SB 3268

Abstract

Amends the Illinois Public Aid Code. Provides that on January 1, 2025, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer the remaining balance from the Electronic Health Record Incentive Fund into the Public Aid Recoveries Trust Fund. Provides that upon completion of the transfer, the Electronic Health Record Incentive Fund is dissolved, and any future deposits due to that Fund and any outstanding obligations or liabilities of that Fund shall pass to the Public Aid Recoveries Trust Fund. Provides that on January 1, 2026, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer the remaining balance from the Juvenile Rehabilitation Services Medicaid Matching Fund into the Public Aid Recoveries Trust Fund. Provides that upon completion of the transfer, the Juvenile Rehabilitation Services Medicaid Matching Fund is dissolved, and any future deposits due to that Fund and any outstanding obligations or liabilities of that Fund shall pass to the Public Aid Recoveries Trust Fund. Repeals a provision requiring the Department of Healthcare and Family Services to conduct annual audits of the County Provider Trust Fund to determine that amounts received from or paid to county providers were correct. Amends the State Finance Act. Provides that on January 1, 2025, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer the remaining balance from the Provider Inquiry Trust Fund into the Healthcare Provider Relief Fund. Provides that upon completion of the transfer, the Provider Inquiry Trust Fund is dissolved, and any future deposits due to that Fund and any outstanding obligations or liabilities of that Fund shall pass to the Healthcare Provider Relief Fund. Repeals provisions in the Illinois Public Aid Code concerning the Medicaid Research and Education Support Fund and enhancement payments for Medicaid research and education. Repeals the Supportive Living Facility Funding Article and the Supportive Living Facility Fund. Effective immediately. House Floor Amendment No. 2 Adds reference to: 305 ILCS 5/5-5 305 ILCS 5/5-5.05h new 305 ILCS 5/5-5.01a 210 ILCS 170/40 305 ILCS 5/5-18.3 new 305 ILCS 5/5H-1 305 ILCS 5/5H-3 5 ILCS 100/5-45.55 new 305 ILCS 5/14-12.5 305 ILCS 5/5A-12.7 305 ILCS 5/5-5.08a new 305 ILCS 5/5-5.07 305 ILCS 5/14-13 305 ILCS 5/5-55 new 305 ILCS 5/5-60 new 305 ILCS 5/5-2.06 305 ILCS 5/5-5.24a new 305 ILCS 5/5-2b 305 ILCS 5/5-52 new 305 ILCS 5/5-4.2 305 ILCS 5/5-5 210 ILCS 49/5-107 305 ILCS 5/5-5.01a 305 ILCS 5/5-36 210 ILCS 49/5-113 new 305 ILCS 5/5-53 new 305 ILCS 5/5-30.1 305 ILCS 5/5-30.18 new 210 ILCS 135/13.3 new 305 ILCS 5/5-5.12f new 305 ILCS 5/5-5.01a 305 ILCS 5/5-2.06a new 305 ILCS 5/5-5.5 from Ch. 23, par. 5-5.5 305 ILCS 5/5-5.2 305 ILCS 5/5-5a.1 225 ILCS 85/3 225 ILCS 85/9.6 Replaces everything after the enacting clause. Amends the Illinois Public Aid Code. Makes changes to the Medical Assistance Article. Provides that beginning with dates of service on and after January 1, 2025, add-on rates for the services delivered by physicians who are board certified in psychiatry and advanced practice registered nurses who hold a current certification in psychiatric and mental health nursing shall be increased so that the sum of the base per service unit rate plus the rate add-on is no less than $264.42 per hour adjusted for time and intensity. In a provision concerning personal needs allowances, provides that the total monthly personal needs allowance from both the State and federal sources for a person who is a resident of a supportive living facility shall equal $120. Requires the Department of Children and Family Services to pay for all inpatient stays at a hospital beginning on the 3rd day a child is in the hospital beyond medical necessity, and the parent or caregiver has denied the child access to the home and has refused or failed to make provisions for another living arrangement for the child or the child's discharge is being delayed due to a pending inquiry or investigation by the Department of Children and Family Services. Provides that beginning January 1, 2025 (rather than January 1, 2020), the Department of Healthcare and Family Services shall reimburse Children's Community-Based Health Care Centers at the lower of their usual and customary charge to the public or at the Department rate of $1,300 (rather than $950). Contains provisions concerning reimbursement for remote ultrasound procedures and remote fetal nonstress