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HB2771 Enrolled LRB104 08638 BDA 18691 b
1 AN ACT concerning health.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Administrative Procedure Act is
5 amended by adding Section 5-45.65 as follows:
6 (5 ILCS 100/5-45.65 new)
7 Sec. 5-45.65. Emergency rulemaking; Medicaid reimbursement
8 rates for hospital inpatient and outpatient services. To
9 provide for the expeditious and timely implementation of the
10 changes made by this amendatory Act of the 104th General
11 Assembly to Sections 5A-2, 5A-7, 5A-8, 5A-10, and 5A-12.7 of
12 the Illinois Public Aid Code, emergency rules implementing the
13 changes made by this amendatory Act of the 104th General
14 Assembly to Sections 5A-2, 5A-7, 5A-8, 5A-10, and 5A-12.7 of
15 the Illinois Public Aid Code may be adopted in accordance with
16 Section 5-45 by the Department of Healthcare and Family
17 Services. The adoption of emergency rules authorized by
18 Section 5-45 and this Section is deemed necessary for the
19 public interest, safety, and welfare.
20 This Section is repealed one year after the effective date
21 of this amendatory Act of the 104th General Assembly.
22 Section 10. The Illinois Public Aid Code is amended by
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1 changing Sections 5A-2, 5A-5, 5A-7, 5A-8, 5A-10, 5A-12.7,
2 5A-14, and 12-4.105 as follows:
3 (305 ILCS 5/5A-2) (from Ch. 23, par. 5A-2)
4 (Section scheduled to be repealed on December 31, 2026)
5 Sec. 5A-2. Assessment.
6 (a)(1) Subject to Sections 5A-3 and 5A-10, for State
7 fiscal years 2009 through 2018, or as long as continued under
8 Section 5A-16, an annual assessment on inpatient services is
9 imposed on each hospital provider in an amount equal to
10 $218.38 multiplied by the difference of the hospital's
11 occupied bed days less the hospital's Medicare bed days,
12 provided, however, that the amount of $218.38 shall be
13 increased by a uniform percentage to generate an amount equal
14 to 75% of the State share of the payments authorized under
15 Section 5A-12.5, with such increase only taking effect upon
16 the date that a State share for such payments is required under
17 federal law. For the period of April through June 2015, the
18 amount of $218.38 used to calculate the assessment under this
19 paragraph shall, by emergency rule under subsection (s) of
20 Section 5-45 of the Illinois Administrative Procedure Act, be
21 increased by a uniform percentage to generate $20,250,000 in
22 the aggregate for that period from all hospitals subject to
23 the annual assessment under this paragraph.
24 (2) In addition to any other assessments imposed under
25 this Article, effective July 1, 2016 and semi-annually
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1 thereafter through June 2018, or as provided in Section 5A-16,
2 in addition to any federally required State share as
3 authorized under paragraph (1), the amount of $218.38 shall be
4 increased by a uniform percentage to generate an amount equal
5 to 75% of the ACA Assessment Adjustment, as defined in
6 subsection (b-6) of this Section.
7 For State fiscal years 2009 through 2018, or as provided
8 in Section 5A-16, a hospital's occupied bed days and Medicare
9 bed days shall be determined using the most recent data
10 available from each hospital's 2005 Medicare cost report as
11 contained in the Healthcare Cost Report Information System
12 file, for the quarter ending on December 31, 2006, without
13 regard to any subsequent adjustments or changes to such data.
14 If a hospital's 2005 Medicare cost report is not contained in
15 the Healthcare Cost Report Information System, then the
16 Illinois Department may obtain the hospital provider's
17 occupied bed days and Medicare bed days from any source
18 available, including, but not limited to, records maintained
19 by the hospital provider, which may be inspected at all times
20 during business hours of the day by the Illinois Department or
21 its duly authorized agents and employees.
22 (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State
23 fiscal years 2019 and 2020, an annual assessment on inpatient
24 services is imposed on each hospital provider in an amount
25 equal to $197.19 multiplied by the difference of the
26 hospital's occupied bed days less the hospital's Medicare bed
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1 days. For State fiscal years 2019 and 2020, a hospital's
2 occupied bed days and Medicare bed days shall be determined
3 using the most recent data available from each hospital's 2015
4 Medicare cost report as contained in the Healthcare Cost
5 Report Information System file, for the quarter ending on
6 March 31, 2017, without regard to any subsequent adjustments
7 or changes to such data. If a hospital's 2015 Medicare cost
8 report is not contained in the Healthcare Cost Report
9 Information System, then the Illinois Department may obtain
10 the hospital provider's occupied bed days and Medicare bed
11 days from any source available, including, but not limited to,
12 records maintained by the hospital provider, which may be
13 inspected at all times during business hours of the day by the
14 Illinois Department or its duly authorized agents and
15 employees. Notwithstanding any other provision in this
16 Article, for a hospital provider that did not have a 2015
17 Medicare cost report, but paid an assessment in State fiscal
18 year 2018 on the basis of hypothetical data, that assessment
19 amount shall be used for State fiscal years 2019 and 2020.
20 (4) Subject to Sections 5A-3 and 5A-10 and to subsection
21 (b-8), for the period of July 1, 2020 through December 31, 2020
22 and calendar years 2021 through 2024 2026, an annual
23 assessment on inpatient services is imposed on each hospital
24 provider in an amount equal to $221.50 multiplied by the
25 difference of the hospital's occupied bed days less the
26 hospital's Medicare bed days, provided however: for the period
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1 of July 1, 2020 through December 31, 2020, (i) the assessment
2 shall be equal to 50% of the annual amount; and (ii) the amount
3 of $221.50 shall be retroactively adjusted by a uniform
4 percentage to generate an amount equal to 50% of the
5 Assessment Adjustment, as defined in subsection (b-7). For the
6 period of July 1, 2020 through December 31, 2020 and calendar
7 years 2021 through 2024 2026, a hospital's occupied bed days
8 and Medicare bed days shall be determined using the most
9 recent data available from each hospital's 2015 Medicare cost
10 report as contained in the Healthcare Cost Report Information
11 System file, for the quarter ending on March 31, 2017, without
12 regard to any subsequent adjustments or changes to such data.
13 If a hospital's 2015 Medicare cost report is not contained in
14 the Healthcare Cost Report Information System, then the
15 Illinois Department may obtain the hospital provider's
16 occupied bed days and Medicare bed days from any source
17 available, including, but not limited to, records maintained
18 by the hospital provider, which may be inspected at all times
19 during business hours of the day by the Illinois Department or
20 its duly authorized agents and employees. Should the change in
21 the assessment methodology for fiscal years 2021 through
22 December 31, 2022 not be approved on or before June 30, 2020,
23 the assessment and payments under this Article in effect for
24 fiscal year 2020 shall remain in place until the new
25 assessment is approved. If the assessment methodology for July
26 1, 2020 through December 31, 2022, is approved on or after July
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1 1, 2020, it shall be retroactive to July 1, 2020, subject to
2 federal approval and provided that the payments authorized
3 under Section 5A-12.7 have the same effective date as the new
4 assessment methodology. In giving retroactive effect to the
5 assessment approved after June 30, 2020, credit toward the new
6 assessment shall be given for any payments of the previous
7 assessment for periods after June 30, 2020. Notwithstanding
8 any other provision of this Article, for a hospital provider
9 that did not have a 2015 Medicare cost report, but paid an
10 assessment in State Fiscal Year 2020 on the basis of
11 hypothetical data, the data that was the basis for the 2020
12 assessment shall be used to calculate the assessment under
13 this paragraph until December 31, 2023. Beginning July 1, 2022
14 and through December 31, 2024, a safety-net hospital that had
15 a change of ownership in calendar year 2021, and whose
16 inpatient utilization had decreased by 90% from the prior year
17 and prior to the change of ownership, may be eligible to pay a
18 tax based on hypothetical data based on a determination of
19 financial distress by the Department. Subject to federal
20 approval, the Department may, by January 1, 2024, develop a
21 hypothetical tax for a specialty cancer hospital which had a
22 structural change of ownership during calendar year 2022 from
23 a for-profit entity to a non-profit entity, and which has
24 experienced a decline of 60% or greater in inpatient days of
25 care as compared to the prior owners 2015 Medicare cost
26 report. This change of ownership may make the hospital
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1 eligible for a hypothetical tax under the new hospital
2 provision of the assessment defined in this Section. This new
3 hypothetical tax may be applicable from January 1, 2024
4 through December 31, 2026.
5 (5) Subject to Sections 5A-3 and 5A-10, beginning January
6 1, 2025, an annual assessment on inpatient services is imposed
7 on each hospital provider in an amount equal to $362, or any
8 reduction thereof in accordance with this subsection,
9 multiplied by the difference of the hospital's occupied bed
10 days less the hospital's Medicare bed days; however, the rate
11 shall be $221.50 until the Department receives federal
12 approval and implements the reimbursement rates in subsection
13 (r) of Section 5A-12.7. The Department may bill for the
14 difference between the assessment rate of $362, or any
15 reduction thereof in accordance with this subsection, and
16 $221.50 no earlier than 17 calendar days after implementing
17 the reimbursement rates in subsection (r) of Section 5A-12.7.
18 (A) Upon receiving federal approval for the
19 reimbursement rates in subsection (r) of Section 5A-12.7,
20 the Department shall bill the hospital for the incremental
21 difference in total tax due resulting from the increase
22 provided in this subsection for the number of months from
23 January 1, 2025 through the date of federal approval. The
24 amount shall be due and payable no later than December 31,
25 2025 and no earlier than 17 calendar days after
26 implementing the reimbursement rates in subsection (r) of
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1 Section 5A-12.7. The Department shall bill hospitals in
2 the same proportional rate as the Department has
3 implemented the inpatient reimbursement rates in
4 subsection (r) of Section 5A-12.7.
5 (B) Beginning January 1, 2025, a hospital's occupied
6 bed days and Medicare bed days shall be determined using
7 the most recent data available from each hospital's 2015
8 Medicare cost report as contained in the Healthcare Cost
9 Report Information System file, for the quarter ending on
10 March 31, 2017, without regard to any subsequent
11 adjustments or changes to such data. If a hospital's 2015
12 Medicare cost report is not contained in the Healthcare
13 Cost Report Information System, then the Department may
14 obtain the hospital provider's occupied bed days and
15 Medicare bed days from any source available, including,
16 but not limited to, records maintained by the hospital
17 provider, which may be inspected at all times during
18 business hours of the day by the Department or its duly
19 authorized agents and employees. If the reimbursement
20 rates in subsection (r) of Section 5A-12.7 require
21 reduction to comply with federal spending limits, then the
22 tax rate of $362 shall be reduced, in accordance with
23 subsection (s) of Section 5A-12.7, by the same percentage
24 reduction to payments required to comply with federal
25 spending limits.
26 (b) (Blank).
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1 (b-5)(1) Subject to Sections 5A-3 and 5A-10, for the
2 portion of State fiscal year 2012, beginning June 10, 2012
3 through June 30, 2012, and for State fiscal years 2013 through
4 2018, or as provided in Section 5A-16, an annual assessment on
5 outpatient services is imposed on each hospital provider in an
6 amount equal to .008766 multiplied by the hospital's
7 outpatient gross revenue, provided, however, that the amount
8 of .008766 shall be increased by a uniform percentage to
9 generate an amount equal to 25% of the State share of the
10 payments authorized under Section 5A-12.5, with such increase
11 only taking effect upon the date that a State share for such
12 payments is required under federal law. For the period
13 beginning June 10, 2012 through June 30, 2012, the annual
14 assessment on outpatient services shall be prorated by
15 multiplying the assessment amount by a fraction, the numerator
16 of which is 21 days and the denominator of which is 365 days.
17 For the period of April through June 2015, the amount of
18 .008766 used to calculate the assessment under this paragraph
19 shall, by emergency rule under subsection (s) of Section 5-45
20 of the Illinois Administrative Procedure Act, be increased by
21 a uniform percentage to generate $6,750,000 in the aggregate
22 for that period from all hospitals subject to the annual
23 assessment under this paragraph.
24 (2) In addition to any other assessments imposed under
25 this Article, effective July 1, 2016 and semi-annually
26 thereafter through June 2018, in addition to any federally
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1 required State share as authorized under paragraph (1), the
2 amount of .008766 shall be increased by a uniform percentage
3 to generate an amount equal to 25% of the ACA Assessment
4 Adjustment, as defined in subsection (b-6) of this Section.
5 For the portion of State fiscal year 2012, beginning June
6 10, 2012 through June 30, 2012, and State fiscal years 2013
7 through 2018, or as provided in Section 5A-16, a hospital's
8 outpatient gross revenue shall be determined using the most
9 recent data available from each hospital's 2009 Medicare cost
10 report as contained in the Healthcare Cost Report Information
11 System file, for the quarter ending on June 30, 2011, without
12 regard to any subsequent adjustments or changes to such data.
