentists
and dental specialists for services rendered under Article V of
the Illinois Public Aid Code, the Covering ALL KIDS and Young
Adults Health Insurance Act, or the Children's Health Insurance
Program Act.
"Dental specialist" means a person who has received a

SB2017 - 69 - LRB101 09603 RAB 54701 b
license as a dentist in this State and who is trained and
qualified to practice in one or more of the following
specialties of dentistry: endodontics, oral and maxillofacial
surgery, orthodontics, pedodontics, periodontics, and
prosthodontics.
"Dentist" means a person who has received a general license
pursuant to paragraph (a) of Section 11 of the Illinois Dental
Practice Act, who may perform any intraoral and extraoral
procedure required in the practice of dentistry, and to whom is
reserved the responsibilities specified in Section 17 of the
Illinois Dental Practice Act.
"Department" means the Department of Public Health.
"Designated shortage area" means a medically underserved
area or health manpower shortage area as defined by the United
States Department of Health and Human Services or as otherwise
designated by the Department of Public Health.
"Educational loans" means higher education student loans
that a person has incurred in attending a registered
professional dental education program.
"Program" means the educational loan repayment assistance
program for dentists and dental specialists or dental
hygienists established by the Department under this Act.
(Source: P.A. 95-297, eff. 8-20-07; 96-757, eff. 8-25-09.)
(110 ILCS 948/25)
Sec. 25. Eligibility. To be eligible for assistance under

SB2017 - 70 - LRB101 09603 RAB 54701 b
the program, an applicant must meet all of the following
qualifications:
(1) He or she must be a citizen or permanent resident
of the United States.
(2) He or she must be a resident of this State.
(3) He or she must be practicing full time in this
State as a dentist, dental specialist, or dental hygienist.
(4) He or she must currently be repaying educational
loans.
(5) He or she must accept dental payments as defined in
this Act.
(6) He or she must practice or commit to practice full
time in this State in a designated shortage area.
(7) He or she must allocate at least 20% of all patient
appointments to patients covered by Article V of the
Illinois Public Aid Code, the Covering ALL KIDS and Young
Adults Health Insurance Act, or the Children's Health
Insurance Program Act.
(Source: P.A. 95-297, eff. 8-20-07; 96-757, eff. 8-25-09.)
(110 ILCS 948/30)
Sec. 30. The award of grants.
(a) Under the program, for each year that a qualified
applicant practices full time in this State in a designated
shortage area as a dentist or dental specialist, the Department
shall, subject to appropriation, award a grant to that person

SB2017 - 71 - LRB101 09603 RAB 54701 b
in an amount equal to the amount in educational loans that the
person must repay that year. However, the total amount in
grants that a person may be awarded under the program must not
exceed $25,000 per year for a 4-year period.
The grant award for a dental hygienist shall be set by rule
of the Department.
(b) The Department shall require recipients to use the
grants to pay off their educational loans.
(c) The initial grant awarded to a dentist or dental
specialist under this Act shall be for a 2-year period. Based
on the successful completion of the initial 2-year grant, the
grantees may be awarded up to 2 subsequent one-year grants.
Grantees are eligible to receive grant funds for no more than a
4-year period. Previous grant recipients shall be given
priority for years 3 and 4 grant funding, provided that the
grantee continues to meet the eligibility requirements set
forth in Section 25 of this Act. Grantees shall practice full
time in a designated shortage area for the period of each grant
awarded.
The grant award for a dental hygienist shall be for a
maximum of 2 years.
(d) Successful applicants shall be eligible for a grant
award upon execution of the grant agreement and shall then
begin to receive grant award payments on a quarterly basis.
(e) The Department shall award grants to otherwise eligible
dental applicants by using the following criteria:

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(1) Dental specialist willing to practice in any
designated shortage area.
(2) Dentist willing to practice in a designated
shortage area with the highest Health Professional
Shortage Area (HPSA) score.
(3) Dentist willing to practice in a designated
shortage area with the highest HPSA score and agreeing to
allocate the highest percentage of patient appointments to
those that are covered by Article V of the Illinois Public
Aid Code, the Covering ALL KIDS and Young Adults Health
Insurance Act, or the Children's Health Insurance Program
Act.
(Source: P.A. 95-297, eff. 8-20-07; 96-757, eff. 8-25-09.)
Section 45. The Children's Health Insurance Program Act is
amended by changing Section 23 as follows:
(215 ILCS 106/23)
Sec. 23. Care coordination.
(a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS and Young Adults Health Insurance Act, shall
be enrolled in a care coordination program by no later than
January 1, 2015. For purposes of this Section, "coordinated

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care" or "care coordination" means delivery systems where
recipients will receive their care from providers who
participate under contract in integrated delivery systems that
are responsible for providing or arranging the majority of
care, including primary care physician services, referrals
from primary care physicians, diagnostic and treatment
services, behavioral health services, in-patient and
outpatient hospital services, dental services, and
rehabilitation and long-term care services. The Department
shall designate or contract for such integrated delivery
systems (i) to ensure enrollees have a choice of systems and of
primary care providers within such systems; (ii) to ensure that
enrollees receive quality care in a culturally and
linguistically appropriate manner; and (iii) to ensure that
coordinated care programs meet the diverse needs of enrollees
with developmental, mental health, physical, and age-related
disabilities.
(b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment

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arrangements.
(c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with
disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of the
effective date of this amendatory Act of the 96th General
Assembly.
(d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of this amendatory
Act of the 96th General Assembly. The Department shall include
in its April 2011 report a full analysis of federal laws or
regulations regarding upper payment limitations to providers
and the necessary revisions or adjustments in rate
methodologies and payments to providers under this Code that
would be necessary to implement coordinated care with full
financial risk by a party other than the Department.
(Source: P.A. 96-1501, eff. 1-25-11.)

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Section 50. The Covering ALL KIDS Health Insurance Act is
amended by changing Sections 1, 5, 10, 15, 20, 25, 35, 40, 45,
47, and 56 as follows:
(215 ILCS 170/1)
(Section scheduled to be repealed on October 1, 2019)
Sec. 1. Short title. This Act may be cited as the Covering
ALL KIDS and Young Adults Health Insurance Act.
(Source: P.A. 94-693, eff. 7-1-06.)
(215 ILCS 170/5)
(Section scheduled to be repealed on October 1, 2019)
Sec. 5. Legislative intent. The General Assembly finds
that, for the economic and social benefit of all residents of
the State, it is important to enable all children and young
adults of this State to access affordable health insurance that
offers comprehensive coverage and emphasizes preventive
healthcare. Many children and young adults in working families,
including many families whose family income ranges between
$40,000 and $80,000, are uninsured. Numerous studies,
including the Institute of Medicine's report, "Health
Insurance Matters", demonstrate that lack of insurance
negatively affects health status. The General Assembly further
finds that access to healthcare is a key component for
children's and young adults' healthy development and
successful education. The effects of lack of insurance also

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negatively impact those who are insured because the cost of
paying for care to the uninsured is often shifted to those who
have insurance in the form of higher health insurance premiums.
A Families USA 2005 report indicates that family premiums in
Illinois are increased by $1,059 due to cost-shifting from the
uninsured. It is, therefore, the intent of this legislation to
provide access to affordable health insurance to all uninsured
children and young adults in Illinois.
(Source: P.A. 94-693, eff. 7-1-06.)
(215 ILCS 170/10)
(Section scheduled to be repealed on October 1, 2019)
Sec. 10. Definitions. In this Act:
"Application agent" means an organization or individual,
such as a licensed health care provider, school, youth service
agency, employer, labor union, local chamber of commerce,
community-based organization, or other organization, approved
by the Department to assist in enrolling children and young
adults in the Program.
"Child" means a person under the age of 19.
"Young adult" means a person age 19 to 26.
"Department" means the Department of Healthcare and Family
Services.
"Medical assistance" means health care benefits provided
under Article V of the Illinois Public Aid Code.
"Program" means the Covering ALL KIDS and Young Adults

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Health Insurance Program.
"Resident" means an individual (i) who is in the State for
other than a temporary or transitory purpose during the taxable
year or (ii) who is domiciled in this State but is absent from
the State for a temporary or transitory purpose during the
taxable year.
(Source: P.A. 94-693, eff. 7-1-06.)
(215 ILCS 170/15)
(Section scheduled to be repealed on October 1, 2019)
Sec. 15. Operation of Program. The Covering ALL KIDS and
Young Adults Health Insurance Program is created. The Program
shall be administered by the Department of Healthcare and
Family Services. The Department shall have the same powers and
authority to administer the Program as are provided to the
Department in connection with the Department's administration
of the Illinois Public Aid Code, including, but not limited to,
the provisions under Section 11-5.1 of the Code, and the
Children's Health Insurance Program Act. The Department shall
coordinate the Program with the existing children's health
programs operated by the Department and other State agencies.
Effective October 1, 2013, the determination of eligibility
under this Act shall comply with the requirements of 42 U.S.C.
1397bb(b)(1)(B)(v) and applicable federal regulations. If
changes made to this Section require federal approval, they
shall not take effect until such approval has been received.