tests; increased reimbursement rates for nursing services for medically fragile and technology dependent children; increased reimbursement rates for optometrist services; coverage and reimbursement rates for custom prosthetic and orthotic devices; per-claim add-on payments for renal dialysis services provided within a skilled nursing facility by a certified home dialysis provider; coverage for music therapy services provided by licensed professional music therapists; a deadline extension for reporting data recommendations for ground ambulance services cost structures; administrative rules updating the Handicapping Labio-Lingual Deviation orthodontic scoring tool; emergency rules; and other matters. Makes changes to provisions under the Hospital Services Trust Fund Article concerning reimbursement for hospital (rather than inpatient) stays extended beyond medical necessity. Makes changes to the Managed Care Organization Provider Assessment Article. Changes the Tier 1 assessment amount for managed care organizations to $78.90 per member month (rather than $60.20 per member month). Changes the Tier 2 assessment amount for managed care organizations to $1.40 per member month (rather than $1.20 per member month). Provides that for State fiscal year 2020, and for each State fiscal year thereafter (rather than for State fiscal year 2020 through State fiscal year 2025), the Department of Healthcare and Family Services may adjust rates or tier parameters or both. Makes changes to the Hospital Services Trust Fund Article. Provides that beginning on and after July 1, 2024, subject to federal approval, in addition to the statewide standardized amount and any other payments authorized under the Code, a safety-net hospital health care equity add-on payment shall be paid for each inpatient General Acute and Psychiatric day of care, excluding Medicare-Medicaid dual eligible crossover days, for safety-net hospitals. Provides that beginning on and after July 1, 2024, subject to federal approval, in addition to the statewide standardized amount and any other payments authorized under this Code, a safety-net hospital low volume add-on payment of $200 shall be paid for each inpatient General Acute and Psychiatric day of care, excluding Medicare-Medicaid dual eligible crossover days, for any safety-net hospital that provided less than 11,000 Medicaid inpatient days of care, excluding Medicare-Medicaid dual eligible crossover days, in the base period. Grants the Department emergency rulemaking authority to implement these add-on payments. Makes changes to the Hospital Provider Funding Article. For purposes of allocating funds included in capitation payments to MCOs, excludes hospitals with over 9,000 Medicaid acute care inpatient admissions per calendar year from the category of safety-net hospitals. Amends the Birth Center Licensing Act. In a provision concerning reimbursement rates set by the Department of Healthcare and Family Services, requires the facility fees for the birthing person and the baby to be no less than 80% (rather than 75%) of the statewide average facility payment rate made to a hospital. Amends the Specialized Mental Health Rehabilitation Act of 2013. In provisions requiring facilities licensed under the Act to be awarded an additional payment for their single occupancy rooms, provides that beginning on January 1, 2025, a payment of no less than $10 per day, per single room occupancy shall be added to the existing $25.50 additional per day, per single room occupancy rate for a total of at least $35.50 per day, per single room occupancy. Makes other changes. Effective immediately. House Floor Amendment No. 3 Provides that subject to federal approval, beginning January 1, 2025, Medicaid rates for supportive living services must be at least 54.75% of the average total nursing services per diem rate for the geographic areas defined by the Department of Healthcare and Family Services and shall include all add-ons for nursing facilities for the geographic area. In provisions amending the Specialized Mental Health Rehabilitation Act of 2013, provides that beginning January 1, 2025, for improving the quality of life and the quality of care, a payment of no less than $8.75 per day, per dual-occupancy room shall be added to the existing $14.50 additional per day, per dual-occupancy room rate for a total of at least $23.25, per Medicaid-occupied bed, in each dual-occupancy room.