13 If a hospital's 2009 Medicare cost report is not contained in
14 the Healthcare Cost Report Information System, then the
15 Department may obtain the hospital provider's outpatient gross
16 revenue from any source available, including, but not limited
17 to, records maintained by the hospital provider, which may be
18 inspected at all times during business hours of the day by the
19 Department or its duly authorized agents and employees.
20 (3) Subject to Sections 5A-3, 5A-10, and 5A-16, for State
21 fiscal years 2019 and 2020, an annual assessment on outpatient
22 services is imposed on each hospital provider in an amount
23 equal to .01358 multiplied by the hospital's outpatient gross
24 revenue. For State fiscal years 2019 and 2020, a hospital's
25 outpatient gross revenue shall be determined using the most
26 recent data available from each hospital's 2015 Medicare cost
HB2771 Enrolled - 11 - LRB104 08638 BDA 18691 b
1 report as contained in the Healthcare Cost Report Information
2 System file, for the quarter ending on March 31, 2017, without
3 regard to any subsequent adjustments or changes to such data.
4 If a hospital's 2015 Medicare cost report is not contained in
5 the Healthcare Cost Report Information System, then the
6 Department may obtain the hospital provider's outpatient gross
7 revenue from any source available, including, but not limited
8 to, records maintained by the hospital provider, which may be
9 inspected at all times during business hours of the day by the
10 Department or its duly authorized agents and employees.
11 Notwithstanding any other provision in this Article, for a
12 hospital provider that did not have a 2015 Medicare cost
13 report, but paid an assessment in State fiscal year 2018 on the
14 basis of hypothetical data, that assessment amount shall be
15 used for State fiscal years 2019 and 2020.
16 (4) Subject to Sections 5A-3 and 5A-10 and to subsection
17 (b-8), for the period of July 1, 2020 through December 31, 2020
18 and calendar years 2021 through 2024 2026, an annual
19 assessment on outpatient services is imposed on each hospital
20 provider in an amount equal to .01525 multiplied by the
21 hospital's outpatient gross revenue, provided however: (i) for
22 the period of July 1, 2020 through December 31, 2020, the
23 assessment shall be equal to 50% of the annual amount; and (ii)
24 the amount of .01525 shall be retroactively adjusted by a
25 uniform percentage to generate an amount equal to 50% of the
26 Assessment Adjustment, as defined in subsection (b-7). For the
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1 period of July 1, 2020 through December 31, 2020 and calendar
2 years 2021 through 2024 2026, a hospital's outpatient gross
3 revenue shall be determined using the most recent data
4 available from each hospital's 2015 Medicare cost report as
5 contained in the Healthcare Cost Report Information System
6 file, for the quarter ending on March 31, 2017, without regard
7 to any subsequent adjustments or changes to such data. If a
8 hospital's 2015 Medicare cost report is not contained in the
9 Healthcare Cost Report Information System, then the Illinois
10 Department may obtain the hospital provider's outpatient
11 revenue data from any source available, including, but not
12 limited to, records maintained by the hospital provider, which
13 may be inspected at all times during business hours of the day
14 by the Illinois Department or its duly authorized agents and
15 employees. Should the change in the assessment methodology
16 above for fiscal years 2021 through calendar year 2022 not be
17 approved prior to July 1, 2020, the assessment and payments
18 under this Article in effect for fiscal year 2020 shall remain
19 in place until the new assessment is approved. If the change in
20 the assessment methodology above for July 1, 2020 through
21 December 31, 2022, is approved after June 30, 2020, it shall
22 have a retroactive effective date of July 1, 2020, subject to
23 federal approval and provided that the payments authorized
24 under Section 12A-7 have the same effective date as the new
25 assessment methodology. In giving retroactive effect to the
26 assessment approved after June 30, 2020, credit toward the new
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1 assessment shall be given for any payments of the previous
2 assessment for periods after June 30, 2020. Notwithstanding
3 any other provision of this Article, for a hospital provider
4 that did not have a 2015 Medicare cost report, but paid an
5 assessment in State Fiscal Year 2020 on the basis of
6 hypothetical data, the data that was the basis for the 2020
7 assessment shall be used to calculate the assessment under
8 this paragraph until December 31, 2023. Beginning July 1, 2022
9 and through December 31, 2024, a safety-net hospital that had
10 a change of ownership in calendar year 2021, and whose
11 inpatient utilization had decreased by 90% from the prior year
12 and prior to the change of ownership, may be eligible to pay a
13 tax based on hypothetical data based on a determination of
14 financial distress by the Department.
15 (5) Subject to Sections 5A-3 and 5A-10, beginning January
16 1, 2025, an annual assessment on outpatient services is
17 imposed on each hospital provider in an amount equal to
18 .03273, or any reduction thereof in accordance with this
19 subsection, multiplied by the hospital's outpatient gross
20 revenue; however the rate shall remain .01525, until the
21 Department receives federal approval and implements the
22 reimbursement rates of payment in subsection (r) of Section
23 5A-12.7. The Department may bill for the difference between
24 the assessment multiplier of .03273 and .01525 no earlier than
25 17 calendar days after the first payment based on the
26 reimbursement rates in subsection (r) of Section 5A-12.7.
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1 (A) Upon receiving federal approval for the
2 reimbursement rates in subsection (r) of Section 5A-12.7,
3 the Department shall bill the hospital for the incremental
4 difference in total tax due resulting from the increase
5 provided in this subsection for the number of months from
6 January 1, 2025 through the date of federal approval. The
7 amount shall be due and payable no later than December 31,
8 2025 and no earlier than 17 calendar days after
9 implementing the reimbursement rates in subsection (r) of
10 Section 5A-12.7. The Department shall bill hospitals in
11 the same proportional rate as the Department has
12 implemented the outpatient reimbursement rates in
13 subsection (r) of Section 5A-12.7.
14 (B) Beginning January 1, 2025, a hospital's outpatient
15 gross revenue shall be determined using the most recent
16 data available from each hospital's 2015 Medicare cost
17 report as contained in the Healthcare Cost Report
18 Information System file, for the quarter ending on March
19 31, 2017, without regard to any subsequent adjustments or
20 changes to such data. If a hospital's 2015 Medicare cost
21 report is not contained in the Healthcare Cost Report
22 Information System, then the Department may obtain the
23 hospital provider's outpatient revenue data from any
24 source available, including, but not limited to, records
25 maintained by the hospital provider, which may be
26 inspected at all times during business hours of the day by
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1 the Department or its duly authorized agents and
2 employees. If the reimbursement rates in subsection (r) of
3 Section 5A-12.7 require reduction to comply with federal
4 spending limits, then the tax rate of .03273 shall be
5 reduced, in accordance with subsection (s) of Section
6 5A-12.7, by the same percentage reduction to payments
7 required to comply with federal spending limits.
8 (b-6)(1) As used in this Section, "ACA Assessment
9 Adjustment" means:
10 (A) For the period of July 1, 2016 through December
11 31, 2016, the product of .19125 multiplied by the sum of
12 the fee-for-service payments to hospitals as authorized
13 under Section 5A-12.5 and the adjustments authorized under
14 subsection (t) of Section 5A-12.2 to managed care
15 organizations for hospital services due and payable in the
16 month of April 2016 multiplied by 6.
17 (B) For the period of January 1, 2017 through June 30,
18 2017, the product of .19125 multiplied by the sum of the
19 fee-for-service payments to hospitals as authorized under
20 Section 5A-12.5 and the adjustments authorized under
21 subsection (t) of Section 5A-12.2 to managed care
22 organizations for hospital services due and payable in the
23 month of October 2016 multiplied by 6, except that the
24 amount calculated under this subparagraph (B) shall be
25 adjusted, either positively or negatively, to account for
26 the difference between the actual payments issued under
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1 Section 5A-12.5 for the period beginning July 1, 2016
2 through December 31, 2016 and the estimated payments due
3 and payable in the month of April 2016 multiplied by 6 as
4 described in subparagraph (A).
5 (C) For the period of July 1, 2017 through December
6 31, 2017, the product of .19125 multiplied by the sum of
7 the fee-for-service payments to hospitals as authorized
8 under Section 5A-12.5 and the adjustments authorized under
9 subsection (t) of Section 5A-12.2 to managed care
10 organizations for hospital services due and payable in the
11 month of April 2017 multiplied by 6, except that the
12 amount calculated under this subparagraph (C) shall be
13 adjusted, either positively or negatively, to account for
14 the difference between the actual payments issued under
15 Section 5A-12.5 for the period beginning January 1, 2017
16 through June 30, 2017 and the estimated payments due and
17 payable in the month of October 2016 multiplied by 6 as
18 described in subparagraph (B).
19 (D) For the period of January 1, 2018 through June 30,
20 2018, the product of .19125 multiplied by the sum of the
21 fee-for-service payments to hospitals as authorized under
22 Section 5A-12.5 and the adjustments authorized under
23 subsection (t) of Section 5A-12.2 to managed care
24 organizations for hospital services due and payable in the
25 month of October 2017 multiplied by 6, except that:
26 (i) the amount calculated under this subparagraph
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1 (D) shall be adjusted, either positively or
2 negatively, to account for the difference between the
3 actual payments issued under Section 5A-12.5 for the
4 period of July 1, 2017 through December 31, 2017 and
5 the estimated payments due and payable in the month of
6 April 2017 multiplied by 6 as described in
7 subparagraph (C); and
8 (ii) the amount calculated under this subparagraph
9 (D) shall be adjusted to include the product of .19125
10 multiplied by the sum of the fee-for-service payments,
11 if any, estimated to be paid to hospitals under
12 subsection (b) of Section 5A-12.5.
13 (2) The Department shall complete and apply a final
14 reconciliation of the ACA Assessment Adjustment prior to June
15 30, 2018 to account for:
16 (A) any differences between the actual payments issued
17 or scheduled to be issued prior to June 30, 2018 as
18 authorized in Section 5A-12.5 for the period of January 1,
19 2018 through June 30, 2018 and the estimated payments due
20 and payable in the month of October 2017 multiplied by 6 as
21 described in subparagraph (D); and
22 (B) any difference between the estimated
23 fee-for-service payments under subsection (b) of Section
24 5A-12.5 and the amount of such payments that are actually
25 scheduled to be paid.
26 The Department shall notify hospitals of any additional
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1 amounts owed or reduction credits to be applied to the June
2 2018 ACA Assessment Adjustment. This is to be considered the
3 final reconciliation for the ACA Assessment Adjustment.
4 (3) Notwithstanding any other provision of this Section,
5 if for any reason the scheduled payments under subsection (b)
6 of Section 5A-12.5 are not issued in full by the final day of
7 the period authorized under subsection (b) of Section 5A-12.5,
8 funds collected from each hospital pursuant to subparagraph
9 (D) of paragraph (1) and pursuant to paragraph (2),
10 attributable to the scheduled payments authorized under
11 subsection (b) of Section 5A-12.5 that are not issued in full
12 by the final day of the period attributable to each payment
13 authorized under subsection (b) of Section 5A-12.5, shall be
14 refunded.
15 (4) The increases authorized under paragraph (2) of
16 subsection (a) and paragraph (2) of subsection (b-5) shall be
17 limited to the federally required State share of the total
18 payments authorized under Section 5A-12.5 if the sum of such
19 payments yields an annualized amount equal to or less than
20 $450,000,000, or if the adjustments authorized under
21 subsection (t) of Section 5A-12.2 are found not to be
22 actuarially sound; however, this limitation shall not apply to
23 the fee-for-service payments described in subsection (b) of
24 Section 5A-12.5.
25 (b-7)(1) As used in this Section, "Assessment Adjustment"
26 means:
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1 (A) For the period of July 1, 2020 through December
2 31, 2020, the product of .3853 multiplied by the total of
3 the actual payments made under subsections (c) through (k)
4 of Section 5A-12.7 attributable to the period, less the
5 total of the assessment imposed under subsections (a) and
6 (b-5) of this Section for the period.
7 (B) For each calendar quarter beginning January 1,
8 2021 through December 31, 2022, the product of .3853
9 multiplied by the total of the actual payments made under
10 subsections (c) through (k) of Section 5A-12.7
11 attributable to the period, less the total of the
12 assessment imposed under subsections (a) and (b-5) of this
13 Section for the period.
14 (C) Beginning on January 1, 2023, and each subsequent
15 July 1 and January 1, the product of .3853 multiplied by
16 the total of the actual payments made under subsections
17 (c) through (j) and subsection (r) of Section 5A-12.7
18 attributable to the 6-month period immediately preceding
19 the period to which the adjustment applies, less the total
20 of the assessment imposed under subsections (a) and (b-5)
21 of this Section for the 6-month period immediately
22 preceding the period to which the adjustment applies.
