Bill Text: IL SB3171 | 2013-2014 | 98th General Assembly | Chaptered

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes a provision requiring the Department of Healthcare and Family Services to limit adult podiatry services to individuals with diabetes. Effective immediately.

Spectrum: Partisan Bill (Democrat 12-0)

Status: (Passed) 2015-01-09 - Public Act . . . . . . . . . 98-1166 [SB3171 Detail]

Download: Illinois-2013-SB3171-Chaptered.html

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Public Act 098-1166
SB3171 Enrolled LRB098 18157 KTG 53286 b
AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5-5e as follows:
(305 ILCS 5/5-5e)
Sec. 5-5e. Adjusted rates of reimbursement.
(a) Rates or payments for services in effect on June 30,
2012 shall be adjusted and services shall be affected as
required by any other provision of this amendatory Act of the
97th General Assembly. In addition, the Department shall do the
following:
(1) Delink the per diem rate paid for supportive living
facility services from the per diem rate paid for nursing
facility services, effective for services provided on or
after May 1, 2011.
(2) Cease payment for bed reserves in nursing
facilities and specialized mental health rehabilitation
facilities; for purposes of therapeutic home visits for
individuals scoring as TBI on the MDS 3.0, beginning June
1, 2015, the Department shall approve payments for bed
reserves in nursing facilities and specialized mental
health rehabilitation facilities that have at least a 90%

occupancy level and at least 80% of their residents are
Medicaid eligible. Payment shall be at a daily rate of 75%
of an individual's current Medicaid per diem and shall not
exceed 10 days in a calendar month.
(2.5) Cease payment for bed reserves for purposes of
inpatient hospitalizations to intermediate care facilities
for persons with development disabilities, except in the
instance of residents who are under 21 years of age.
(3) Cease payment of the $10 per day add-on payment to
nursing facilities for certain residents with
developmental disabilities.
(b) After the application of subsection (a),
notwithstanding any other provision of this Code to the
contrary and to the extent permitted by federal law, on and
after July 1, 2012, the rates of reimbursement for services and
other payments provided under this Code shall further be
reduced as follows:
(1) Rates or payments for physician services, dental
services, or community health center services reimbursed
through an encounter rate, and services provided under the
Medicaid Rehabilitation Option of the Illinois Title XIX
State Plan shall not be further reduced.
(2) Rates or payments, or the portion thereof, paid to
a provider that is operated by a unit of local government
or State University that provides the non-federal share of
such services shall not be further reduced.

(3) Rates or payments for hospital services delivered
by a hospital defined as a Safety-Net Hospital under
Section 5-5e.1 of this Code shall not be further reduced.
(4) Rates or payments for hospital services delivered
by a Critical Access Hospital, which is an Illinois
hospital designated as a critical care hospital by the
Department of Public Health in accordance with 42 CFR 485,
Subpart F, shall not be further reduced.
(5) Rates or payments for Nursing Facility Services
shall only be further adjusted pursuant to Section 5-5.2 of
this Code.
(6) Rates or payments for services delivered by long
term care facilities licensed under the ID/DD Community
Care Act and developmental training services shall not be
further reduced.
(7) Rates or payments for services provided under
capitation rates shall be adjusted taking into
consideration the rates reduction and covered services
required by this amendatory Act of the 97th General
Assembly.
(8) For hospitals not previously described in this
subsection, the rates or payments for hospital services
shall be further reduced by 3.5%, except for payments
authorized under Section 5A-12.4 of this Code.
(9) For all other rates or payments for services
delivered by providers not specifically referenced in

paragraphs (1) through (8), rates or payments shall be
further reduced by 2.7%.
(c) Any assessment imposed by this Code shall continue and
nothing in this Section shall be construed to cause it to
cease.
(d) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for services provided for the purpose
of transitioning children from a hospital to home placement or
other appropriate setting by a children's community-based
health care center authorized under the Alternative Health Care
Delivery Act shall be $683 per day.
(e) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for home health visits shall be $72.
(f) Notwithstanding any other provision of this Code to the
contrary, subject to federal approval under Title XIX of the
Social Security Act, for dates of service on and after July 1,
2014, rates or payments for the certified nursing assistant
component of the home health agency rate shall be $20.
(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13;
98-651, eff. 6-16-14.)
Section 99. Effective date. This Act takes effect June 1,
2015.