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(Source: P.A. 98-104, eff. 7-22-13.)
(215 ILCS 170/20)
(Section scheduled to be repealed on October 1, 2019)
Sec. 20. Eligibility.
(a) To be eligible for the Program, a person must be a
child or young adult:
(1) who is a resident of the State of Illinois;
(2) who is ineligible for medical assistance under the
Illinois Public Aid Code or benefits under the Children's
Health Insurance Program Act;
(3) who (i) effective July 1, 2014, in accordance with
42 CFR 457.805 (78 FR 42313, July 15, 2013) or any other
federal requirement necessary to obtain federal financial
participation for expenditures made under this Act, has
been without health insurance coverage for 90 days; (ii) is
a newborn whose responsible relative does not have
available affordable private or employer-sponsored health
insurance; or (iii) within one year of applying for
coverage under this Act, lost medical benefits under the
Illinois Public Aid Code or the Children's Health Insurance
Program Act; and
(3.5) whose household income, as determined, effective
October 1, 2013, by the Department, is at or below 300% of
the federal poverty level as determined in compliance with
42 U.S.C. 1397bb(b)(1)(B)(v) and applicable federal

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regulations.
An entity that provides health insurance coverage (as
defined in Section 2 of the Comprehensive Health Insurance Plan
Act) to Illinois residents shall provide health insurance data
match to the Department of Healthcare and Family Services as
provided by and subject to Section 5.5 of the Illinois
Insurance Code. The Department of Healthcare and Family
Services may impose an administrative penalty as provided under
Section 12-4.45 of the Illinois Public Aid Code on entities
that have established a pattern of failure to provide the
information required under this Section.
The Department of Healthcare and Family Services, in
collaboration with the Department of Insurance, shall adopt
rules governing the exchange of information under this Section.
The rules shall be consistent with all laws relating to the
confidentiality or privacy of personal information or medical
records, including provisions under the Federal Health
Insurance Portability and Accountability Act (HIPAA).
(b) The Department shall monitor the availability and
retention of employer-sponsored dependent health insurance
coverage and shall modify the period described in subdivision
(a)(3) if necessary to promote retention of private or
employer-sponsored health insurance and timely access to
healthcare services, but at no time shall the period described
in subdivision (a)(3) be less than 6 months.
(c) The Department, at its discretion, may take into

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account the affordability of dependent health insurance when
determining whether employer-sponsored dependent health
insurance coverage is available upon reemployment of a child's
parent as provided in subdivision (a)(3).
(d) A child or young adult who is determined to be eligible
for the Program shall remain eligible for 12 months, provided
that the child or young adult maintains his or her residence in
this State, has not yet attained 26 19 years of age, and is not
excluded under subsection (e).
(e) A child or young adult is not eligible for coverage
under the Program if:
(1) the premium required under Section 40 has not been
timely paid; if the required premiums are not paid, the
liability of the Program shall be limited to benefits
incurred under the Program for the time period for which
premiums have been paid; re-enrollment shall be completed
before the next covered medical visit, and the first
month's required premium shall be paid in advance of the
next covered medical visit; or
(2) the child or young adult is an inmate of a public
institution or an institution for mental diseases.
(f) The Department may adopt rules, including, but not
limited to: rules regarding annual renewals of eligibility for
the Program in conformance with Section 7 of this Act; rules
providing for re-enrollment, grace periods, notice
requirements, and hearing procedures under subdivision (e)(1)

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of this Section; and rules regarding what constitutes
availability and affordability of private or
employer-sponsored health insurance, with consideration of
such factors as the percentage of income needed to purchase
children or family health insurance, the availability of
employer subsidies, and other relevant factors.
(g) Each child enrolled in the Program as of July 1, 2011
whose family income, as established by the Department, exceeds
300% of the federal poverty level may remain enrolled in the
Program for 12 additional months commencing July 1, 2011.
Continued enrollment pursuant to this subsection shall be
available only if the child continues to meet all eligibility
criteria established under the Program as of the effective date
of this amendatory Act of the 96th General Assembly without a
break in coverage. Nothing contained in this subsection shall
prevent a child from qualifying for any other health benefits
program operated by the Department.
(Source: P.A. 98-130, eff. 8-2-13; 98-651, eff. 6-16-14.)
(215 ILCS 170/25)
(Section scheduled to be repealed on October 1, 2019)
Sec. 25. Enrollment in Program. The Department shall
develop procedures to allow application agents to assist in
enrolling children and young adults in the Program or other
children's health programs operated by the Department. At the
Department's discretion, technical assistance payments may be

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made available for approved applications facilitated by an
application agent. The Department shall permit day and
temporary labor service agencies, as defined in the Day and
Temporary Labor Services Act and doing business in Illinois, to
enroll as unpaid application agents. As established in the Free
Healthcare Benefits Application Assistance Act, it shall be
unlawful for any person to charge another person or family for
assisting in completing and submitting an application for
enrollment in this Program.
(Source: P.A. 96-326, eff. 8-11-09.)
(215 ILCS 170/35)
(Section scheduled to be repealed on October 1, 2019)
Sec. 35. Health care benefits for children.
(a) The Department shall purchase or provide health care
benefits for eligible children that are identical to the
benefits provided for children under the Illinois Children's
Health Insurance Program Act, except for non-emergency
transportation. The Department shall purchase or provide
health care benefits for eligible young adults that are
identical to the benefits provided for individuals under the
Medical Assistance Program established under Article V of the
Illinois Public Aid Code.
(b) As an alternative to the benefits set forth in
subsection (a), and when cost-effective, the Department may
offer families subsidies toward the cost of privately sponsored

SB2017 - 83 - LRB101 09603 RAB 54701 b
health insurance, including employer-sponsored health
insurance.
(c) Notwithstanding clause (i) of subdivision (a)(3) of
Section 20, the Department may consider offering, as an
alternative to the benefits set forth in subsection (a),
partial coverage to children and young adults who are enrolled
in a high-deductible private health insurance plan.
(d) Notwithstanding clause (i) of subdivision (a)(3) of
Section 20, the Department may consider offering, as an
alternative to the benefits set forth in subsection (a), a
limited package of benefits to children or young adults in
families who have private or employer-sponsored health
insurance that does not cover certain benefits such as dental
or vision benefits.
(e) The content and availability of benefits described in
subsections (b), (c), and (d), and the terms of eligibility for
those benefits, shall be at the Department's discretion and the
Department's determination of efficacy and cost-effectiveness
as a means of promoting retention of private or
employer-sponsored health insurance.
(f) On and after July 1, 2012, the Department shall reduce
any rate of reimbursement for services or other payments or
alter any methodologies authorized by this Act or the Illinois
Public Aid Code to reduce any rate of reimbursement for
services or other payments in accordance with Section 5-5e of
the Illinois Public Aid Code.

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(Source: P.A. 97-689, eff. 6-14-12.)
(215 ILCS 170/40)
(Section scheduled to be repealed on October 1, 2019)
Sec. 40. Cost-sharing.
(a) Children and young adults enrolled in the Program under
subsection (a) of Section 35 are subject to the following
cost-sharing requirements:
(1) The Department, by rule, shall set forth
requirements concerning co-payments and coinsurance for
health care services and monthly premiums. This
cost-sharing shall be on a sliding scale based on family
income. The Department may periodically modify such
cost-sharing.
(2) Notwithstanding paragraph (1), there shall be no
co-payment required for well-baby or well-child health
care, including, but not limited to, age-appropriate
immunizations as required under State or federal law.
(b) Children and young adults enrolled in a privately
sponsored health insurance plan under subsection (b) of Section
35 are subject to the cost-sharing provisions stated in the
privately sponsored health insurance plan.
(c) Notwithstanding any other provision of law, rates paid
by the Department shall not be used in any way to determine the
usual and customary or reasonable charge, which is the charge
for health care that is consistent with the average rate or

SB2017 - 85 - LRB101 09603 RAB 54701 b
charge for similar services furnished by similar providers in a
certain geographic area.
(Source: P.A. 94-693, eff. 7-1-06.)
(215 ILCS 170/45)
(Section scheduled to be repealed on October 1, 2019)
Sec. 45. Study; contracts.
(a) The Department shall conduct a study that includes, but
is not limited to, the following:
(1) Establishing estimates, broken down by regions of
the State, of the number of children with and without
health insurance coverage; the number of children who are
eligible for Medicaid or the Children's Health Insurance
Program, and, of that number, the number who are enrolled
in Medicaid or the Children's Health Insurance Program; and
the number of children with access to dependent coverage
through an employer, and, of that number, the number who
are enrolled in dependent coverage through an employer.
(2) Surveying those families whose children have
access to employer-sponsored dependent coverage but who
decline such coverage as to the reasons for declining
coverage.
(3) Ascertaining, for the population of children
accessing employer-sponsored dependent coverage or who
have access to such coverage, the comprehensiveness of
dependent coverage available, the amount of cost-sharing