23 (2) The Department shall calculate and notify each
24 hospital of the total Assessment Adjustment and any additional
25 assessment owed by the hospital or refund owed to the hospital
26 on either a semi-annual or annual basis. Such notice shall be
HB2771 Enrolled - 20 - LRB104 08638 BDA 18691 b
1 issued at least 30 days prior to any period in which the
2 assessment will be adjusted. Any additional assessment owed by
3 the hospital or refund owed to the hospital shall be uniformly
4 applied to the assessment owed by the hospital in monthly
5 installments for the subsequent semi-annual period or calendar
6 year. If no assessment is owed in the subsequent year, any
7 amount owed by the hospital or refund due to the hospital,
8 shall be paid in a lump sum. If the calculation that is
9 computed under this Section could result in a decrease in the
10 Department's federal financial participation percentage for
11 payments authorized under Section 5A-12.7, then the Department
12 shall instead apply a uniform percentage reduction to the
13 payment rates outlined in subsection (r) of Section 5A-12.7
14 for all classes as defined in subsections (g) and (h) of
15 Section 5A-12.7 by an amount no more than necessary to
16 maximize federal reimbursement.
17 (3) The Department shall publish all details of the
18 Assessment Adjustment calculation performed each year on its
19 website within 30 days of completing the calculation, and also
20 submit the details of the Assessment Adjustment calculation as
21 part of the Department's annual report to the General
22 Assembly.
23 (b-8) Notwithstanding any other provision of this Article,
24 the Department shall reduce the assessments imposed on each
25 hospital under subsections (a) and (b-5) by the uniform
26 percentage necessary to reduce the total assessment imposed on
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1 all hospitals by an aggregate amount of $240,000,000, with
2 such reduction being applied by June 30, 2022. The assessment
3 reduction required for each hospital under this subsection
4 shall be forever waived, forgiven, and released by the
5 Department.
6 (c) (Blank).
7 (d) Notwithstanding any of the other provisions of this
8 Section, the Department is authorized to adopt rules to reduce
9 the rate of any annual assessment imposed under this Section,
10 as authorized by Section 5-46.2 of the Illinois Administrative
11 Procedure Act.
12 (e) Notwithstanding any other provision of this Section,
13 any plan providing for an assessment on a hospital provider as
14 a permissible tax under Title XIX of the federal Social
15 Security Act and Medicaid-eligible payments to hospital
16 providers from the revenues derived from that assessment shall
17 be reviewed by the Illinois Department of Healthcare and
18 Family Services, as the Single State Medicaid Agency required
19 by federal law, to determine whether those assessments and
20 hospital provider payments meet federal Medicaid standards. If
21 the Department determines that the elements of the plan may
22 meet federal Medicaid standards and a related State Medicaid
23 Plan Amendment is prepared in a manner and form suitable for
24 submission, that State Plan Amendment shall be submitted in a
25 timely manner for review by the Centers for Medicare and
26 Medicaid Services of the United States Department of Health
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1 and Human Services and subject to approval by the Centers for
2 Medicare and Medicaid Services of the United States Department
3 of Health and Human Services. No such plan shall become
4 effective without approval by the Illinois General Assembly by
5 the enactment into law of related legislation. Notwithstanding
6 any other provision of this Section, the Department is
7 authorized to adopt rules to reduce the rate of any annual
8 assessment imposed under this Section. Any such rules may be
9 adopted by the Department under Section 5-50 of the Illinois
10 Administrative Procedure Act.
11 (f) To provide for the expeditious and timely
12 implementation of the changes made to this Section by this
13 amendatory Act of the 104th General Assembly, the Department
14 may adopt emergency rules as authorized by Section 5-45 of the
15 Illinois Administrative Procedure Act. The adoption of
16 emergency rules is deemed to be necessary for the public
17 interest, safety, and welfare.
18 (Source: P.A. 102-886, eff. 5-17-22; 103-102, eff. 1-1-24.)
19 (305 ILCS 5/5A-5) (from Ch. 23, par. 5A-5)
20 Sec. 5A-5. Notice; penalty; maintenance of records.
21 (a) The Illinois Department shall send a notice of
22 assessment to every hospital provider subject to assessment
23 under this Article. The notice of assessment shall notify the
24 hospital of its assessment and shall be sent after receipt by
25 the Department of notification from the Centers for Medicare
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1 and Medicaid Services of the U.S. Department of Health and
2 Human Services that the payment methodologies required under
3 this Article and, if necessary, the waiver granted under 42
4 CFR 433.68 have been approved. The notice shall be on a form
5 prepared by the Illinois Department and shall state the
6 following:
7 (1) The name of the hospital provider.
8 (2) The address of the hospital provider's principal
9 place of business from which the provider engages in the
10 occupation of hospital provider in this State, and the
11 name and address of each hospital operated, conducted, or
12 maintained by the provider in this State.
13 (3) The occupied bed days, occupied bed days less
14 Medicare days, adjusted gross hospital revenue, or
15 outpatient gross revenue of the hospital provider
16 (whichever is applicable), the amount of assessment
17 imposed under Section 5A-2 for the State fiscal year for
18 which the notice is sent, and the amount of each
19 installment to be paid during the State fiscal year.
20 (4) (Blank).
21 (5) Other reasonable information as determined by the
22 Illinois Department.
23 (b) If a hospital provider conducts, operates, or
24 maintains more than one hospital licensed by the Illinois
25 Department of Public Health, the provider shall pay the
26 assessment for each hospital separately.
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1 (c) Notwithstanding any other provision in this Article,
2 in the case of a person who ceases to conduct, operate, or
3 maintain a hospital in respect of which the person is subject
4 to assessment under this Article as a hospital provider, the
5 assessment for the State fiscal year in which the cessation
6 occurs shall be adjusted by multiplying the assessment
7 computed under Section 5A-2 by a fraction, the numerator of
8 which is the number of days in the year during which the
9 provider conducts, operates, or maintains the hospital and the
10 denominator of which is 365. Immediately upon ceasing to
11 conduct, operate, or maintain a hospital, the person shall pay
12 the assessment for the year as so adjusted (to the extent not
13 previously paid).
14 (d) Notwithstanding any other provision in this Article, a
15 provider who commences conducting, operating, or maintaining a
16 hospital, upon notice by the Illinois Department, shall pay
17 the assessment computed under Section 5A-2 and subsection (e)
18 in installments on the due dates stated in the notice and on
19 the regular installment due dates for the State fiscal year
20 occurring after the due dates of the initial notice.
21 (e) Notwithstanding any other provision in this Article,
22 for State fiscal years 2009 through 2018, in the case of a
23 hospital provider that did not conduct, operate, or maintain a
24 hospital in 2005, the assessment for that State fiscal year
25 shall be computed on the basis of hypothetical occupied bed
26 days for the full calendar year as determined by the Illinois
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1 Department. Notwithstanding any other provision in this
2 Article, for the portion of State fiscal year 2012 beginning
3 June 10, 2012 through June 30, 2012, and for State fiscal years
4 2013 through 2018, in the case of a hospital provider that did
5 not conduct, operate, or maintain a hospital in 2009, the
6 assessment under subsection (b-5) of Section 5A-2 for that
7 State fiscal year shall be computed on the basis of
8 hypothetical gross outpatient revenue for the full calendar
9 year as determined by the Illinois Department.
10 Notwithstanding any other provision in this Article,
11 beginning July 1, 2018 through December 31, 2026, in the case
12 of a hospital provider that did not conduct, operate, or
13 maintain a hospital in the year that is the basis of the
14 calculation of the assessment under this Article, the
15 assessment under paragraph (3) of subsection (a) of Section
16 5A-2 for the State fiscal year shall be computed on the basis
17 of hypothetical occupied bed days for the full calendar year
18 as determined by the Illinois Department, except that for a
19 hospital provider that did not have a 2015 Medicare cost
20 report, but paid an assessment in State fiscal year 2018 on the
21 basis of hypothetical data, that assessment amount shall be
22 used for State fiscal years 2019 and 2020; however, for State
23 fiscal year 2020, the assessment amount shall be increased by
24 the proportion that it represents of the total annual
25 assessment that is generated from all hospitals in order to
26 generate $6,250,000 in the aggregate for that period from all
HB2771 Enrolled - 26 - LRB104 08638 BDA 18691 b
1 hospitals subject to the annual assessment under this
2 paragraph.
3 Notwithstanding any other provision in this Article,
4 beginning July 1, 2018 through December 31, 2026, in the case
5 of a hospital provider that did not conduct, operate, or
6 maintain a hospital in the year that is the basis of the
7 calculation of the assessment under this Article, the
8 assessment under subsection (b-5) of Section 5A-2 for that
9 State fiscal year shall be computed on the basis of
10 hypothetical gross outpatient revenue for the full calendar
11 year as determined by the Illinois Department, except that for
12 a hospital provider that did not have a 2015 Medicare cost
13 report, but paid an assessment in State fiscal year 2018 on the
14 basis of hypothetical data, that assessment amount shall be
15 used for State fiscal years 2019 and 2020; however, for State
16 fiscal year 2020, the assessment amount shall be increased by
17 the proportion that it represents of the total annual
18 assessment that is generated from all hospitals in order to
19 generate $6,250,000 in the aggregate for that period from all
20 hospitals subject to the annual assessment under this
21 paragraph.
22 (f) Every hospital provider subject to assessment under
23 this Article shall keep sufficient records to permit the
24 determination of adjusted gross hospital revenue for the
25 hospital's fiscal year. All such records shall be kept in the
26 English language and shall, at all times during regular
HB2771 Enrolled - 27 - LRB104 08638 BDA 18691 b
1 business hours of the day, be subject to inspection by the
2 Illinois Department or its duly authorized agents and
3 employees.
4 (g) The Illinois Department may, by rule, provide a
5 hospital provider a reasonable opportunity to request a
6 clarification or correction of any clerical or computational
7 errors contained in the calculation of its assessment, but
8 such corrections shall not extend to updating the cost report
9 information used to calculate the assessment.
10 (h) (Blank).
11 (Source: P.A. 102-886, eff. 5-17-22.)
12 (305 ILCS 5/5A-7) (from Ch. 23, par. 5A-7)
13 Sec. 5A-7. Administration; enforcement provisions.
14 (a) The Illinois Department shall establish and maintain a
15 listing of all hospital providers appearing in the licensing
16 records of the Illinois Department of Public Health, which
17 shall show each provider's name and principal place of
18 business and the name and address of each hospital operated,
19 conducted, or maintained by the provider in this State. The
20 listing shall also include the monthly assessment amounts owed
21 for each hospital and any unpaid assessment liability greater
22 than 90 days delinquent. The Illinois Department shall
23 administer and enforce this Article and collect the
24 assessments and penalty assessments imposed under this Article
25 using procedures employed in its administration of this Code
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1 generally. The Illinois Department, its Director, and every
2 hospital provider subject to assessment under this Article
3 shall have the following powers, duties, and rights:
4 (1) The Illinois Department may initiate either
5 administrative or judicial proceedings, or both, to
6 enforce provisions of this Article. Administrative
7 enforcement proceedings initiated hereunder shall be
8 governed by the Illinois Department's administrative
9 rules. Judicial enforcement proceedings initiated
10 hereunder shall be governed by the rules of procedure
11 applicable in the courts of this State.
12 (2) (Blank). No proceedings for collection, refund,
13 credit, or other adjustment of an assessment amount shall
14 be issued more than 3 years after the due date of the
15 assessment, except in the case of an extended period
16 agreed to in writing by the Illinois Department and the
17 hospital provider before the expiration of this limitation
18 period.
19 (3) Any unpaid assessment under this Article shall
20 become a lien upon the assets of the hospital upon which it
21 was assessed. If any hospital provider, outside the usual
22 course of its business, sells or transfers the major part
23 of any one or more of (A) the real property and
24 improvements, (B) the machinery and equipment, or (C) the
25 furniture or fixtures, of any hospital that is subject to
26 the provisions of this Article, the seller or transferor
HB2771 Enrolled - 29 - LRB104 08638 BDA 18691 b
1 shall pay the Illinois Department the amount of any
2 assessment, assessment penalty, and interest (if any) due
3 from it under this Article up to the date of the sale or
4 transfer. The Illinois Department may, in its discretion,
5 foreclose on such a lien, but shall do so in a manner that
6 is consistent with Section 5e of the Retailers' Occupation
7 Tax Act. If the seller or transferor fails to pay any
8 assessment, assessment penalty, and interest (if any) due,
9 the purchaser or transferee of such asset shall be liable
10 for the amount of the assessment, penalties, and interest
11 (if any) up to the amount of the reasonable value of the
12 property acquired by the purchaser or transferee. The
13 purchaser or transferee shall continue to be liable until
14 the purchaser or transferee pays the full amount of the
15 assessment, penalties, and interest (if any) up to the
16 amount of the reasonable value of the property acquired by
17 the purchaser or transferee or until the purchaser or
18 transferee receives from the Illinois Department a
19 certificate showing that such assessment, penalty, and
20 interest have been paid or a certificate from the Illinois
21 Department showing that no assessment, penalty, or
22 interest is due from the seller or transferor under this
23 Article.
24 (4) Payments under this Article are not subject to the
25 Illinois Prompt Payment Act. Credits or refunds shall not
26 bear interest.