SB2017 - 86 - LRB101 09603 RAB 54701 b
currently paid by the employees, and the cost-sharing
associated with such coverage.
(4) Measuring the health outcomes or other benefits for
children utilizing the Covering ALL KIDS and Young Adults
Health Insurance Program and analyzing the effects on
utilization of healthcare services for children after
enrollment in the Program compared to the preceding period
of uninsured status.
(b) The studies described in subsection (a) shall be
conducted in a manner that compares a time period preceding or
at the initiation of the program with a later period.
(c) The Department shall submit the preliminary results of
the study to the Governor and the General Assembly no later
than July 1, 2008 and shall submit the final results to the
Governor and the General Assembly no later than July 1, 2010.
(d) The Department shall submit copies of all contracts
awarded for the administration of the Program to the Speaker of
the House of Representatives, the Minority Leader of the House
of Representatives, the President of the Senate, and the
Minority Leader of the Senate.
(Source: P.A. 94-693, eff. 7-1-06; 95-985, eff. 6-1-09.)
(215 ILCS 170/47)
(Section scheduled to be repealed on October 1, 2019)
Sec. 47. Program information. The Department shall report
to the General Assembly no later than September 1 of each year

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beginning in 2007, all of the following information:
(a) The number of professionals serving in the primary
care case management program, by licensed profession and by
county, and, for counties with a population of 100,000 or
greater, by geo zip code.
(b) The number of non-primary care providers accepting
referrals, by specialty designation, by licensed
profession and by county, and, for counties with a
population of 100,000 or greater, by geo zip code.
(c) The number of individuals enrolled in the Covering
ALL KIDS and Young Adults Health Insurance Program by
income or premium level and by county, and, for counties
with a population of 100,000 or greater, by geo zip code.
(Source: P.A. 95-650, eff. 6-1-08.)
(215 ILCS 170/56)
(Section scheduled to be repealed on October 1, 2019)
Sec. 56. Care coordination.
(a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS and Young Adults Health Insurance Act, shall
be enrolled in a care coordination program by no later than
January 1, 2015. For purposes of this Section, "coordinated
care" or "care coordination" means delivery systems where

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recipients will receive their care from providers who
participate under contract in integrated delivery systems that
are responsible for providing or arranging the majority of
care, including primary care physician services, referrals
from primary care physicians, diagnostic and treatment
services, behavioral health services, in-patient and
outpatient hospital services, dental services, and
rehabilitation and long-term care services. The Department
shall designate or contract for such integrated delivery
systems (i) to ensure enrollees have a choice of systems and of
primary care providers within such systems; (ii) to ensure that
enrollees receive quality care in a culturally and
linguistically appropriate manner; and (iii) to ensure that
coordinated care programs meet the diverse needs of enrollees
with developmental, mental health, physical, and age-related
disabilities.
(b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment
arrangements.

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(c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with
disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of the
effective date of this amendatory Act of the 96th General
Assembly.
(d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of this amendatory
Act of the 96th General Assembly. The Department shall include
in its April 2011 report a full analysis of federal laws or
regulations regarding upper payment limitations to providers
and the necessary revisions or adjustments in rate
methodologies and payments to providers under this Code that
would be necessary to implement coordinated care with full
financial risk by a party other than the Department.
(Source: P.A. 96-1501, eff. 1-25-11.)
Section 55. The Illinois Public Aid Code is amended by

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changing Sections 5-5, 5-29, and 5-30 as follows:
(305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
Sec. 5-5. Medical services. The Illinois Department, by
rule, shall determine the quantity and quality of and the rate
of reimbursement for the medical assistance for which payment
will be authorized, and the medical services to be provided,
which may include all or part of the following: (1) inpatient
hospital services; (2) outpatient hospital services; (3) other
laboratory and X-ray services; (4) skilled nursing home
services; (5) physicians' services whether furnished in the
office, the patient's home, a hospital, a skilled nursing home,
or elsewhere; (6) medical care, or any other type of remedial
care furnished by licensed practitioners; (7) home health care
services; (8) private duty nursing service; (9) clinic
services; (10) dental services, including prevention and
treatment of periodontal disease and dental caries disease for
pregnant women, provided by an individual licensed to practice
dentistry or dental surgery; for purposes of this item (10),
"dental services" means diagnostic, preventive, or corrective
procedures provided by or under the supervision of a dentist in
the practice of his or her profession; (11) physical therapy
and related services; (12) prescribed drugs, dentures, and
prosthetic devices; and eyeglasses prescribed by a physician
skilled in the diseases of the eye, or by an optometrist,
whichever the person may select; (13) other diagnostic,

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screening, preventive, and rehabilitative services, including
to ensure that the individual's need for intervention or
treatment of mental disorders or substance use disorders or
co-occurring mental health and substance use disorders is
determined using a uniform screening, assessment, and
evaluation process inclusive of criteria, for children and
adults; for purposes of this item (13), a uniform screening,
assessment, and evaluation process refers to a process that
includes an appropriate evaluation and, as warranted, a
referral; "uniform" does not mean the use of a singular
instrument, tool, or process that all must utilize; (14)
transportation and such other expenses as may be necessary;
(15) medical treatment of sexual assault survivors, as defined
in Section 1a of the Sexual Assault Survivors Emergency
Treatment Act, for injuries sustained as a result of the sexual
assault, including examinations and laboratory tests to
discover evidence which may be used in criminal proceedings
arising from the sexual assault; (16) the diagnosis and
treatment of sickle cell anemia; and (17) any other medical
care, and any other type of remedial care recognized under the
laws of this State. The term "any other type of remedial care"
shall include nursing care and nursing home service for persons
who rely on treatment by spiritual means alone through prayer
for healing.
Notwithstanding any other provision of this Section, a
comprehensive tobacco use cessation program that includes

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purchasing prescription drugs or prescription medical devices
approved by the Food and Drug Administration shall be covered
under the medical assistance program under this Article for
persons who are otherwise eligible for assistance under this
Article.
Notwithstanding any other provision of this Code,
reproductive health care that is otherwise legal in Illinois
shall be covered under the medical assistance program for
persons who are otherwise eligible for medical assistance under
this Article.
Notwithstanding any other provision of this Code, the
Illinois Department may not require, as a condition of payment
for any laboratory test authorized under this Article, that a
physician's handwritten signature appear on the laboratory
test order form. The Illinois Department may, however, impose
other appropriate requirements regarding laboratory test order
documentation.
Upon receipt of federal approval of an amendment to the
Illinois Title XIX State Plan for this purpose, the Department
shall authorize the Chicago Public Schools (CPS) to procure a
vendor or vendors to manufacture eyeglasses for individuals
enrolled in a school within the CPS system. CPS shall ensure
that its vendor or vendors are enrolled as providers in the
medical assistance program and in any capitated Medicaid
managed care entity (MCE) serving individuals enrolled in a
school within the CPS system. Under any contract procured under

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this provision, the vendor or vendors must serve only
individuals enrolled in a school within the CPS system. Claims
for services provided by CPS's vendor or vendors to recipients
of benefits in the medical assistance program under this Code,
the Children's Health Insurance Program, or the Covering ALL
KIDS and Young Adults Health Insurance Program shall be
submitted to the Department or the MCE in which the individual
is enrolled for payment and shall be reimbursed at the
Department's or the MCE's established rates or rate
methodologies for eyeglasses.
On and after July 1, 2012, the Department of Healthcare and
Family Services may provide the following services to persons
eligible for assistance under this Article who are
participating in education, training or employment programs
operated by the Department of Human Services as successor to
the Department of Public Aid:
(1) dental services provided by or under the
supervision of a dentist; and
(2) eyeglasses prescribed by a physician skilled in the
diseases of the eye, or by an optometrist, whichever the
person may select.
On and after July 1, 2018, the Department of Healthcare and
Family Services shall provide dental services to any adult who
is otherwise eligible for assistance under the medical
assistance program. As used in this paragraph, "dental
services" means diagnostic, preventative, restorative, or

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corrective procedures, including procedures and services for
the prevention and treatment of periodontal disease and dental
caries disease, provided by an individual who is licensed to
practice dentistry or dental surgery or who is under the
supervision of a dentist in the practice of his or her
profession.
On and after July 1, 2018, targeted dental services, as set
forth in Exhibit D of the Consent Decree entered by the United
States District Court for the Northern District of Illinois,
Eastern Division, in the matter of Memisovski v. Maram, Case
No. 92 C 1982, that are provided to adults under the medical
assistance program shall be established at no less than the
rates set forth in the "New Rate" column in Exhibit D of the
Consent Decree for targeted dental services that are provided
to persons under the age of 18 under the medical assistance
program.
Notwithstanding any other provision of this Code and
subject to federal approval, the Department may adopt rules to
allow a dentist who is volunteering his or her service at no
cost to render dental services through an enrolled
not-for-profit health clinic without the dentist personally
enrolling as a participating provider in the medical assistance
program. A not-for-profit health clinic shall include a public
health clinic or Federally Qualified Health Center or other
enrolled provider, as determined by the Department, through
which dental services covered under this Section are performed.