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1 (b) In addition to any other remedy provided for and
2 without sending a notice of assessment liability, the Illinois
3 Department shall may collect an unpaid assessment by
4 withholding, as payment of the assessment, reimbursements or
5 other amounts otherwise payable by the Illinois Department to
6 the hospital provider, including, but not limited to, payment
7 amounts otherwise payable from a managed care organization
8 performing duties under contract with the Illinois Department.
9 (1) The requirements of this subsection may be waived
10 in instances when a disaster proclamation has been
11 declared by the Governor. In such circumstances, a
12 hospital must demonstrate temporary financial distress and
13 establish an agreement with the Illinois Department
14 specifying when repayment in full of all taxes owed will
15 occur.
16 (2) The requirements of this subsection may be waived
17 by the Illinois Department in instances when a hospital
18 has entered into and remains in compliance with a
19 repayment plan or a tax deferral plan. A repayment plan or
20 tax deferral plan must be entered into no later than 30
21 days after notice of an unpaid assessment payment. No
22 repayment plan may exceed a period of 36 months. No tax
23 deferral plan may exceed a period of 6 months, and
24 repayment after the end of a tax deferral plan shall not
25 exceed 36 months. Failure to remain in compliance with a
26 repayment plan or tax deferral plan shall cause immediate
HB2771 Enrolled - 31 - LRB104 08638 BDA 18691 b
1 termination of such plan unless there is prior written
2 consent from the Illinois Department for a period of
3 non-compliance.
4 (3) Beginning September 1, 2025, the Illinois
5 Department shall immediately collect all overdue unpaid
6 assessments and penalties through the collection methods
7 authorized under this Section, unless a repayment plan or
8 tax deferral plan has already been agreed to by September
9 1, 2025.
10 (c) To provide for the expeditious and timely
11 implementation of the changes made to this Section by this
12 amendatory Act of the 104th General Assembly, the Department
13 may adopt emergency rules as authorized by Section 5-45 of the
14 Illinois Administrative Procedure Act. The adoption of
15 emergency rules is deemed to be necessary for the public
16 interest, safety, and welfare.
17 (Source: P.A. 93-659, eff. 2-3-04; 93-841, eff. 7-30-04;
18 94-242, eff. 7-18-05.)
19 (305 ILCS 5/5A-8) (from Ch. 23, par. 5A-8)
20 Sec. 5A-8. Hospital Provider Fund.
21 (a) There is created in the State Treasury the Hospital
22 Provider Fund. Interest earned by the Fund shall be credited
23 to the Fund. The Fund shall not be used to replace any moneys
24 appropriated to the Medicaid program by the General Assembly.
25 (b) The Fund is created for the purpose of receiving
HB2771 Enrolled - 32 - LRB104 08638 BDA 18691 b
1 moneys in accordance with Section 5A-6 and disbursing moneys
2 only for the following purposes, notwithstanding any other
3 provision of law:
4 (1) For making payments to hospitals as required under
5 this Code, under the Children's Health Insurance Program
6 Act, under the Covering ALL KIDS Health Insurance Act, and
7 under the Long Term Acute Care Hospital Quality
8 Improvement Transfer Program Act.
9 (2) For the reimbursement of moneys collected by the
10 Illinois Department from hospitals or hospital providers
11 through error or mistake in performing the activities
12 authorized under this Code.
13 (3) For payment of administrative expenses incurred by
14 the Illinois Department or its agent in performing
15 activities under this Code, under the Children's Health
16 Insurance Program Act, under the Covering ALL KIDS Health
17 Insurance Act, and under the Long Term Acute Care Hospital
18 Quality Improvement Transfer Program Act.
19 (4) For payments of any amounts which are reimbursable
20 to the federal government for payments from this Fund
21 which are required to be paid by State warrant.
22 (5) For making transfers, as those transfers are
23 authorized in the proceedings authorizing debt under the
24 Short Term Borrowing Act, but transfers made under this
25 paragraph (5) shall not exceed the principal amount of
26 debt issued in anticipation of the receipt by the State of
HB2771 Enrolled - 33 - LRB104 08638 BDA 18691 b
1 moneys to be deposited into the Fund.
2 (6) For making transfers to any other fund in the
3 State treasury, but transfers made under this paragraph
4 (6) shall not exceed the amount transferred previously
5 from that other fund into the Hospital Provider Fund plus
6 any interest that would have been earned by that fund on
7 the monies that had been transferred.
8 (6.5) For making transfers to the Healthcare Provider
9 Relief Fund, except that transfers made under this
10 paragraph (6.5) shall not exceed $60,000,000 in the
11 aggregate.
12 (7) For making transfers not exceeding the following
13 amounts, related to State fiscal years 2013 through 2018,
14 to the following designated funds:
15 Health and Human Services Medicaid Trust
16 Fund ............................ $20,000,000
17 Long-Term Care Provider Fund ........ $30,000,000
18 General Revenue Fund ................ $80,000,000.
19 Transfers under this paragraph shall be made within 7 days
20 after the payments have been received pursuant to the
21 schedule of payments provided in subsection (a) of Section
22 5A-4.
23 (7.1) (Blank).
24 (7.5) (Blank).
25 (7.8) (Blank).
26 (7.9) (Blank).
HB2771 Enrolled - 34 - LRB104 08638 BDA 18691 b
1 (7.10) For State fiscal year 2014, for making
2 transfers of the moneys resulting from the assessment
3 under subsection (b-5) of Section 5A-2 and received from
4 hospital providers under Section 5A-4 and transferred into
5 the Hospital Provider Fund under Section 5A-6 to the
6 designated funds not exceeding the following amounts in
7 that State fiscal year:
8 Healthcare Provider Relief Fund ...... $100,000,000
9 Transfers under this paragraph shall be made within 7
10 days after the payments have been received pursuant to the
11 schedule of payments provided in subsection (a) of Section
12 5A-4.
13 The additional amount of transfers in this paragraph
14 (7.10), authorized by Public Act 98-651, shall be made
15 within 10 State business days after June 16, 2014 (the
16 effective date of Public Act 98-651). That authority shall
17 remain in effect even if Public Act 98-651 does not become
18 law until State fiscal year 2015.
19 (7.10a) For State fiscal years 2015 through 2018, for
20 making transfers of the moneys resulting from the
21 assessment under subsection (b-5) of Section 5A-2 and
22 received from hospital providers under Section 5A-4 and
23 transferred into the Hospital Provider Fund under Section
24 5A-6 to the designated funds not exceeding the following
25 amounts related to each State fiscal year:
26 Healthcare Provider Relief Fund ...... $50,000,000
HB2771 Enrolled - 35 - LRB104 08638 BDA 18691 b
1 Transfers under this paragraph shall be made within 7
2 days after the payments have been received pursuant to the
3 schedule of payments provided in subsection (a) of Section
4 5A-4.
5 (7.11) (Blank).
6 (7.12) For State fiscal year 2013, for increasing by
7 21/365ths the transfer of the moneys resulting from the
8 assessment under subsection (b-5) of Section 5A-2 and
9 received from hospital providers under Section 5A-4 for
10 the portion of State fiscal year 2012 beginning June 10,
11 2012 through June 30, 2012 and transferred into the
12 Hospital Provider Fund under Section 5A-6 to the
13 designated funds not exceeding the following amounts in
14 that State fiscal year:
15 Healthcare Provider Relief Fund ........ $2,870,000
16 Since the federal Centers for Medicare and Medicaid
17 Services approval of the assessment authorized under
18 subsection (b-5) of Section 5A-2, received from hospital
19 providers under Section 5A-4 and the payment methodologies
20 to hospitals required under Section 5A-12.4 was not
21 received by the Department until State fiscal year 2014
22 and since the Department made retroactive payments during
23 State fiscal year 2014 related to the referenced period of
24 June 2012, the transfer authority granted in this
25 paragraph (7.12) is extended through the date that is 10
26 State business days after June 16, 2014 (the effective
HB2771 Enrolled - 36 - LRB104 08638 BDA 18691 b
1 date of Public Act 98-651).
2 (7.13) In addition to any other transfers authorized
3 under this Section, for State fiscal years 2017 and 2018,
4 for making transfers to the Healthcare Provider Relief
5 Fund of moneys collected from the ACA Assessment
6 Adjustment authorized under subsections (a) and (b-5) of
7 Section 5A-2 and paid by hospital providers under Section
8 5A-4 into the Hospital Provider Fund under Section 5A-6
9 for each State fiscal year. Timing of transfers to the
10 Healthcare Provider Relief Fund under this paragraph shall
11 be at the discretion of the Department, but no less
12 frequently than quarterly.
13 (7.14) For making transfers not exceeding the
14 following amounts, related to State fiscal years 2019 and
15 2020, to the following designated funds:
16 Health and Human Services Medicaid Trust
17 Fund ............................ $20,000,000
18 Long-Term Care Provider Fund ........ $30,000,000
19 Healthcare Provider Relief Fund .... $325,000,000.
20 Transfers under this paragraph shall be made within 7
21 days after the payments have been received pursuant to the
22 schedule of payments provided in subsection (a) of Section
23 5A-4.
24 (7.15) For making transfers not exceeding the
25 following amounts, related to State fiscal years 2023
26 through 2024 2026, to the following designated funds:
HB2771 Enrolled - 37 - LRB104 08638 BDA 18691 b
1 Health and Human Services Medicaid Trust
2 Fund ............................ $20,000,000
3 Long-Term Care Provider Fund ........ $30,000,000
4 Healthcare Provider Relief Fund ...... $365,000,000
5 (7.16) For making transfers not exceeding the
6 following amounts, related to July 1, 2024 2026 to
7 December 31, 2024 2026, to the following designated funds:
8 Health and Human Services Medicaid Trust
9 Fund ............................ $10,000,000
10 Long-Term Care Provider Fund ........ $15,000,000
11 Healthcare Provider Relief Fund ...... $182,500,000
12 (7.17) For making transfers not exceeding the
13 following amounts, related to calendar years 2025 and each
14 calendar year thereafter, the following designated funds:
15 Health and Human Services Medicaid Trust
16 Fund ............................ $20,000,000
17 Long-Term Care Provider Fund ........ $30,000,000
18 Healthcare Provider Relief Fund .... $505,637,082;
19 however the amount shall remain $365,000,000 until the
20 reimbursement rates described in subsection (r) of Section
21 5A-12.7 are fully implemented. If for any reason the
22 assessment imposed by subsection (a) or (b-5) of Section 5A-2
23 is reduced, the amount of $505,637,082 shall be reduced by the
24 same percentage.
25 To provide for the expeditious and timely implementation
26 of the changes made to this subsection by this amendatory Act
HB2771 Enrolled - 38 - LRB104 08638 BDA 18691 b
1 of the 104th General Assembly, the Department may adopt
2 emergency rules as authorized by Section 5-45 of the Illinois
3 Administrative Procedure Act. The adoption of emergency rules
4 is deemed to be necessary for the public interest, safety, and
5 welfare.
6 (8) For making refunds to hospital providers pursuant
7 to Section 5A-10.
8 (9) For making payment to capitated managed care
9 organizations as described in subsections (s) and (t) of
10 Section 5A-12.2, subsection (r) of Section 5A-12.6, and
11 Section 5A-12.7 of this Code.
12 Disbursements from the Fund, other than transfers
13 authorized under paragraphs (5) and (6) of this subsection,
14 shall be by warrants drawn by the State Comptroller upon
15 receipt of vouchers duly executed and certified by the
16 Illinois Department.
17 (c) The Fund shall consist of the following:
18 (1) All moneys collected or received by the Illinois
19 Department from the hospital provider assessment imposed
20 by this Article.
21 (2) All federal matching funds received by the
22 Illinois Department as a result of expenditures made by
23 the Illinois Department that are attributable to moneys
24 deposited in the Fund.
25 (3) Any interest or penalty levied in conjunction with
26 the administration of this Article.
HB2771 Enrolled - 39 - LRB104 08638 BDA 18691 b
1 (3.5) As applicable, proceeds from surety bond
2 payments payable to the Department as referenced in
3 subsection (s) of Section 5A-12.2 of this Code.
4 (4) Moneys transferred from another fund in the State
5 treasury.
6 (5) All other moneys received for the Fund from any
7 other source, including interest earned thereon.
8 (d) (Blank).
9 (Source: P.A. 101-650, eff. 7-7-20; 102-886, eff. 5-17-22.)