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The Department shall establish a process for payment of claims
for reimbursement for covered dental services rendered under
this provision.
The Illinois Department, by rule, may distinguish and
classify the medical services to be provided only in accordance
with the classes of persons designated in Section 5-2.
The Department of Healthcare and Family Services must
provide coverage and reimbursement for amino acid-based
elemental formulas, regardless of delivery method, for the
diagnosis and treatment of (i) eosinophilic disorders and (ii)
short bowel syndrome when the prescribing physician has issued
a written order stating that the amino acid-based elemental
formula is medically necessary.
The Illinois Department shall authorize the provision of,
and shall authorize payment for, screening by low-dose
mammography for the presence of occult breast cancer for women
35 years of age or older who are eligible for medical
assistance under this Article, as follows:
(A) A baseline mammogram for women 35 to 39 years of
age.
(B) An annual mammogram for women 40 years of age or
older.
(C) A mammogram at the age and intervals considered
medically necessary by the woman's health care provider for
women under 40 years of age and having a family history of
breast cancer, prior personal history of breast cancer,

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positive genetic testing, or other risk factors.
(D) A comprehensive ultrasound screening and MRI of an
entire breast or breasts if a mammogram demonstrates
heterogeneous or dense breast tissue, when medically
necessary as determined by a physician licensed to practice
medicine in all of its branches.
(E) A screening MRI when medically necessary, as
determined by a physician licensed to practice medicine in
all of its branches.
All screenings shall include a physical breast exam,
instruction on self-examination and information regarding the
frequency of self-examination and its value as a preventative
tool. For purposes of this Section, "low-dose mammography"
means the x-ray examination of the breast using equipment
dedicated specifically for mammography, including the x-ray
tube, filter, compression device, and image receptor, with an
average radiation exposure delivery of less than one rad per
breast for 2 views of an average size breast. The term also
includes digital mammography and includes breast
tomosynthesis. As used in this Section, the term "breast
tomosynthesis" means a radiologic procedure that involves the
acquisition of projection images over the stationary breast to
produce cross-sectional digital three-dimensional images of
the breast. If, at any time, the Secretary of the United States
Department of Health and Human Services, or its successor
agency, promulgates rules or regulations to be published in the

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Federal Register or publishes a comment in the Federal Register
or issues an opinion, guidance, or other action that would
require the State, pursuant to any provision of the Patient
Protection and Affordable Care Act (Public Law 111-148),
including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any
successor provision, to defray the cost of any coverage for
breast tomosynthesis outlined in this paragraph, then the
requirement that an insurer cover breast tomosynthesis is
inoperative other than any such coverage authorized under
Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and
the State shall not assume any obligation for the cost of
coverage for breast tomosynthesis set forth in this paragraph.
On and after January 1, 2016, the Department shall ensure
that all networks of care for adult clients of the Department
include access to at least one breast imaging Center of Imaging
Excellence as certified by the American College of Radiology.
On and after January 1, 2012, providers participating in a
quality improvement program approved by the Department shall be
reimbursed for screening and diagnostic mammography at the same
rate as the Medicare program's rates, including the increased
reimbursement for digital mammography.
The Department shall convene an expert panel including
representatives of hospitals, free-standing mammography
facilities, and doctors, including radiologists, to establish
quality standards for mammography.
On and after January 1, 2017, providers participating in a

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breast cancer treatment quality improvement program approved
by the Department shall be reimbursed for breast cancer
treatment at a rate that is no lower than 95% of the Medicare
program's rates for the data elements included in the breast
cancer treatment quality program.
The Department shall convene an expert panel, including
representatives of hospitals, free-standing breast cancer
treatment centers, breast cancer quality organizations, and
doctors, including breast surgeons, reconstructive breast
surgeons, oncologists, and primary care providers to establish
quality standards for breast cancer treatment.
Subject to federal approval, the Department shall
establish a rate methodology for mammography at federally
qualified health centers and other encounter-rate clinics.
These clinics or centers may also collaborate with other
hospital-based mammography facilities. By January 1, 2016, the
Department shall report to the General Assembly on the status
of the provision set forth in this paragraph.
The Department shall establish a methodology to remind
women who are age-appropriate for screening mammography, but
who have not received a mammogram within the previous 18
months, of the importance and benefit of screening mammography.
The Department shall work with experts in breast cancer
outreach and patient navigation to optimize these reminders and
shall establish a methodology for evaluating their
effectiveness and modifying the methodology based on the

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evaluation.
The Department shall establish a performance goal for
primary care providers with respect to their female patients
over age 40 receiving an annual mammogram. This performance
goal shall be used to provide additional reimbursement in the
form of a quality performance bonus to primary care providers
who meet that goal.
The Department shall devise a means of case-managing or
patient navigation for beneficiaries diagnosed with breast
cancer. This program shall initially operate as a pilot program
in areas of the State with the highest incidence of mortality
related to breast cancer. At least one pilot program site shall
be in the metropolitan Chicago area and at least one site shall
be outside the metropolitan Chicago area. On or after July 1,
2016, the pilot program shall be expanded to include one site
in western Illinois, one site in southern Illinois, one site in
central Illinois, and 4 sites within metropolitan Chicago. An
evaluation of the pilot program shall be carried out measuring
health outcomes and cost of care for those served by the pilot
program compared to similarly situated patients who are not
served by the pilot program.
The Department shall require all networks of care to
develop a means either internally or by contract with experts
in navigation and community outreach to navigate cancer
patients to comprehensive care in a timely fashion. The
Department shall require all networks of care to include access

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for patients diagnosed with cancer to at least one academic
commission on cancer-accredited cancer program as an
in-network covered benefit.
Any medical or health care provider shall immediately
recommend, to any pregnant woman who is being provided prenatal
services and is suspected of having a substance use disorder as
defined in the Substance Use Disorder Act, referral to a local
substance use disorder treatment program licensed by the
Department of Human Services or to a licensed hospital which
provides substance abuse treatment services. The Department of
Healthcare and Family Services shall assure coverage for the
cost of treatment of the drug abuse or addiction for pregnant
recipients in accordance with the Illinois Medicaid Program in
conjunction with the Department of Human Services.
All medical providers providing medical assistance to
pregnant women under this Code shall receive information from
the Department on the availability of services under any
program providing case management services for addicted women,
including information on appropriate referrals for other
social services that may be needed by addicted women in
addition to treatment for addiction.
The Illinois Department, in cooperation with the
Departments of Human Services (as successor to the Department
of Alcoholism and Substance Abuse) and Public Health, through a
public awareness campaign, may provide information concerning
treatment for alcoholism and drug abuse and addiction, prenatal

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health care, and other pertinent programs directed at reducing
the number of drug-affected infants born to recipients of
medical assistance.
Neither the Department of Healthcare and Family Services
nor the Department of Human Services shall sanction the
recipient solely on the basis of her substance abuse.
The Illinois Department shall establish such regulations
governing the dispensing of health services under this Article
as it shall deem appropriate. The Department should seek the
advice of formal professional advisory committees appointed by
the Director of the Illinois Department for the purpose of
providing regular advice on policy and administrative matters,
information dissemination and educational activities for
medical and health care providers, and consistency in
procedures to the Illinois Department.
The Illinois Department may develop and contract with
Partnerships of medical providers to arrange medical services
for persons eligible under Section 5-2 of this Code.
Implementation of this Section may be by demonstration projects
in certain geographic areas. The Partnership shall be
represented by a sponsor organization. The Department, by rule,
shall develop qualifications for sponsors of Partnerships.
Nothing in this Section shall be construed to require that the
sponsor organization be a medical organization.
The sponsor must negotiate formal written contracts with
medical providers for physician services, inpatient and

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outpatient hospital care, home health services, treatment for
alcoholism and substance abuse, and other services determined
necessary by the Illinois Department by rule for delivery by
Partnerships. Physician services must include prenatal and
obstetrical care. The Illinois Department shall reimburse
medical services delivered by Partnership providers to clients
in target areas according to provisions of this Article and the
Illinois Health Finance Reform Act, except that:
(1) Physicians participating in a Partnership and
providing certain services, which shall be determined by
the Illinois Department, to persons in areas covered by the
Partnership may receive an additional surcharge for such
services.
(2) The Department may elect to consider and negotiate
financial incentives to encourage the development of
Partnerships and the efficient delivery of medical care.
(3) Persons receiving medical services through
Partnerships may receive medical and case management
services above the level usually offered through the
medical assistance program.
Medical providers shall be required to meet certain
qualifications to participate in Partnerships to ensure the
delivery of high quality medical services. These
qualifications shall be determined by rule of the Illinois
Department and may be higher than qualifications for
participation in the medical assistance program. Partnership