10 (305 ILCS 5/5A-10) (from Ch. 23, par. 5A-10)
11 Sec. 5A-10. Applicability.
12 (a) The assessment imposed by subsection (a) of Section
13 5A-2 shall cease to be imposed and the Department's obligation
14 to make payments shall immediately cease, and any moneys
15 remaining in the Fund shall be refunded to hospital providers
16 in proportion to the amounts paid by them, if:
17 (1) The payments to hospitals required under this
18 Article are not eligible for federal matching funds under
19 Title XIX or XXI of the Social Security Act;
20 (2) For State fiscal years 2009 through 2018, and as
21 provided in Section 5A-16, the Department of Healthcare
22 and Family Services adopts any administrative rule change
23 to reduce payment rates or alters any payment methodology
24 that reduces any payment rates made to operating hospitals
25 under the approved Title XIX or Title XXI State plan in
HB2771 Enrolled - 40 - LRB104 08638 BDA 18691 b
1 effect January 1, 2008 except for:
2 (A) any changes for hospitals described in
3 subsection (b) of Section 5A-3;
4 (B) any rates for payments made under this Article
5 V-A;
6 (C) any changes proposed in State plan amendment
7 transmittal numbers 08-01, 08-02, 08-04, 08-06, and
8 08-07;
9 (D) in relation to any admissions on or after
10 January 1, 2011, a modification in the methodology for
11 calculating outlier payments to hospitals for
12 exceptionally costly stays, for hospitals reimbursed
13 under the diagnosis-related grouping methodology in
14 effect on July 1, 2011; provided that the Department
15 shall be limited to one such modification during the
16 36-month period after the effective date of this
17 amendatory Act of the 96th General Assembly;
18 (E) any changes affecting hospitals authorized by
19 Public Act 97-689;
20 (F) any changes authorized by Section 14-12 of
21 this Code, or for any changes authorized under Section
22 5A-15 of this Code; or
23 (G) any changes authorized under Section 5-5b.1.
24 (b) The assessment imposed by Section 5A-2 shall not take
25 effect or shall cease to be imposed, and the Department's
26 obligation to make payments shall immediately cease, if the
HB2771 Enrolled - 41 - LRB104 08638 BDA 18691 b
1 assessment is determined to be an impermissible tax under
2 Title XIX of the Social Security Act. Moneys in the Hospital
3 Provider Fund derived from assessments imposed prior thereto
4 shall be disbursed in accordance with Section 5A-8 to the
5 extent federal financial participation is not reduced due to
6 the impermissibility of the assessments, and any remaining
7 moneys shall be refunded to hospital providers in proportion
8 to the amounts paid by them.
9 (c) The assessments imposed by subsection (b-5) of Section
10 5A-2 shall not take effect or shall cease to be imposed, the
11 Department's obligation to make payments shall immediately
12 cease, and any moneys remaining in the Fund shall be refunded
13 to hospital providers in proportion to the amounts paid by
14 them, if the payments to hospitals required under Section
15 5A-12.4 or Section 5A-12.6 are not eligible for federal
16 matching funds under Title XIX of the Social Security Act.
17 (d) The assessments imposed by Section 5A-2 shall not take
18 effect or shall cease to be imposed, the Department's
19 obligation to make payments shall immediately cease, and any
20 moneys remaining in the Fund shall be refunded to hospital
21 providers in proportion to the amounts paid by them, if:
22 (1) for State fiscal years 2013 through 2018, and as
23 provided in Section 5A-16, the Department reduces any
24 payment rates to hospitals as in effect on May 1, 2012, or
25 alters any payment methodology as in effect on May 1,
26 2012, that has the effect of reducing payment rates to
HB2771 Enrolled - 42 - LRB104 08638 BDA 18691 b
1 hospitals, except for any changes affecting hospitals
2 authorized in Public Act 97-689 and any changes authorized
3 by Section 14-12 of this Code, and except for any changes
4 authorized under Section 5A-15, and except for any changes
5 authorized under Section 5-5b.1;
6 (2) for State fiscal years 2013 through 2018, and as
7 provided in Section 5A-16, the Department reduces any
8 supplemental payments made to hospitals below the amounts
9 paid for services provided in State fiscal year 2011 as
10 implemented by administrative rules adopted and in effect
11 on or prior to June 30, 2011, except for any changes
12 affecting hospitals authorized in Public Act 97-689 and
13 any changes authorized by Section 14-12 of this Code, and
14 except for any changes authorized under Section 5A-15, and
15 except for any changes authorized under Section 5-5b.1; or
16 (3) for State fiscal years 2015 through 2018, and as
17 provided in Section 5A-16, the Department reduces the
18 overall effective rate of reimbursement to hospitals below
19 the level authorized under Section 14-12 of this Code,
20 except for any changes under Section 14-12 or Section
21 5A-15 of this Code, and except for any changes authorized
22 under Section 5-5b.1.
23 (e) In State fiscal year 2019 through State fiscal year
24 2020, the assessments imposed under Section 5A-2 shall not
25 take effect or shall cease to be imposed, the Department's
26 obligation to make payments shall immediately cease, and any
HB2771 Enrolled - 43 - LRB104 08638 BDA 18691 b
1 moneys remaining in the Fund shall be refunded to hospital
2 providers in proportion to the amounts paid by them, if:
3 (1) the payments to hospitals required under Section
4 5A-12.6 are not eligible for federal matching funds under
5 Title XIX of the Social Security Act; or
6 (2) the Department reduces the overall effective rate
7 of reimbursement to hospitals below the level authorized
8 under Section 14-12 of this Code, as in effect on December
9 31, 2017, except for any changes authorized under Sections
10 14-12 or Section 5A-15 of this Code, and except for any
11 changes authorized under changes to Sections 5A-12.2,
12 5A-12.4, 5A-12.5, 5A-12.6, and 14-12 made by Public Act
13 100-581.
14 (f) Beginning in State Fiscal Year 2021 through December
15 31, 2024, the assessments imposed under Section 5A-2 shall not
16 take effect or shall cease to be imposed, the Department's
17 obligation to make payments shall immediately cease, and any
18 moneys remaining in the Fund shall be refunded to hospital
19 providers in proportion to the amounts paid by them, if:
20 (1) the payments to hospitals required under Section
21 5A-12.7 are not eligible for federal matching funds under
22 Title XIX of the Social Security Act; or
23 (2) the Department reduces the overall effective rate
24 of reimbursement to hospitals below the level authorized
25 under Section 14-12, as in effect on December 31, 2021,
26 except for any changes authorized under Sections 14-12 or
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1 5A-15, and except for any changes authorized under changes
2 to Sections 5A-12.7 and 14-12 made by this amendatory Act
3 of the 101st General Assembly, and except for any changes
4 to Section 5A-12.7 made by this amendatory Act of the
5 102nd General Assembly.
6 (g) Beginning January 1, 2025, the assessments imposed
7 under Section 5A-2 shall not take effect or shall cease to be
8 imposed, if:
9 (1) the payments to hospitals required under Section
10 5A-12.7 are not eligible for federal matching funds under
11 Title XIX of the Social Security Act; or
12 (2) the Department reduces the rates of reimbursement
13 below the rates in effect December 31, 2024, resulting in
14 an aggregate reduction below the levels of reimbursement
15 for the 12-month period ending 6 months prior to the
16 effective date of the proposed new rates.
17 (h) To provide for the expeditious and timely
18 implementation of the changes made to this Section by this
19 amendatory Act of the 104th General Assembly, the Department
20 may adopt emergency rules as authorized by Section 5-45 of the
21 Illinois Administrative Procedure Act. The adoption of
22 emergency rules is deemed to be necessary for the public
23 interest, safety, and welfare.
24 (Source: P.A. 101-650, eff. 7-7-20; 102-886, eff. 5-17-22.)
25 (305 ILCS 5/5A-12.7)
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1 (Section scheduled to be repealed on December 31, 2026)
2 Sec. 5A-12.7. Continuation of hospital access payments on
3 and after July 1, 2020.
4 (a) To preserve and improve access to hospital services,
5 for hospital services rendered on and after July 1, 2020, the
6 Department shall, except for hospitals described in subsection
7 (b) of Section 5A-3, make payments to hospitals or require
8 capitated managed care organizations to make payments as set
9 forth in this Section. Payments under this Section are not due
10 and payable, however, until: (i) the methodologies described
11 in this Section are approved by the federal government in an
12 appropriate State Plan amendment or directed payment preprint;
13 and (ii) the assessment imposed under this Article is
14 determined to be a permissible tax under Title XIX of the
15 Social Security Act. In determining the hospital access
16 payments authorized under subsection (g) of this Section, if a
17 hospital ceases to qualify for payments from the pool, the
18 payments for all hospitals continuing to qualify for payments
19 from such pool shall be uniformly adjusted to fully expend the
20 aggregate net amount of the pool, with such adjustment being
21 effective on the first day of the second month following the
22 date the hospital ceases to receive payments from such pool.
23 (b) Amounts moved into claims-based rates and distributed
24 in accordance with Section 14-12 shall remain in those
25 claims-based rates.
26 (c) Graduate medical education.
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1 (1) The calculation of graduate medical education
2 payments shall be based on the hospital's Medicare cost
3 report ending in Calendar Year 2018, as reported in the
4 Healthcare Cost Report Information System file, release
5 date September 30, 2019. An Illinois hospital reporting
6 intern and resident cost on its Medicare cost report shall
7 be eligible for graduate medical education payments.
8 (2) Each hospital's annualized Medicaid Intern
9 Resident Cost is calculated using annualized intern and
10 resident total costs obtained from Worksheet B Part I,
11 Columns 21 and 22 the sum of Lines 30-43, 50-76, 90-93,
12 96-98, and 105-112 multiplied by the percentage that the
13 hospital's Medicaid days (Worksheet S3 Part I, Column 7,
14 Lines 2, 3, 4, 14, 16-18, and 32) comprise of the
15 hospital's total days (Worksheet S3 Part I, Column 8,
16 Lines 14, 16-18, and 32).
17 (3) An annualized Medicaid indirect medical education
18 (IME) payment is calculated for each hospital using its
19 IME payments (Worksheet E Part A, Line 29, Column 1)
20 multiplied by the percentage that its Medicaid days
21 (Worksheet S3 Part I, Column 7, Lines 2, 3, 4, 14, 16-18,
22 and 32) comprise of its Medicare days (Worksheet S3 Part
23 I, Column 6, Lines 2, 3, 4, 14, and 16-18).
24 (4) For each hospital, its annualized Medicaid Intern
25 Resident Cost and its annualized Medicaid IME payment are
26 summed, and, except as capped at 120% of the average cost
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1 per intern and resident for all qualifying hospitals as
2 calculated under this paragraph, is multiplied by the
3 applicable reimbursement factor as described in this
4 paragraph, to determine the hospital's final graduate
5 medical education payment. Each hospital's average cost
6 per intern and resident shall be calculated by summing its
7 total annualized Medicaid Intern Resident Cost plus its
8 annualized Medicaid IME payment and dividing that amount
9 by the hospital's total Full Time Equivalent Residents and
10 Interns. If the hospital's average per intern and resident
11 cost is greater than 120% of the same calculation for all
12 qualifying hospitals, the hospital's per intern and
13 resident cost shall be capped at 120% of the average cost
14 for all qualifying hospitals.
15 (A) For the period of July 1, 2020 through
16 December 31, 2022, the applicable reimbursement factor
17 shall be 22.6%.
18 (B) Beginning For the period of January 1, 2023
19 through December 31, 2026, the applicable
20 reimbursement factor shall be 35% for all qualified
21 safety-net hospitals, as defined in Section 5-5e.1 of
22 this Code, and all hospitals with 100 or more Full Time
23 Equivalent Residents and Interns, as reported on the
24 hospital's Medicare cost report ending in Calendar
25 Year 2018, and for all other qualified hospitals the
26 applicable reimbursement factor shall be 30%.
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1 (d) Fee-for-service supplemental payments. For the period
2 of July 1, 2020 through December 31, 2022, each Illinois
3 hospital shall receive an annual payment equal to the amounts
4 below, to be paid in 12 equal installments on or before the
5 seventh State business day of each month, except that no
6 payment shall be due within 30 days after the later of the date
7 of notification of federal approval of the payment
8 methodologies required under this Section or any waiver
9 required under 42 CFR 433.68, at which time the sum of amounts
10 required under this Section prior to the date of notification
11 is due and payable.
12 (1) For critical access hospitals, $385 per covered
13 inpatient day contained in paid fee-for-service claims and
14 $530 per paid fee-for-service outpatient claim for dates
15 of service in Calendar Year 2019 in the Department's
16 Enterprise Data Warehouse as of May 11, 2020.
17 (2) For safety-net hospitals, $960 per covered
18 inpatient day contained in paid fee-for-service claims and
19 $625 per paid fee-for-service outpatient claim for dates
20 of service in Calendar Year 2019 in the Department's
21 Enterprise Data Warehouse as of May 11, 2020.
22 (3) For long term acute care hospitals, $295 per
23 covered inpatient day contained in paid fee-for-service
24 claims for dates of service in Calendar Year 2019 in the
25 Department's Enterprise Data Warehouse as of May 11, 2020.
26 (4) For freestanding psychiatric hospitals, $125 per
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1 covered inpatient day contained in paid fee-for-service
2 claims and $130 per paid fee-for-service outpatient claim
3 for dates of service in Calendar Year 2019 in the
4 Department's Enterprise Data Warehouse as of May 11, 2020.
5 (5) For freestanding rehabilitation hospitals, $355
6 per covered inpatient day contained in paid
7 fee-for-service claims for dates of service in Calendar
8 Year 2019 in the Department's Enterprise Data Warehouse as
9 of May 11, 2020.