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sponsors may prescribe reasonable additional qualifications
for participation by medical providers, only with the prior
written approval of the Illinois Department.
Nothing in this Section shall limit the free choice of
practitioners, hospitals, and other providers of medical
services by clients. In order to ensure patient freedom of
choice, the Illinois Department shall immediately promulgate
all rules and take all other necessary actions so that provided
services may be accessed from therapeutically certified
optometrists to the full extent of the Illinois Optometric
Practice Act of 1987 without discriminating between service
providers.
The Department shall apply for a waiver from the United
States Health Care Financing Administration to allow for the
implementation of Partnerships under this Section.
The Illinois Department shall require health care
providers to maintain records that document the medical care
and services provided to recipients of Medical Assistance under
this Article. Such records must be retained for a period of not
less than 6 years from the date of service or as provided by
applicable State law, whichever period is longer, except that
if an audit is initiated within the required retention period
then the records must be retained until the audit is completed
and every exception is resolved. The Illinois Department shall
require health care providers to make available, when
authorized by the patient, in writing, the medical records in a

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timely fashion to other health care providers who are treating
or serving persons eligible for Medical Assistance under this
Article. All dispensers of medical services shall be required
to maintain and retain business and professional records
sufficient to fully and accurately document the nature, scope,
details and receipt of the health care provided to persons
eligible for medical assistance under this Code, in accordance
with regulations promulgated by the Illinois Department. The
rules and regulations shall require that proof of the receipt
of prescription drugs, dentures, prosthetic devices and
eyeglasses by eligible persons under this Section accompany
each claim for reimbursement submitted by the dispenser of such
medical services. No such claims for reimbursement shall be
approved for payment by the Illinois Department without such
proof of receipt, unless the Illinois Department shall have put
into effect and shall be operating a system of post-payment
audit and review which shall, on a sampling basis, be deemed
adequate by the Illinois Department to assure that such drugs,
dentures, prosthetic devices and eyeglasses for which payment
is being made are actually being received by eligible
recipients. Within 90 days after September 16, 1984 (the
effective date of Public Act 83-1439), the Illinois Department
shall establish a current list of acquisition costs for all
prosthetic devices and any other items recognized as medical
equipment and supplies reimbursable under this Article and
shall update such list on a quarterly basis, except that the

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acquisition costs of all prescription drugs shall be updated no
less frequently than every 30 days as required by Section
5-5.12.
Notwithstanding any other law to the contrary, the Illinois
Department shall, within 365 days after July 22, 2013 (the
effective date of Public Act 98-104), establish procedures to
permit skilled care facilities licensed under the Nursing Home
Care Act to submit monthly billing claims for reimbursement
purposes. Following development of these procedures, the
Department shall, by July 1, 2016, test the viability of the
new system and implement any necessary operational or
structural changes to its information technology platforms in
order to allow for the direct acceptance and payment of nursing
home claims.
Notwithstanding any other law to the contrary, the Illinois
Department shall, within 365 days after August 15, 2014 (the
effective date of Public Act 98-963), establish procedures to
permit ID/DD facilities licensed under the ID/DD Community Care
Act and MC/DD facilities licensed under the MC/DD Act to submit
monthly billing claims for reimbursement purposes. Following
development of these procedures, the Department shall have an
additional 365 days to test the viability of the new system and
to ensure that any necessary operational or structural changes
to its information technology platforms are implemented.
The Illinois Department shall require all dispensers of
medical services, other than an individual practitioner or

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group of practitioners, desiring to participate in the Medical
Assistance program established under this Article to disclose
all financial, beneficial, ownership, equity, surety or other
interests in any and all firms, corporations, partnerships,
associations, business enterprises, joint ventures, agencies,
institutions or other legal entities providing any form of
health care services in this State under this Article.
The Illinois Department may require that all dispensers of
medical services desiring to participate in the medical
assistance program established under this Article disclose,
under such terms and conditions as the Illinois Department may
by rule establish, all inquiries from clients and attorneys
regarding medical bills paid by the Illinois Department, which
inquiries could indicate potential existence of claims or liens
for the Illinois Department.
Enrollment of a vendor shall be subject to a provisional
period and shall be conditional for one year. During the period
of conditional enrollment, the Department may terminate the
vendor's eligibility to participate in, or may disenroll the
vendor from, the medical assistance program without cause.
Unless otherwise specified, such termination of eligibility or
disenrollment is not subject to the Department's hearing
process. However, a disenrolled vendor may reapply without
penalty.
The Department has the discretion to limit the conditional
enrollment period for vendors based upon category of risk of

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the vendor.
Prior to enrollment and during the conditional enrollment
period in the medical assistance program, all vendors shall be
subject to enhanced oversight, screening, and review based on
the risk of fraud, waste, and abuse that is posed by the
category of risk of the vendor. The Illinois Department shall
establish the procedures for oversight, screening, and review,
which may include, but need not be limited to: criminal and
financial background checks; fingerprinting; license,
certification, and authorization verifications; unscheduled or
unannounced site visits; database checks; prepayment audit
reviews; audits; payment caps; payment suspensions; and other
screening as required by federal or State law.
The Department shall define or specify the following: (i)
by provider notice, the "category of risk of the vendor" for
each type of vendor, which shall take into account the level of
screening applicable to a particular category of vendor under
federal law and regulations; (ii) by rule or provider notice,
the maximum length of the conditional enrollment period for
each category of risk of the vendor; and (iii) by rule, the
hearing rights, if any, afforded to a vendor in each category
of risk of the vendor that is terminated or disenrolled during
the conditional enrollment period.
To be eligible for payment consideration, a vendor's
payment claim or bill, either as an initial claim or as a
resubmitted claim following prior rejection, must be received

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by the Illinois Department, or its fiscal intermediary, no
later than 180 days after the latest date on the claim on which
medical goods or services were provided, with the following
exceptions:
(1) In the case of a provider whose enrollment is in
process by the Illinois Department, the 180-day period
shall not begin until the date on the written notice from
the Illinois Department that the provider enrollment is
complete.
(2) In the case of errors attributable to the Illinois
Department or any of its claims processing intermediaries
which result in an inability to receive, process, or
adjudicate a claim, the 180-day period shall not begin
until the provider has been notified of the error.
(3) In the case of a provider for whom the Illinois
Department initiates the monthly billing process.
(4) In the case of a provider operated by a unit of
local government with a population exceeding 3,000,000
when local government funds finance federal participation
for claims payments.
For claims for services rendered during a period for which
a recipient received retroactive eligibility, claims must be
filed within 180 days after the Department determines the
applicant is eligible. For claims for which the Illinois
Department is not the primary payer, claims must be submitted
to the Illinois Department within 180 days after the final

SB2017 - 109 - LRB101 09603 RAB 54701 b
adjudication by the primary payer.
In the case of long term care facilities, within 45
calendar days of receipt by the facility of required
prescreening information, new admissions with associated
admission documents shall be submitted through the Medical
Electronic Data Interchange (MEDI) or the Recipient
Eligibility Verification (REV) System or shall be submitted
directly to the Department of Human Services using required
admission forms. Effective September 1, 2014, admission
documents, including all prescreening information, must be
submitted through MEDI or REV. Confirmation numbers assigned to
an accepted transaction shall be retained by a facility to
verify timely submittal. Once an admission transaction has been
completed, all resubmitted claims following prior rejection
are subject to receipt no later than 180 days after the
admission transaction has been completed.
Claims that are not submitted and received in compliance
with the foregoing requirements shall not be eligible for
payment under the medical assistance program, and the State
shall have no liability for payment of those claims.
To the extent consistent with applicable information and
privacy, security, and disclosure laws, State and federal
agencies and departments shall provide the Illinois Department
access to confidential and other information and data necessary
to perform eligibility and payment verifications and other
Illinois Department functions. This includes, but is not

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limited to: information pertaining to licensure;
certification; earnings; immigration status; citizenship; wage
reporting; unearned and earned income; pension income;
employment; supplemental security income; social security
numbers; National Provider Identifier (NPI) numbers; the
National Practitioner Data Bank (NPDB); program and agency
exclusions; taxpayer identification numbers; tax delinquency;
corporate information; and death records.
The Illinois Department shall enter into agreements with
State agencies and departments, and is authorized to enter into
agreements with federal agencies and departments, under which
such agencies and departments shall share data necessary for
medical assistance program integrity functions and oversight.
The Illinois Department shall develop, in cooperation with
other State departments and agencies, and in compliance with
applicable federal laws and regulations, appropriate and
effective methods to share such data. At a minimum, and to the
extent necessary to provide data sharing, the Illinois
Department shall enter into agreements with State agencies and
departments, and is authorized to enter into agreements with
federal agencies and departments, including but not limited to:
the Secretary of State; the Department of Revenue; the
Department of Public Health; the Department of Human Services;
and the Department of Financial and Professional Regulation.
Beginning in fiscal year 2013, the Illinois Department
shall set forth a request for information to identify the