10 (6) For all general acute care hospitals and high
11 Medicaid hospitals as defined in subsection (f), $350 per
12 covered inpatient day for dates of service in Calendar
13 Year 2019 contained in paid fee-for-service claims and
14 $620 per paid fee-for-service outpatient claim in the
15 Department's Enterprise Data Warehouse as of May 11, 2020.
16 (7) Alzheimer's treatment access payment. Each
17 Illinois academic medical center or teaching hospital, as
18 defined in Section 5-5e.2 of this Code, that is identified
19 as the primary hospital affiliate of one of the Regional
20 Alzheimer's Disease Assistance Centers, as designated by
21 the Alzheimer's Disease Assistance Act and identified in
22 the Department of Public Health's Alzheimer's Disease
23 State Plan dated December 2016, shall be paid an
24 Alzheimer's treatment access payment equal to the product
25 of the qualifying hospital's State Fiscal Year 2018 total
26 inpatient fee-for-service days multiplied by the
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1 applicable Alzheimer's treatment rate of $226.30 for
2 hospitals located in Cook County and $116.21 for hospitals
3 located outside Cook County.
4 (d-2) Fee-for-service supplemental payments. Beginning
5 January 1, 2023, each Illinois hospital shall receive an
6 annual payment equal to the amounts listed below, to be paid in
7 12 equal installments on or before the seventh State business
8 day of each month, except that no payment shall be due within
9 30 days after the later of the date of notification of federal
10 approval of the payment methodologies required under this
11 Section or any waiver required under 42 CFR 433.68, at which
12 time the sum of amounts required under this Section prior to
13 the date of notification is due and payable. The Department
14 may adjust the rates in paragraphs (1) through (7) to comply
15 with the federal upper payment limits, with such adjustments
16 being determined so that the total estimated spending by
17 hospital class, under such adjusted rates, remains
18 substantially similar to the total estimated spending under
19 the original rates set forth in this subsection.
20 (1) For critical access hospitals, as defined in
21 subsection (f), $750 per covered inpatient day contained
22 in paid fee-for-service claims and $750 per paid
23 fee-for-service outpatient claim for dates of service in
24 Calendar Year 2019 in the Department's Enterprise Data
25 Warehouse as of August 6, 2021.
26 (2) For safety-net hospitals, as described in
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1 subsection (f), $1,350 per inpatient day contained in paid
2 fee-for-service claims and $1,350 per paid fee-for-service
3 outpatient claim for dates of service in Calendar Year
4 2019 in the Department's Enterprise Data Warehouse as of
5 August 6, 2021.
6 (3) For long term acute care hospitals, $550 per
7 covered inpatient day contained in paid fee-for-service
8 claims for dates of service in Calendar Year 2019 in the
9 Department's Enterprise Data Warehouse as of August 6,
10 2021.
11 (4) For freestanding psychiatric hospitals, $200 per
12 covered inpatient day contained in paid fee-for-service
13 claims and $200 per paid fee-for-service outpatient claim
14 for dates of service in Calendar Year 2019 in the
15 Department's Enterprise Data Warehouse as of August 6,
16 2021.
17 (5) For freestanding rehabilitation hospitals, $550
18 per covered inpatient day contained in paid
19 fee-for-service claims and $125 per paid fee-for-service
20 outpatient claim for dates of service in Calendar Year
21 2019 in the Department's Enterprise Data Warehouse as of
22 August 6, 2021.
23 (6) For all general acute care hospitals and high
24 Medicaid hospitals as defined in subsection (f), $500 per
25 covered inpatient day for dates of service in Calendar
26 Year 2019 contained in paid fee-for-service claims and
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1 $500 per paid fee-for-service outpatient claim in the
2 Department's Enterprise Data Warehouse as of August 6,
3 2021.
4 (7) For public hospitals, as defined in subsection
5 (f), $275 per covered inpatient day contained in paid
6 fee-for-service claims and $275 per paid fee-for-service
7 outpatient claim for dates of service in Calendar Year
8 2019 in the Department's Enterprise Data Warehouse as of
9 August 6, 2021.
10 (8) Alzheimer's treatment access payment. Each
11 Illinois academic medical center or teaching hospital, as
12 defined in Section 5-5e.2 of this Code, that is identified
13 as the primary hospital affiliate of one of the Regional
14 Alzheimer's Disease Assistance Centers, as designated by
15 the Alzheimer's Disease Assistance Act and identified in
16 the Department of Public Health's Alzheimer's Disease
17 State Plan dated December 2016, shall be paid an
18 Alzheimer's treatment access payment equal to the product
19 of the qualifying hospital's Calendar Year 2019 total
20 inpatient fee-for-service days, in the Department's
21 Enterprise Data Warehouse as of August 6, 2021, multiplied
22 by the applicable Alzheimer's treatment rate of $244.37
23 for hospitals located in Cook County and $312.03 for
24 hospitals located outside Cook County.
25 (e) The Department shall require managed care
26 organizations (MCOs) to make directed payments and
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1 pass-through payments according to this Section. Each calendar
2 year, the Department shall require MCOs to pay the maximum
3 amount out of these funds as allowed as pass-through payments
4 under federal regulations. The Department shall require MCOs
5 to make such pass-through payments as specified in this
6 Section. The Department shall require the MCOs to pay the
7 remaining amounts as directed Payments as specified in this
8 Section. The Department shall issue payments to the
9 Comptroller by the seventh business day of each month for all
10 MCOs that are sufficient for MCOs to make the directed
11 payments and pass-through payments according to this Section.
12 The Department shall require the MCOs to make pass-through
13 payments and directed payments using electronic funds
14 transfers (EFT), if the hospital provides the information
15 necessary to process such EFTs, in accordance with directions
16 provided monthly by the Department, within 7 business days of
17 the date the funds are paid to the MCOs, as indicated by the
18 "Paid Date" on the website of the Office of the Comptroller if
19 the funds are paid by EFT and the MCOs have received directed
20 payment instructions. If funds are not paid through the
21 Comptroller by EFT, payment must be made within 7 business
22 days of the date actually received by the MCO. The MCO will be
23 considered to have paid the pass-through payments when the
24 payment remittance number is generated or the date the MCO
25 sends the check to the hospital, if EFT information is not
26 supplied. If an MCO is late in paying a pass-through payment or
HB2771 Enrolled - 54 - LRB104 08638 BDA 18691 b
1 directed payment as required under this Section (including any
2 extensions granted by the Department), it shall pay a penalty,
3 unless waived by the Department for reasonable cause, to the
4 Department equal to 5% of the amount of the pass-through
5 payment or directed payment not paid on or before the due date
6 plus 5% of the portion thereof remaining unpaid on the last day
7 of each 30-day period thereafter. Payments to MCOs that would
8 be paid consistent with actuarial certification and enrollment
9 in the absence of the increased capitation payments under this
10 Section shall not be reduced as a consequence of payments made
11 under this subsection. The Department shall publish and
12 maintain on its website for a period of no less than 8 calendar
13 quarters, the quarterly calculation of directed payments and
14 pass-through payments owed to each hospital from each MCO. All
15 calculations and reports shall be posted no later than the
16 first day of the quarter for which the payments are to be
17 issued.
18 (f)(1) For purposes of allocating the funds included in
19 capitation payments to MCOs, Illinois hospitals shall be
20 divided into the following classes as defined in
21 administrative rules:
22 (A) Beginning July 1, 2020 through December 31, 2022,
23 critical access hospitals. Beginning January 1, 2023,
24 "critical access hospital" means a hospital designated by
25 the Department of Public Health as a critical access
26 hospital, excluding any hospital meeting the definition of
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1 a public hospital in subparagraph (F).
2 (B) Safety-net hospitals, except that stand-alone
3 children's hospitals that are not specialty children's
4 hospitals, safety-net hospitals that elect not to be
5 included as provided in item (i), and, for calendar years
6 2025 and 2026 only, hospitals with over 9,000 Medicaid
7 acute care inpatient admissions per calendar year,
8 excluding admissions for Medicare-Medicaid dual eligible
9 patients, will not be included. For the calendar year
10 beginning January 1, 2023, and each calendar year
11 thereafter, assignment to the safety-net class shall be
12 based on the annual safety-net rate year beginning 15
13 months before the beginning of the first Payout Quarter of
14 the calendar year.
15 (i) Beginning calendar year 2026, all hospitals
16 qualifying as a safety-net hospital under subsection
17 (a) of Section 5-5e.1 for rates years beginning on and
18 after October 1, 2024 shall be permitted to elect to
19 remain in the high Medicaid hospital class as defined
20 in subparagraph (G) for purposes of the State directed
21 payments described in subsection (r) instead of being
22 assigned to the safety-net fixed pool directed
23 payments class as described in subsection (g).
24 (ii) If a hospital elects assignment in the high
25 Medicaid hospital class as defined in subparagraph
26 (G), the hospital must remain in the high Medicaid
HB2771 Enrolled - 56 - LRB104 08638 BDA 18691 b
1 hospital class for the entire calendar year.
2 (C) Long term acute care hospitals.
3 (D) Freestanding psychiatric hospitals.
4 (E) Freestanding rehabilitation hospitals.
5 (F) Beginning January 1, 2023, "public hospital" means
6 a hospital that is owned or operated by an Illinois
7 Government body or municipality, excluding a hospital
8 provider that is a State agency, a State university, or a
9 county with a population of 3,000,000 or more.
10 (G) High Medicaid hospitals.
11 (i) As used in this Section, "high Medicaid
12 hospital" means a general acute care hospital that:
13 (I) For the payout periods July 1, 2020
14 through December 31, 2022, is not a safety-net
15 hospital or critical access hospital and that has
16 a Medicaid Inpatient Utilization Rate above 30% or
17 a hospital that had over 35,000 inpatient Medicaid
18 days during the applicable period. For the period
19 July 1, 2020 through December 31, 2020, the
20 applicable period for the Medicaid Inpatient
21 Utilization Rate (MIUR) is the rate year 2020 MIUR
22 and for the number of inpatient days it is State
23 fiscal year 2018. Beginning in calendar year 2021,
24 the Department shall use the most recently
25 determined MIUR, as defined in subsection (h) of
26 Section 5-5.02, and for the inpatient day
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1 threshold, the State fiscal year ending 18 months
2 prior to the beginning of the calendar year. For
3 purposes of calculating MIUR under this Section,
4 children's hospitals and affiliated general acute
5 care hospitals shall be considered a single
6 hospital.
7 (II) For the calendar year beginning January
8 1, 2023, and each calendar year thereafter, is not
9 a public hospital, safety-net hospital, or
10 critical access hospital and that qualifies as a
11 regional high volume hospital or is a hospital
12 that has a Medicaid Inpatient Utilization Rate
13 (MIUR) above 30%. As used in this item, "regional
14 high volume hospital" means a hospital which ranks
15 in the top 2 quartiles based on total hospital
16 services volume, of all eligible general acute
17 care hospitals, when ranked in descending order
18 based on total hospital services volume, within
19 the same Medicaid managed care region, as
20 designated by the Department, as of January 1,
21 2022. As used in this item, "total hospital
22 services volume" means the total of all Medical
23 Assistance hospital inpatient admissions plus all
24 Medical Assistance hospital outpatient visits. For
25 purposes of determining regional high volume
26 hospital inpatient admissions and outpatient
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1 visits, the Department shall use dates of service
2 provided during State Fiscal Year 2020 for the
3 Payout Quarter beginning January 1, 2023. The
4 Department shall use dates of service from the
5 State fiscal year ending 18 month before the
6 beginning of the first Payout Quarter of the
7 subsequent annual determination period.
8 (ii) For the calendar year beginning January 1,
9 2023, the Department shall use the Rate Year 2022
10 Medicaid inpatient utilization rate (MIUR), as defined
11 in subsection (h) of Section 5-5.02. For each
12 subsequent annual determination, the Department shall
13 use the MIUR applicable to the rate year ending
14 September 30 of the year preceding the beginning of
15 the calendar year.
16 (H) General acute care hospitals. As used under this
17 Section, "general acute care hospitals" means all other
18 Illinois hospitals not identified in subparagraphs (A)
19 through (G).
20 (2) Hospitals' qualification for each class shall be
21 assessed prior to the beginning of each calendar year and the
22 new class designation shall be effective January 1 of the next
23 year. The Department shall publish by rule the process for
24 establishing class determination.
25 (3) Beginning January 1, 2024, the Department may reassign
26 hospitals or entire hospital classes as defined above, if
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1 federal limits on the payments to the class to which the
2 hospitals are assigned based on the criteria in this
3 subsection prevent the Department from making payments to the
4 class that would otherwise be due under this Section. The
5 Department shall publish the criteria and composition of each
6 new class based on the reassignments, and the projected impact
7 on payments to each hospital under the new classes on its
8 website by November 15 of the year before the year in which the
9 class changes become effective.
10 (g) Fixed pool directed payments. Beginning July 1, 2020,
11 the Department shall issue payments to MCOs which shall be
12 used to issue directed payments to qualified Illinois
13 safety-net hospitals and critical access hospitals on a
14 monthly basis in accordance with this subsection. Prior to the
15 beginning of each Payout Quarter beginning July 1, 2020, the
16 Department shall use encounter claims data from the
17 Determination Quarter, accepted by the Department's Medicaid
18 Management Information System for inpatient and outpatient
19 services rendered by safety-net hospitals and critical access
20 hospitals to determine a quarterly uniform per unit add-on for
21 each hospital class.
22 (1) Inpatient per unit add-on. A quarterly uniform per
23 diem add-on shall be derived by dividing the quarterly
24 Inpatient Directed Payments Pool amount allocated to the
25 applicable hospital class by the total inpatient days
26 contained on all encounter claims received during the
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1 Determination Quarter, for all hospitals in the class.
2 (A) Each hospital in the class shall have a
3 quarterly inpatient directed payment calculated that
4 is equal to the product of the number of inpatient days
5 attributable to the hospital used in the calculation
6 of the quarterly uniform class per diem add-on,
7 multiplied by the calculated applicable quarterly
8 uniform class per diem add-on of the hospital class.
9 (B) Each hospital shall be paid 1/3 of its
10 quarterly inpatient directed payment in each of the 3
11 months of the Payout Quarter, in accordance with
12 directions provided to each MCO by the Department.
13 (2) Outpatient per unit add-on. A quarterly uniform
14 per claim add-on shall be derived by dividing the
15 quarterly Outpatient Directed Payments Pool amount
16 allocated to the applicable hospital class by the total
17 outpatient encounter claims received during the
18 Determination Quarter, for all hospitals in the class.
19 (A) Each hospital in the class shall have a
20 quarterly outpatient directed payment calculated that
21 is equal to the product of the number of outpatient
22 encounter claims attributable to the hospital used in
23 the calculation of the quarterly uniform class per
24 claim add-on, multiplied by the calculated applicable
25 quarterly uniform class per claim add-on of the
26 hospital class.
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1 (B) Each hospital shall be paid 1/3 of its
2 quarterly outpatient directed payment in each of the 3
3 months of the Payout Quarter, in accordance with
4 directions provided to each MCO by the Department.
5 (3) Each MCO shall pay each hospital the Monthly
6 Directed Payment as identified by the Department on its
7 quarterly determination report.
8 (4) Definitions. As used in this subsection:
9 (A) "Payout Quarter" means each 3 month calendar
10 quarter, beginning July 1, 2020.
11 (B) "Determination Quarter" means each 3 month
12 calendar quarter, which ends 3 months prior to the
13 first day of each Payout Quarter.
14 (5) For the period July 1, 2020 through December 2020,
15 the following amounts shall be allocated to the following
16 hospital class directed payment pools for the quarterly
17 development of a uniform per unit add-on:
18 (A) $2,894,500 for hospital inpatient services for
19 critical access hospitals.
20 (B) $4,294,374 for hospital outpatient services
21 for critical access hospitals.
22 (C) $29,109,330 for hospital inpatient services
23 for safety-net hospitals.
24 (D) $35,041,218 for hospital outpatient services
25 for safety-net hospitals.
26 (6) For the period January 1, 2023 through December
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1 31, 2023, the Department shall establish the amounts that
2 shall be allocated to the hospital class directed payment
3 fixed pools identified in this paragraph for the quarterly
4 development of a uniform per unit add-on. The Department
5 shall establish such amounts so that the total amount of
6 payments to each hospital under this Section in calendar
7 year 2023 is projected to be substantially similar to the
8 total amount of such payments received by the hospital
9 under this Section in calendar year 2021, adjusted for
10 increased funding provided for fixed pool directed
11 payments under subsection (g) in calendar year 2022,
12 assuming that the volume and acuity of claims are held
13 constant. The Department shall publish the directed
14 payment fixed pool amounts to be established under this
15 paragraph on its website by November 15, 2022.
16 (A) Hospital inpatient services for critical
17 access hospitals.
18 (B) Hospital outpatient services for critical
19 access hospitals.
20 (C) Hospital inpatient services for public
21 hospitals.
22 (D) Hospital outpatient services for public
23 hospitals.
24 (E) Hospital inpatient services for safety-net
25 hospitals.
26 (F) Hospital outpatient services for safety-net
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1 hospitals.
2 (7) Semi-annual rate maintenance review. The
3 Department shall ensure that hospitals assigned to the
4 fixed pools in paragraph (6) are paid no less than 95% of
5 the annual initial rate for each 6-month period of each
6 annual payout period. For each calendar year, the
7 Department shall calculate the annual initial rate per day
8 and per visit for each fixed pool hospital class listed in
9 paragraph (6), by dividing the total of all applicable
10 inpatient or outpatient directed payments issued in the
11 preceding calendar year to the hospitals in each fixed
12 pool class for the calendar year, plus any increase
13 resulting from the annual adjustments described in
14 subsection (i), by the actual applicable total service
15 units for the preceding calendar year which were the basis
16 of the total applicable inpatient or outpatient directed
17 payments issued to the hospitals in each fixed pool class
18 in the calendar year, except that for calendar year 2023,
19 the service units from calendar year 2021 shall be used.
20 (A) The Department shall calculate the effective
21 rate, per day and per visit, for the payout periods of
22 January to June and July to December of each year, for
23 each fixed pool listed in paragraph (6), by dividing
24 50% of the annual pool by the total applicable
25 reported service units for the 2 applicable
26 determination quarters.
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1 (B) If the effective rate calculated in
2 subparagraph (A) is less than 95% of the annual
3 initial rate assigned to the class for each pool under
4 paragraph (6), the Department shall adjust the payment
5 for each hospital to a level equal to no less than 95%
6 of the annual initial rate, by issuing a retroactive
7 adjustment payment for the 6-month period under review
8 as identified in subparagraph (A).
9 (h) Fixed rate directed payments. Effective July 1, 2020,
10 the Department shall issue payments to MCOs which shall be
11 used to issue directed payments to Illinois hospitals not
12 identified in paragraph (g) on a monthly basis. Prior to the
13 beginning of each Payout Quarter beginning July 1, 2020, the
14 Department shall use encounter claims data from the
15 Determination Quarter, accepted by the Department's Medicaid
16 Management Information System for inpatient and outpatient
17 services rendered by hospitals in each hospital class
18 identified in paragraph (f) and not identified in paragraph
19 (g). For the period July 1, 2020 through December 2020, the
20 Department shall direct MCOs to make payments as follows:
21 (1) For general acute care hospitals an amount equal
22 to $1,750 multiplied by the hospital's category of service
23 20 case mix index for the determination quarter multiplied
24 by the hospital's total number of inpatient admissions for
25 category of service 20 for the determination quarter.
26 (2) For general acute care hospitals an amount equal
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1 to $160 multiplied by the hospital's category of service
2 21 case mix index for the determination quarter multiplied
3 by the hospital's total number of inpatient admissions for
4 category of service 21 for the determination quarter.
5 (3) For general acute care hospitals an amount equal
6 to $80 multiplied by the hospital's category of service 22
7 case mix index for the determination quarter multiplied by
8 the hospital's total number of inpatient admissions for
9 category of service 22 for the determination quarter.
10 (4) For general acute care hospitals an amount equal
11 to $375 multiplied by the hospital's category of service
12 24 case mix index for the determination quarter multiplied
13 by the hospital's total number of category of service 24
14 paid EAPG (EAPGs) for the determination quarter.
15 (5) For general acute care hospitals an amount equal
16 to $240 multiplied by the hospital's category of service
17 27 and 28 case mix index for the determination quarter
18 multiplied by the hospital's total number of category of
19 service 27 and 28 paid EAPGs for the determination
20 quarter.
21 (6) For general acute care hospitals an amount equal
22 to $290 multiplied by the hospital's category of service
23 29 case mix index for the determination quarter multiplied
24 by the hospital's total number of category of service 29
25 paid EAPGs for the determination quarter.
26 (7) For high Medicaid hospitals an amount equal to
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1 $1,800 multiplied by the hospital's category of service 20
2 case mix index for the determination quarter multiplied by
3 the hospital's total number of inpatient admissions for
4 category of service 20 for the determination quarter.
5 (8) For high Medicaid hospitals an amount equal to
6 $160 multiplied by the hospital's category of service 21
7 case mix index for the determination quarter multiplied by
8 the hospital's total number of inpatient admissions for
9 category of service 21 for the determination quarter.
10 (9) For high Medicaid hospitals an amount equal to $80
11 multiplied by the hospital's category of service 22 case
12 mix index for the determination quarter multiplied by the
13 hospital's total number of inpatient admissions for
14 category of service 22 for the determination quarter.
15 (10) For high Medicaid hospitals an amount equal to
16 $400 multiplied by the hospital's category of service 24
17 case mix index for the determination quarter multiplied by
18 the hospital's total number of category of service 24 paid
19 EAPG outpatient claims for the determination quarter.
20 (11) For high Medicaid hospitals an amount equal to
21 $240 multiplied by the hospital's category of service 27
22 and 28 case mix index for the determination quarter
23 multiplied by the hospital's total number of category of
24 service 27 and 28 paid EAPGs for the determination
25 quarter.
26 (12) For high Medicaid hospitals an amount equal to
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1 $290 multiplied by the hospital's category of service 29
2 case mix index for the determination quarter multiplied by
3 the hospital's total number of category of service 29 paid
4 EAPGs for the determination quarter.
5 (13) For long term acute care hospitals the amount of
6 $495 multiplied by the hospital's total number of
7 inpatient days for the determination quarter.
8 (14) For psychiatric hospitals the amount of $210
9 multiplied by the hospital's total number of inpatient
10 days for category of service 21 for the determination
11 quarter.
12 (15) For psychiatric hospitals the amount of $250
13 multiplied by the hospital's total number of outpatient
14 claims for category of service 27 and 28 for the
15 determination quarter.
16 (16) For rehabilitation hospitals the amount of $410
17 multiplied by the hospital's total number of inpatient
18 days for category of service 22 for the determination
19 quarter.
20 (17) For rehabilitation hospitals the amount of $100
21 multiplied by the hospital's total number of outpatient
22 claims for category of service 29 for the determination
23 quarter.
24 (18) Effective for the Payout Quarter beginning
25 January 1, 2023, for the directed payments to hospitals
26 required under this subsection, the Department shall
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1 establish the amounts that shall be used to calculate such
2 directed payments using the methodologies specified in
3 this paragraph. The Department shall use a single, uniform
4 rate, adjusted for acuity as specified in paragraphs (1)
5 through (12), for all categories of inpatient services
6 provided by each class of hospitals and a single uniform
7 rate, adjusted for acuity as specified in paragraphs (1)
8 through (12), for all categories of outpatient services
9 provided by each class of hospitals. The Department shall
10 establish such amounts so that the total amount of
11 payments to each hospital under this Section in calendar
12 year 2023 is projected to be substantially similar to the
13 total amount of such payments received by the hospital
14 under this Section in calendar year 2021, adjusted for
15 increased funding provided for fixed pool directed
16 payments under subsection (g) in calendar year 2022,
17 assuming that the volume and acuity of claims are held
18 constant. The Department shall publish the directed
19 payment amounts to be established under this subsection on
20 its website by November 15, 2022.
21 (19) Each hospital shall be paid 1/3 of their
22 quarterly inpatient and outpatient directed payment in
23 each of the 3 months of the Payout Quarter, in accordance
24 with directions provided to each MCO by the Department.
25 (20) Each MCO shall pay each hospital the Monthly
26 Directed Payment amount as identified by the Department on
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1 its quarterly determination report.
2 Notwithstanding any other provision of this subsection, if
3 the Department determines that the actual total hospital
4 utilization data that is used to calculate the fixed rate
5 directed payments is substantially different than anticipated
6 when the rates in this subsection were initially determined
7 for unforeseeable circumstances (such as the COVID-19 pandemic
8 or some other public health emergency), the Department may
9 adjust the rates specified in this subsection so that the
10 total directed payments approximate the total spending amount
11 anticipated when the rates were initially established.
12 Definitions. As used in this subsection:
13 (A) "Payout Quarter" means each calendar quarter,
14 beginning July 1, 2020.
15 (B) "Determination Quarter" means each calendar
16 quarter which ends 3 months prior to the first day of
17 each Payout Quarter.
18 (C) "Case mix index" means a hospital specific
19 calculation. For inpatient claims the case mix index
20 is calculated each quarter by summing the relative
21 weight of all inpatient Diagnosis-Related Group (DRG)
22 claims for a category of service in the applicable
23 Determination Quarter and dividing the sum by the
24 number of sum total of all inpatient DRG admissions
25 for the category of service for the associated claims.
26 The case mix index for outpatient claims is calculated
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1 each quarter by summing the relative weight of all
2 paid EAPGs in the applicable Determination Quarter and
3 dividing the sum by the sum total of paid EAPGs for the
4 associated claims.