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benefits of a pre-payment, post-adjudication, and post-edit
claims system with the goals of streamlining claims processing
and provider reimbursement, reducing the number of pending or
rejected claims, and helping to ensure a more transparent
adjudication process through the utilization of: (i) provider
data verification and provider screening technology; and (ii)
clinical code editing; and (iii) pre-pay, pre- or
post-adjudicated predictive modeling with an integrated case
management system with link analysis. Such a request for
information shall not be considered as a request for proposal
or as an obligation on the part of the Illinois Department to
take any action or acquire any products or services.
The Illinois Department shall establish policies,
procedures, standards and criteria by rule for the acquisition,
repair and replacement of orthotic and prosthetic devices and
durable medical equipment. Such rules shall provide, but not be
limited to, the following services: (1) immediate repair or
replacement of such devices by recipients; and (2) rental,
lease, purchase or lease-purchase of durable medical equipment
in a cost-effective manner, taking into consideration the
recipient's medical prognosis, the extent of the recipient's
needs, and the requirements and costs for maintaining such
equipment. Subject to prior approval, such rules shall enable a
recipient to temporarily acquire and use alternative or
substitute devices or equipment pending repairs or
replacements of any device or equipment previously authorized

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for such recipient by the Department. Notwithstanding any
provision of Section 5-5f to the contrary, the Department may,
by rule, exempt certain replacement wheelchair parts from prior
approval and, for wheelchairs, wheelchair parts, wheelchair
accessories, and related seating and positioning items,
determine the wholesale price by methods other than actual
acquisition costs.
The Department shall require, by rule, all providers of
durable medical equipment to be accredited by an accreditation
organization approved by the federal Centers for Medicare and
Medicaid Services and recognized by the Department in order to
bill the Department for providing durable medical equipment to
recipients. No later than 15 months after the effective date of
the rule adopted pursuant to this paragraph, all providers must
meet the accreditation requirement.
In order to promote environmental responsibility, meet the
needs of recipients and enrollees, and achieve significant cost
savings, the Department, or a managed care organization under
contract with the Department, may provide recipients or managed
care enrollees who have a prescription or Certificate of
Medical Necessity access to refurbished durable medical
equipment under this Section (excluding prosthetic and
orthotic devices as defined in the Orthotics, Prosthetics, and
Pedorthics Practice Act and complex rehabilitation technology
products and associated services) through the State's
assistive technology program's reutilization program, using

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staff with the Assistive Technology Professional (ATP)
Certification if the refurbished durable medical equipment:
(i) is available; (ii) is less expensive, including shipping
costs, than new durable medical equipment of the same type;
(iii) is able to withstand at least 3 years of use; (iv) is
cleaned, disinfected, sterilized, and safe in accordance with
federal Food and Drug Administration regulations and guidance
governing the reprocessing of medical devices in health care
settings; and (v) equally meets the needs of the recipient or
enrollee. The reutilization program shall confirm that the
recipient or enrollee is not already in receipt of same or
similar equipment from another service provider, and that the
refurbished durable medical equipment equally meets the needs
of the recipient or enrollee. Nothing in this paragraph shall
be construed to limit recipient or enrollee choice to obtain
new durable medical equipment or place any additional prior
authorization conditions on enrollees of managed care
organizations.
The Department shall execute, relative to the nursing home
prescreening project, written inter-agency agreements with the
Department of Human Services and the Department on Aging, to
effect the following: (i) intake procedures and common
eligibility criteria for those persons who are receiving
non-institutional services; and (ii) the establishment and
development of non-institutional services in areas of the State
where they are not currently available or are undeveloped; and

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(iii) notwithstanding any other provision of law, subject to
federal approval, on and after July 1, 2012, an increase in the
determination of need (DON) scores from 29 to 37 for applicants
for institutional and home and community-based long term care;
if and only if federal approval is not granted, the Department
may, in conjunction with other affected agencies, implement
utilization controls or changes in benefit packages to
effectuate a similar savings amount for this population; and
(iv) no later than July 1, 2013, minimum level of care
eligibility criteria for institutional and home and
community-based long term care; and (v) no later than October
1, 2013, establish procedures to permit long term care
providers access to eligibility scores for individuals with an
admission date who are seeking or receiving services from the
long term care provider. In order to select the minimum level
of care eligibility criteria, the Governor shall establish a
workgroup that includes affected agency representatives and
stakeholders representing the institutional and home and
community-based long term care interests. This Section shall
not restrict the Department from implementing lower level of
care eligibility criteria for community-based services in
circumstances where federal approval has been granted.
The Illinois Department shall develop and operate, in
cooperation with other State Departments and agencies and in
compliance with applicable federal laws and regulations,
appropriate and effective systems of health care evaluation and

SB2017 - 115 - LRB101 09603 RAB 54701 b
programs for monitoring of utilization of health care services
and facilities, as it affects persons eligible for medical
assistance under this Code.
The Illinois Department shall report annually to the
General Assembly, no later than the second Friday in April of
1979 and each year thereafter, in regard to:
(a) actual statistics and trends in utilization of
medical services by public aid recipients;
(b) actual statistics and trends in the provision of
the various medical services by medical vendors;
(c) current rate structures and proposed changes in
those rate structures for the various medical vendors; and
(d) efforts at utilization review and control by the
Illinois Department.
The period covered by each report shall be the 3 years
ending on the June 30 prior to the report. The report shall
include suggested legislation for consideration by the General
Assembly. The requirement for reporting to the General Assembly
shall be satisfied by filing copies of the report as required
by Section 3.1 of the General Assembly Organization Act, and
filing such additional copies with the State Government Report
Distribution Center for the General Assembly as is required
under paragraph (t) of Section 7 of the State Library Act.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure

SB2017 - 116 - LRB101 09603 RAB 54701 b
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate of
reimbursement for services or other payments in accordance with
Section 5-5e.
Because kidney transplantation can be an appropriate,
cost-effective alternative to renal dialysis when medically
necessary and notwithstanding the provisions of Section 1-11 of
this Code, beginning October 1, 2014, the Department shall
cover kidney transplantation for noncitizens with end-stage
renal disease who are not eligible for comprehensive medical
benefits, who meet the residency requirements of Section 5-3 of
this Code, and who would otherwise meet the financial
requirements of the appropriate class of eligible persons under
Section 5-2 of this Code. To qualify for coverage of kidney
transplantation, such person must be receiving emergency renal
dialysis services covered by the Department. Providers under
this Section shall be prior approved and certified by the
Department to perform kidney transplantation and the services
under this Section shall be limited to services associated with
kidney transplantation.
Notwithstanding any other provision of this Code to the
contrary, on or after July 1, 2015, all FDA approved forms of

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medication assisted treatment prescribed for the treatment of
alcohol dependence or treatment of opioid dependence shall be
covered under both fee for service and managed care medical
assistance programs for persons who are otherwise eligible for
medical assistance under this Article and shall not be subject
to any (1) utilization control, other than those established
under the American Society of Addiction Medicine patient
placement criteria, (2) prior authorization mandate, or (3)
lifetime restriction limit mandate.
On or after July 1, 2015, opioid antagonists prescribed for
the treatment of an opioid overdose, including the medication
product, administration devices, and any pharmacy fees related
to the dispensing and administration of the opioid antagonist,
shall be covered under the medical assistance program for
persons who are otherwise eligible for medical assistance under
this Article. As used in this Section, "opioid antagonist"
means a drug that binds to opioid receptors and blocks or
inhibits the effect of opioids acting on those receptors,
including, but not limited to, naloxone hydrochloride or any
other similarly acting drug approved by the U.S. Food and Drug
Administration.
Upon federal approval, the Department shall provide
coverage and reimbursement for all drugs that are approved for
marketing by the federal Food and Drug Administration and that
are recommended by the federal Public Health Service or the
United States Centers for Disease Control and Prevention for

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pre-exposure prophylaxis and related pre-exposure prophylaxis
services, including, but not limited to, HIV and sexually
transmitted infection screening, treatment for sexually
transmitted infections, medical monitoring, assorted labs, and
counseling to reduce the likelihood of HIV infection among
individuals who are not infected with HIV but who are at high
risk of HIV infection.
A federally qualified health center, as defined in Section
1905(l)(2)(B) of the federal Social Security Act, shall be
reimbursed by the Department in accordance with the federally
qualified health center's encounter rate for services provided
to medical assistance recipients that are performed by a dental
hygienist, as defined under the Illinois Dental Practice Act,
working under the general supervision of a dentist and employed
by a federally qualified health center.
Notwithstanding any other provision of this Code, the
Illinois Department shall authorize licensed dietitian
nutritionists and certified diabetes educators to counsel
senior diabetes patients in the senior diabetes patients' homes
to remove the hurdle of transportation for senior diabetes
patients to receive treatment.
(Source: P.A. 99-78, eff. 7-20-15; 99-180, eff. 7-29-15;
99-236, eff. 8-3-15; 99-407 (see Section 20 of P.A. 99-588 for
the effective date of P.A. 99-407); 99-433, eff. 8-21-15;
99-480, eff. 9-9-15; 99-588, eff. 7-20-16; 99-642, eff.
7-28-16; 99-772, eff. 1-1-17; 99-895, eff. 1-1-17; 100-201,

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eff. 8-18-17; 100-395, eff. 1-1-18; 100-449, eff. 1-1-18;
100-538, eff. 1-1-18; 100-587, eff. 6-4-18; 100-759, eff.
1-1-19; 100-863, eff. 8-14-18; 100-974, eff. 8-19-18;
100-1009, eff. 1-1-19; 100-1018, eff. 1-1-19; 100-1148, eff.
12-10-18.)
(305 ILCS 5/5-29)
Sec. 5-29. Income Limits and Parental Responsibility. In
light of the unprecedented fiscal crisis confronting the State,
it is the intent of the General Assembly to explore whether the
income limits and income counting methods established for
children under the Covering ALL KIDS and Young Adults Health
Insurance Act, pursuant to this amendatory Act of the 96th
General Assembly, should apply to medical assistance programs
available to children made eligible under the Illinois Public
Aid Code, including through home and community based services
waiver programs authorized under Section 1915(c) of the Social
Security Act, where parental income is currently not considered
in determining a child's eligibility for medical assistance.
The Department of Healthcare and Family Services is hereby
directed, with the participation of the Department of Human
Services and stakeholders, to conduct an analysis of these
programs to determine parental cost sharing opportunities, how
these opportunities may impact the children currently in the
programs, waivers and on the waiting list, and any other
factors which may increase efficiencies and decrease State

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costs. The Department is further directed to review how
services under these programs and waivers may be provided by
the use of a combination of skilled, unskilled, and
uncompensated care and to advise as to what revisions to the
Nurse Practice Act, and Acts regulating other relevant
professions, are necessary to accomplish this combination of
care. The Department shall submit a written analysis on the
children's programs and waivers as part of the Department's
annual Medicaid reports due to the General Assembly in 2011 and
2012.
(Source: P.A. 96-1501, eff. 1-25-11.)
(305 ILCS 5/5-30)
Sec. 5-30. Care coordination.
(a) At least 50% of recipients eligible for comprehensive
medical benefits in all medical assistance programs or other
health benefit programs administered by the Department,
including the Children's Health Insurance Program Act and the
Covering ALL KIDS and Young Adults Health Insurance Act, shall
be enrolled in a care coordination program by no later than
January 1, 2015. For purposes of this Section, "coordinated
care" or "care coordination" means delivery systems where
recipients will receive their care from providers who
participate under contract in integrated delivery systems that
are responsible for providing or arranging the majority of
care, including primary care physician services, referrals

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from primary care physicians, diagnostic and treatment
services, behavioral health services, in-patient and
outpatient hospital services, dental services, and
rehabilitation and long-term care services. The Department
shall designate or contract for such integrated delivery
systems (i) to ensure enrollees have a choice of systems and of
primary care providers within such systems; (ii) to ensure that
enrollees receive quality care in a culturally and
linguistically appropriate manner; and (iii) to ensure that
coordinated care programs meet the diverse needs of enrollees
with developmental, mental health, physical, and age-related
disabilities.
(b) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related to
health care outcomes, the use of evidence-based practices, the
use of primary care delivered through comprehensive medical
homes, the use of electronic medical records, and the
appropriate exchange of health information electronically made
either on a capitated basis in which a fixed monthly premium
per recipient is paid and full financial risk is assumed for
the delivery of services, or through other risk-based payment
arrangements.
(c) To qualify for compliance with this Section, the 50%
goal shall be achieved by enrolling medical assistance
enrollees from each medical assistance enrollment category,
including parents, children, seniors, and people with

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disabilities to the extent that current State Medicaid payment
laws would not limit federal matching funds for recipients in
care coordination programs. In addition, services must be more
comprehensively defined and more risk shall be assumed than in
the Department's primary care case management program as of
January 25, 2011 (the effective date of Public Act 96-1501).
(d) The Department shall report to the General Assembly in
a separate part of its annual medical assistance program
report, beginning April, 2012 until April, 2016, on the
progress and implementation of the care coordination program
initiatives established by the provisions of Public Act
96-1501. The Department shall include in its April 2011 report
a full analysis of federal laws or regulations regarding upper
payment limitations to providers and the necessary revisions or
adjustments in rate methodologies and payments to providers
under this Code that would be necessary to implement
coordinated care with full financial risk by a party other than
the Department.
(e) Integrated Care Program for individuals with chronic
mental health conditions.
(1) The Integrated Care Program shall encompass
services administered to recipients of medical assistance
under this Article to prevent exacerbations and
complications using cost-effective, evidence-based
practice guidelines and mental health management
strategies.

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(2) The Department may utilize and expand upon existing
contractual arrangements with integrated care plans under
the Integrated Care Program for providing the coordinated
care provisions of this Section.
(3) Payment for such coordinated care shall be based on
arrangements where the State pays for performance related
to mental health outcomes on a capitated basis in which a
fixed monthly premium per recipient is paid and full
financial risk is assumed for the delivery of services, or
through other risk-based payment arrangements such as
provider-based care coordination.
(4) The Department shall examine whether chronic
mental health management programs and services for
recipients with specific chronic mental health conditions
do any or all of the following:
(A) Improve the patient's overall mental health in
a more expeditious and cost-effective manner.
(B) Lower costs in other aspects of the medical
assistance program, such as hospital admissions,
emergency room visits, or more frequent and
inappropriate psychotropic drug use.
(5) The Department shall work with the facilities and
any integrated care plan participating in the program to
identify and correct barriers to the successful
implementation of this subsection (e) prior to and during
the implementation to best facilitate the goals and

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objectives of this subsection (e).
(f) A hospital that is located in a county of the State in
which the Department mandates some or all of the beneficiaries
of the Medical Assistance Program residing in the county to
enroll in a Care Coordination Program, as set forth in Section
5-30 of this Code, shall not be eligible for any non-claims
based payments not mandated by Article V-A of this Code for
which it would otherwise be qualified to receive, unless the
hospital is a Coordinated Care Participating Hospital no later
than 60 days after June 14, 2012 (the effective date of Public
Act 97-689) or 60 days after the first mandatory enrollment of
a beneficiary in a Coordinated Care program. For purposes of
this subsection, "Coordinated Care Participating Hospital"
means a hospital that meets one of the following criteria:
(1) The hospital has entered into a contract to provide
hospital services with one or more MCOs to enrollees of the
care coordination program.
(2) The hospital has not been offered a contract by a
care coordination plan that the Department has determined
to be a good faith offer and that pays at least as much as
the Department would pay, on a fee-for-service basis, not
including disproportionate share hospital adjustment
payments or any other supplemental adjustment or add-on
payment to the base fee-for-service rate, except to the
extent such adjustments or add-on payments are
incorporated into the development of the applicable MCO

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capitated rates.
As used in this subsection (f), "MCO" means any entity
which contracts with the Department to provide services where
payment for medical services is made on a capitated basis.
(g) No later than August 1, 2013, the Department shall
issue a purchase of care solicitation for Accountable Care
Entities (ACE) to serve any children and parents or caretaker
relatives of children eligible for medical assistance under
this Article. An ACE may be a single corporate structure or a
network of providers organized through contractual
relationships with a single corporate entity. The solicitation
shall require that:
(1) An ACE operating in Cook County be capable of
serving at least 40,000 eligible individuals in that
county; an ACE operating in Lake, Kane, DuPage, or Will
Counties be capable of serving at least 20,000 eligible
individuals in those counties and an ACE operating in other
regions of the State be capable of serving at least 10,000
eligible individuals in the region in which it operates.
During initial periods of mandatory enrollment, the
Department shall require its enrollment services
contractor to use a default assignment algorithm that
ensures if possible an ACE reaches the minimum enrollment
levels set forth in this paragraph.
(2) An ACE must include at a minimum the following
types of providers: primary care, specialty care,

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hospitals, and behavioral healthcare.
(3) An ACE shall have a governance structure that
includes the major components of the health care delivery
system, including one representative from each of the
groups listed in paragraph (2).
(4) An ACE must be an integrated delivery system,
including a network able to provide the full range of
services needed by Medicaid beneficiaries and system
capacity to securely pass clinical information across
participating entities and to aggregate and analyze that
data in order to coordinate care.
(5) An ACE must be capable of providing both care
coordination and complex case management, as necessary, to
beneficiaries. To be responsive to the solicitation, a
potential ACE must outline its care coordination and
complex case management model and plan to reduce the cost
of care.
(6) In the first 18 months of operation, unless the ACE
selects a shorter period, an ACE shall be paid care
coordination fees on a per member per month basis that are
projected to be cost neutral to the State during the term
of their payment and, subject to federal approval, be
eligible to share in additional savings generated by their
care coordination.
(7) In months 19 through 36 of operation, unless the
ACE selects a shorter period, an ACE shall be paid on a