5 (i) Beginning January 1, 2021, the rates for directed
6 payments shall be recalculated in order to spend the
7 additional funds for directed payments that result from
8 reduction in the amount of pass-through payments allowed under
9 federal regulations. The additional funds for directed
10 payments shall be allocated proportionally to each class of
11 hospitals based on that class' proportion of services.
12 (1) Beginning January 1, 2024, the fixed pool directed
13 payment amounts and the associated annual initial rates
14 referenced in paragraph (6) of subsection (f) for each
15 hospital class shall be uniformly increased by a ratio of
16 not less than, the ratio of the total pass-through
17 reduction amount pursuant to paragraph (4) of subsection
18 (j), for the hospitals comprising the hospital fixed pool
19 directed payment class for the next calendar year, to the
20 total inpatient and outpatient directed payments for the
21 hospitals comprising the hospital fixed pool directed
22 payment class paid during the preceding calendar year.
23 (2) Beginning January 1, 2024, the fixed rates for the
24 directed payments referenced in paragraph (18) of
25 subsection (h) for each hospital class shall be uniformly
26 increased by a ratio of not less than, the ratio of the
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1 total pass-through reduction amount pursuant to paragraph
2 (4) of subsection (j), for the hospitals comprising the
3 hospital directed payment class for the next calendar
4 year, to the total inpatient and outpatient directed
5 payments for the hospitals comprising the hospital fixed
6 rate directed payment class paid during the preceding
7 calendar year.
8 (j) Pass-through payments.
9 (1) For the period July 1, 2020 through December 31,
10 2020, the Department shall assign quarterly pass-through
11 payments to each class of hospitals equal to one-fourth of
12 the following annual allocations:
13 (A) $390,487,095 to safety-net hospitals.
14 (B) $62,553,886 to critical access hospitals.
15 (C) $345,021,438 to high Medicaid hospitals.
16 (D) $551,429,071 to general acute care hospitals.
17 (E) $27,283,870 to long term acute care hospitals.
18 (F) $40,825,444 to freestanding psychiatric
19 hospitals.
20 (G) $9,652,108 to freestanding rehabilitation
21 hospitals.
22 (2) For the period of July 1, 2020 through December
23 31, 2020, the pass-through payments shall at a minimum
24 ensure hospitals receive a total amount of monthly
25 payments under this Section as received in calendar year
26 2019 in accordance with this Article and paragraph (1) of
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1 subsection (d-5) of Section 14-12, exclusive of amounts
2 received through payments referenced in subsection (b).
3 (3) For the calendar year beginning January 1, 2023,
4 the Department shall establish the annual pass-through
5 allocation to each class of hospitals and the pass-through
6 payments to each hospital so that the total amount of
7 payments to each hospital under this Section in calendar
8 year 2023 is projected to be substantially similar to the
9 total amount of such payments received by the hospital
10 under this Section in calendar year 2021, adjusted for
11 increased funding provided for fixed pool directed
12 payments under subsection (g) in calendar year 2022,
13 assuming that the volume and acuity of claims are held
14 constant. The Department shall publish the pass-through
15 allocation to each class and the pass-through payments to
16 each hospital to be established under this subsection on
17 its website by November 15, 2022.
18 (4) For the calendar years beginning January 1, 2021
19 and January 1, 2022, each hospital's pass-through payment
20 amount shall be reduced proportionally to the reduction of
21 all pass-through payments required by federal regulations.
22 Beginning January 1, 2024, the Department shall reduce
23 total pass-through payments by the minimum amount
24 necessary to comply with federal regulations. Pass-through
25 payments to safety-net hospitals, as defined in Section
26 5-5e.1 of this Code, shall not be reduced until all
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1 pass-through payments to other hospitals have been
2 eliminated. All other hospitals shall have their
3 pass-through payments reduced proportionally.
4 (k) At least 30 days prior to each calendar year, the
5 Department shall notify each hospital of changes to the
6 payment methodologies in this Section, including, but not
7 limited to, changes in the fixed rate directed payment rates,
8 the aggregate pass-through payment amount for all hospitals,
9 and the hospital's pass-through payment amount for the
10 upcoming calendar year.
11 (l) Notwithstanding any other provisions of this Section,
12 the Department may adopt rules to change the methodology for
13 directed and pass-through payments as set forth in this
14 Section, but only to the extent necessary to obtain federal
15 approval of a necessary State Plan amendment or Directed
16 Payment Preprint or to otherwise conform to federal law or
17 federal regulation.
18 (m) As used in this subsection, "managed care
19 organization" or "MCO" means an entity which contracts with
20 the Department to provide services where payment for medical
21 services is made on a capitated basis, excluding contracted
22 entities for dual eligible or Department of Children and
23 Family Services youth populations.
24 (n) In order to address the escalating infant mortality
25 rates among minority communities in Illinois, the State shall,
26 subject to appropriation, create a pool of funding of at least
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1 $50,000,000 annually to be disbursed among safety-net
2 hospitals that maintain perinatal designation from the
3 Department of Public Health. The funding shall be used to
4 preserve or enhance OB/GYN services or other specialty
5 services at the receiving hospital, with the distribution of
6 funding to be established by rule and with consideration to
7 perinatal hospitals with safe birthing levels and quality
8 metrics for healthy mothers and babies.
9 (o) In order to address the growing challenges of
10 providing stable access to healthcare in rural Illinois,
11 including perinatal services, behavioral healthcare including
12 substance use disorder services (SUDs) and other specialty
13 services, and to expand access to telehealth services among
14 rural communities in Illinois, the Department of Healthcare
15 and Family Services shall administer a program to provide at
16 least $10,000,000 in financial support annually to critical
17 access hospitals for delivery of perinatal and OB/GYN
18 services, behavioral healthcare including SUDS, other
19 specialty services and telehealth services. The funding shall
20 be used to preserve or enhance perinatal and OB/GYN services,
21 behavioral healthcare including SUDS, other specialty
22 services, as well as the explanation of telehealth services by
23 the receiving hospital, with the distribution of funding to be
24 established by rule.
25 (p) For calendar year 2023, the final amounts, rates, and
26 payments under subsections (c), (d-2), (g), (h), and (j) shall
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1 be established by the Department, so that the sum of the total
2 estimated annual payments under subsections (c), (d-2), (g),
3 (h), and (j) for each hospital class for calendar year 2023, is
4 no less than:
5 (1) $858,260,000 to safety-net hospitals.
6 (2) $86,200,000 to critical access hospitals.
7 (3) $1,765,000,000 to high Medicaid hospitals.
8 (4) $673,860,000 to general acute care hospitals.
9 (5) $48,330,000 to long term acute care hospitals.
10 (6) $89,110,000 to freestanding psychiatric hospitals.
11 (7) $24,300,000 to freestanding rehabilitation
12 hospitals.
13 (8) $32,570,000 to public hospitals.
14 (q) Hospital Pandemic Recovery Stabilization Payments. The
15 Department shall disburse a pool of $460,000,000 in stability
16 payments to hospitals prior to April 1, 2023. The allocation
17 of the pool shall be based on the hospital directed payment
18 classes and directed payments issued, during Calendar Year
19 2022 with added consideration to safety net hospitals, as
20 defined in subdivision (f)(1)(B) of this Section, and critical
21 access hospitals.
22 (r) Directed payment update. For calendar year 2025, and
23 each calendar year thereafter, the final amounts, rates, and
24 payments for the fixed pool directed payments described in
25 subsection (g) and the fixed rate directed payments described
26 in subsection (h) shall be established by the Department at no
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1 less than the following:
2 (1) $579,261,585 for inpatient services at safety-net
3 hospitals.
4 (2) $763,418,138 for outpatient services at safety-net
5 hospitals.
6 (3) $12,389,160 for inpatient services at critical
7 access hospitals.
8 (4) $137,437,866 for outpatient services at critical
9 access hospitals.
10 (5) $5,418 as a base fixed rate per admit prior to
11 adjusting for acuity, for inpatient services at high
12 Medicaid hospitals.
13 (6) $1,512 as a base fixed rate per paid E-APG prior to
14 adjusting for acuity, for outpatient services at high
15 Medicaid hospitals.
16 (7) $3,898 as a base fixed rate per admit prior to
17 adjusting for acuity, for inpatient services at other
18 acute care hospitals.
19 (8) $1,322 as a base fixed rate per E-APG prior to
20 adjusting for acuity, for outpatient services at other
21 acute hospitals.
22 (9) $773 per day for inpatient services at long term
23 acute care hospitals.
24 (10) $206 per day for inpatient services at
25 freestanding psychiatric hospitals.
26 (11) $223 per claim for outpatient services at
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1 freestanding psychiatric hospitals.
2 (12) $776 per day for inpatient services at
3 freestanding rehabilitation hospitals.
4 (13) $252 per claim for outpatient services at
5 freestanding rehabilitation hospitals.
6 (14) $7,793,812 for inpatient services at public
7 hospitals.
8 (15) $26,849,592 for outpatient services at public
9 hospitals.
10 Implementation of the rate increases described in this
11 subsection (r) shall be contingent on federal approval. The
12 rates for fixed pool directed payments as described in
13 subsection (g) and for fixed rate directed payments as
14 described in subsection (h) shall remain as published by the
15 Department on November 27, 2024 until the Department receives
16 federal approval for the updated rates described in this
17 subsection (r).
18 (s) If, in order to secure approval by the Centers for
19 Medicare and Medicaid Services, the rates under subsection (r)
20 are reduced, the Department may submit a State Plan amendment
21 to increase rates in place at the time of the reduction
22 pertaining to subsection (d-2) to offset the annual amount of
23 reduction to the rates under subsection (r), in amounts equal
24 to the required reduction on a class-specific basis to ensure
25 that funds are not reallocated from one class to another; or
26 the rates in subsection (r) shall be reduced uniformly to the
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1 amounts necessary to achieve approval and the assessments
2 imposed by subsection (a) or (b-5) of Section 5A-2 shall be
3 reduced uniformly to achieve a total annual reduction across
4 both assessments equal to the product of the total annual
5 reduction to payments and .3853. In addition, the assessments
6 shall further be reduced uniformly to achieve a total annual
7 reduction across both assessments equal to the difference of
8 subtracting the product calculated in the previous sentence
9 from the resulting quotient of dividing the product described
10 in the previous sentence by .92 for a reduction to the
11 transfers in subsection 7.16 and 7.17 of Section 5A-8.
12 (t) To provide for the expeditious and timely
13 implementation of the changes made to this Section by this
14 amendatory Act of the 104th General Assembly, the Department
15 may adopt emergency rules as authorized by Section 5-45 of the
16 Illinois Administrative Procedure Act. The adoption of
17 emergency rules is deemed to be necessary for the public
18 interest, safety, and welfare.
19 (Source: P.A. 102-4, eff. 4-27-21; 102-16, eff. 6-17-21;
20 102-886, eff. 5-17-22; 102-1115, eff. 1-9-23; 103-102, eff.
21 6-16-23; 103-593, eff. 6-7-24; 103-605, eff. 7-1-24.)
22 (305 ILCS 5/5A-14)
23 Sec. 5A-14. Repeal of assessments and disbursements.
24 (a) (Blank). Section 5A-2 is repealed on December 31,
25 2026.
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1 (b) Section 5A-12 is repealed on July 1, 2005.
2 (c) Section 5A-12.1 is repealed on July 1, 2008.
3 (d) Section 5A-12.2 and Section 5A-12.4 are repealed on
4 July 1, 2018, subject to Section 5A-16.
5 (e) Section 5A-12.3 is repealed on July 1, 2011.
6 (f) Section 5A-12.6 is repealed on July 1, 2020.
7 (g) (Blank). Section 5A-12.7 is repealed on December 31,
8 2026.
9 (Source: P.A. 101-650, eff. 7-7-20; 102-886, eff. 5-17-22.)
10 (305 ILCS 5/12-4.105)
11 Sec. 12-4.105. Human poison control center; payment
12 program. Subject to funding availability resulting from
13 transfers made from the Hospital Provider Fund to the
14 Healthcare Provider Relief Fund as authorized under this Code,
15 for State fiscal year 2017 and State fiscal year 2018, and for
16 each State fiscal year thereafter in which the assessment
17 under Section 5A-2 is imposed, the Department of Healthcare
18 and Family Services shall pay to the human poison control
19 center designated under the Poison Control System Act an
20 amount of not less than $3,000,000 for each of State fiscal
21 years 2017 through 2020, and for State fiscal years 2021
22 through 2023 an amount of not less than $3,750,000 and for
23 State fiscal year years 2024 through 2026 an amount of not less
24 than $4,000,000, and for State fiscal year 2025 an amount not
25 less than $4,500,000, and for State fiscal year 2026, and each
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1 fiscal year thereafter, an amount of not less than $4,750,000
2 and for the period July 1, 2026 through December 31, 2026 an
3 amount of not less than $2,000,000, if the human poison
4 control center is in operation.
5 (Source: P.A. 102-886, eff. 5-17-22; 103-102, eff. 6-16-23.)
6 Section 99. Effective date. This Act takes effect upon
7 becoming law.Every fact on this page links to its source, starting with the official bill record.