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pre-paid capitation basis for all medical assistance
covered services, under contract terms similar to Managed
Care Organizations (MCO), with the Department sharing the
risk through either stop-loss insurance for extremely high
cost individuals or corridors of shared risk based on the
overall cost of the total enrollment in the ACE. The ACE
shall be responsible for claims processing, encounter data
submission, utilization control, and quality assurance.
(8) In the fourth and subsequent years of operation, an
ACE shall convert to a Managed Care Community Network
(MCCN), as defined in this Article, or Health Maintenance
Organization pursuant to the Illinois Insurance Code,
accepting full-risk capitation payments.
The Department shall allow potential ACE entities 5 months
from the date of the posting of the solicitation to submit
proposals. After the solicitation is released, in addition to
the MCO rate development data available on the Department's
website, subject to federal and State confidentiality and
privacy laws and regulations, the Department shall provide 2
years of de-identified summary service data on the targeted
population, split between children and adults, showing the
historical type and volume of services received and the cost of
those services to those potential bidders that sign a data use
agreement. The Department may add up to 2 non-state government
employees with expertise in creating integrated delivery
systems to its review team for the purchase of care

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solicitation described in this subsection. Any such
individuals must sign a no-conflict disclosure and
confidentiality agreement and agree to act in accordance with
all applicable State laws.
During the first 2 years of an ACE's operation, the
Department shall provide claims data to the ACE on its
enrollees on a periodic basis no less frequently than monthly.
Nothing in this subsection shall be construed to limit the
Department's mandate to enroll 50% of its beneficiaries into
care coordination systems by January 1, 2015, using all
available care coordination delivery systems, including Care
Coordination Entities (CCE), MCCNs, or MCOs, nor be construed
to affect the current CCEs, MCCNs, and MCOs selected to serve
seniors and persons with disabilities prior to that date.
Nothing in this subsection precludes the Department from
considering future proposals for new ACEs or expansion of
existing ACEs at the discretion of the Department.
(h) Department contracts with MCOs and other entities
reimbursed by risk based capitation shall have a minimum
medical loss ratio of 85%, shall require the entity to
establish an appeals and grievances process for consumers and
providers, and shall require the entity to provide a quality
assurance and utilization review program. Entities contracted
with the Department to coordinate healthcare regardless of risk
shall be measured utilizing the same quality metrics. The
quality metrics may be population specific. Any contracted

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entity serving at least 5,000 seniors or people with
disabilities or 15,000 individuals in other populations
covered by the Medical Assistance Program that has been
receiving full-risk capitation for a year shall be accredited
by a national accreditation organization authorized by the
Department within 2 years after the date it is eligible to
become accredited. The requirements of this subsection shall
apply to contracts with MCOs entered into or renewed or
extended after June 1, 2013.
(h-5) The Department shall monitor and enforce compliance
by MCOs with agreements they have entered into with providers
on issues that include, but are not limited to, timeliness of
payment, payment rates, and processes for obtaining prior
approval. The Department may impose sanctions on MCOs for
violating provisions of those agreements that include, but are
not limited to, financial penalties, suspension of enrollment
of new enrollees, and termination of the MCO's contract with
the Department. As used in this subsection (h-5), "MCO" has the
meaning ascribed to that term in Section 5-30.1 of this Code.
(i) Unless otherwise required by federal law, Medicaid
Managed Care Entities and their respective business associates
shall not disclose, directly or indirectly, including by
sending a bill or explanation of benefits, information
concerning the sensitive health services received by enrollees
of the Medicaid Managed Care Entity to any person other than
covered entities and business associates, which may receive,

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use, and further disclose such information solely for the
purposes permitted under applicable federal and State laws and
regulations if such use and further disclosure satisfies all
applicable requirements of such laws and regulations. The
Medicaid Managed Care Entity or its respective business
associates may disclose information concerning the sensitive
health services if the enrollee who received the sensitive
health services requests the information from the Medicaid
Managed Care Entity or its respective business associates and
authorized the sending of a bill or explanation of benefits.
Communications including, but not limited to, statements of
care received or appointment reminders either directly or
indirectly to the enrollee from the health care provider,
health care professional, and care coordinators, remain
permissible. Medicaid Managed Care Entities or their
respective business associates may communicate directly with
their enrollees regarding care coordination activities for
those enrollees.
For the purposes of this subsection, the term "Medicaid
Managed Care Entity" includes Care Coordination Entities,
Accountable Care Entities, Managed Care Organizations, and
Managed Care Community Networks.
For purposes of this subsection, the term "sensitive health
services" means mental health services, substance abuse
treatment services, reproductive health services, family
planning services, services for sexually transmitted

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infections and sexually transmitted diseases, and services for
sexual assault or domestic abuse. Services include prevention,
screening, consultation, examination, treatment, or follow-up.
For purposes of this subsection, "business associate",
"covered entity", "disclosure", and "use" have the meanings
ascribed to those terms in 45 CFR 160.103.
Nothing in this subsection shall be construed to relieve a
Medicaid Managed Care Entity or the Department of any duty to
report incidents of sexually transmitted infections to the
Department of Public Health or to the local board of health in
accordance with regulations adopted under a statute or
ordinance or to report incidents of sexually transmitted
infections as necessary to comply with the requirements under
Section 5 of the Abused and Neglected Child Reporting Act or as
otherwise required by State or federal law.
The Department shall create policy in order to implement
the requirements in this subsection.
(j) Managed Care Entities (MCEs), including MCOs and all
other care coordination organizations, shall develop and
maintain a written language access policy that sets forth the
standards, guidelines, and operational plan to ensure language
appropriate services and that is consistent with the standard
of meaningful access for populations with limited English
proficiency. The language access policy shall describe how the
MCEs will provide all of the following required services:
(1) Translation (the written replacement of text from

SB2017 - 132 - LRB101 09603 RAB 54701 b
one language into another) of all vital documents and forms
as identified by the Department.
(2) Qualified interpreter services (the oral
communication of a message from one language into another
by a qualified interpreter).
(3) Staff training on the language access policy,
including how to identify language needs, access and
provide language assistance services, work with
interpreters, request translations, and track the use of
language assistance services.
(4) Data tracking that identifies the language need.
(5) Notification to participants on the availability
of language access services and on how to access such
services.
(k) The Department shall actively monitor the contractual
relationship between Managed Care Organizations (MCOs) and any
dental administrator contracted by an MCO to provide dental
services. The Department shall adopt appropriate dental
Healthcare Effectiveness Data and Information Set (HEDIS)
measures and shall include the Annual Dental Visit (ADV) HEDIS
measure in its Health Plan Comparison Tool and Illinois
Medicaid Plan Report Card that is available on the Department's
website for enrolled individuals.
The Department shall collect from each MCO specific
information about the types of contracted, broad-based care
coordination occurring between the MCO and any dental

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administrator, including, but not limited to, pregnant women
and diabetic patients in need of oral care.
(Source: P.A. 99-106, eff. 1-1-16; 99-181, eff. 7-29-15;
99-566, eff. 1-1-17; 99-642, eff. 7-28-16; 100-587, eff.
6-4-18.)
Section 60. The Prenatal and Newborn Care Act is amended by
changing Section 9 as follows:
(410 ILCS 225/9)
Sec. 9. The Illinois Department of Healthcare and Family
Services; consultation; data reporting.
(a) The Illinois Department of Healthcare and Family
Services, which administers the Illinois Medicaid Program and
the Covering ALL KIDS and Young Adults Health Insurance
Program, shall consult with statewide organizations focused on
premature infant healthcare in order to:
(1) examine and improve hospital discharge and
follow-up care procedures for premature infants born
earlier than 37 weeks gestational age to ensure
standardized and coordinated processes are followed as
premature infants leave the hospital from either a Level 1
(well baby nursery), Level 2 (step down or transitional
nursery), or Level 3 (neonatal intensive care unit) unit
and transition to follow-up care by a health care provider
in the community; and

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(2) use guidance from the Centers for Medicare and
Medicaid Services' Neonatal Outcome Improvement Project to
implement programs to improve newborn outcome, reduce
newborn health costs, and establish ongoing quality
improvement for newborns.
(b) In consultation with statewide organizations
representing hospitals, the Department of Public Health shall
consider mechanisms to collect discharge data for purposes of
analyzing readmission rates of certain premature infants.
(Source: P.A. 96-1117, eff. 7-20-10.)
SB2017 - 135 - LRB101 09603 RAB 54701 b
INDEX
Statutes amended in order of appearance
20 ILCS 1705/71a
30 ILCS 105/6z-52
30 ILCS 105/6z-73
30 ILCS 105/6z-81
30 ILCS 105/25 from Ch. 127, par. 161
30 ILCS 540/3-2
35 ILCS 105/3-8
35 ILCS 120/2-9
35 ILCS 200/15-86
40 ILCS 5/24-102 from Ch. 108 1/2, par. 24-102
110 ILCS 948/10
110 ILCS 948/25
110 ILCS 948/30
215 ILCS 106/23
215 ILCS 170/1
215 ILCS 170/5
215 ILCS 170/10
215 ILCS 170/15
215 ILCS 170/20
215 ILCS 170/25
215 ILCS 170/35
215 ILCS 170/40
215 ILCS 170/45
SB2017 - 136 - LRB101 09603 RAB 54701 b