Bill Text: IL HB3244 | 2023-2024 | 103rd General Assembly | Introduced
Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the rate of reimbursement for inpatient psychiatric services for safety-net hospitals shall be no less than $800 per day.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2023-05-19 - Rule 19(a) / Re-referred to Rules Committee [HB3244 Detail]
Download: Illinois-2023-HB3244-Introduced.html
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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Public Aid Code is amended by | |||||||||||||||||||
5 | changing Section 5-5e.1 as follows:
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6 | (305 ILCS 5/5-5e.1) | |||||||||||||||||||
7 | Sec. 5-5e.1. Safety-Net Hospitals. | |||||||||||||||||||
8 | (a) A Safety-Net Hospital is an Illinois hospital that: | |||||||||||||||||||
9 | (1) is licensed by the Department of Public Health as | |||||||||||||||||||
10 | a general acute care or pediatric hospital; and | |||||||||||||||||||
11 | (2) is a disproportionate share hospital, as described | |||||||||||||||||||
12 | in Section 1923 of the federal Social Security Act, as | |||||||||||||||||||
13 | determined by the Department; and | |||||||||||||||||||
14 | (3) meets one of the following: | |||||||||||||||||||
15 | (A) has a MIUR of at least 40% and a charity | |||||||||||||||||||
16 | percent of at least 4%; or | |||||||||||||||||||
17 | (B) has a MIUR of at least 50%. | |||||||||||||||||||
18 | (b) Definitions. As used in this Section: | |||||||||||||||||||
19 | (1) "Charity percent" means the ratio of (i) the | |||||||||||||||||||
20 | hospital's charity charges for services provided to | |||||||||||||||||||
21 | individuals without health insurance or another source of | |||||||||||||||||||
22 | third party coverage to (ii) the Illinois total hospital | |||||||||||||||||||
23 | charges, each as reported on the hospital's OBRA form. |
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1 | (2) "MIUR" means Medicaid Inpatient Utilization Rate | ||||||
2 | and is defined as a fraction, the numerator of which is the | ||||||
3 | number of a hospital's inpatient days provided in the | ||||||
4 | hospital's fiscal year ending 3 years prior to the rate | ||||||
5 | year, to patients who, for such days, were eligible for | ||||||
6 | Medicaid under Title XIX of the federal Social Security | ||||||
7 | Act, 42 USC 1396a et seq., excluding those persons | ||||||
8 | eligible for medical assistance pursuant to 42 U.S.C. | ||||||
9 | 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of | ||||||
10 | Section 5-2 of this Article, and the denominator of which | ||||||
11 | is the total number of the hospital's inpatient days in | ||||||
12 | that same period, excluding those persons eligible for | ||||||
13 | medical assistance pursuant to 42 U.S.C. | ||||||
14 | 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of | ||||||
15 | Section 5-2 of this Article. | ||||||
16 | (3) "OBRA form" means form HFS-3834, OBRA '93 data | ||||||
17 | collection form, for the rate year. | ||||||
18 | (4) "Rate year" means the 12-month period beginning on | ||||||
19 | October 1. | ||||||
20 | (c) Beginning July 1, 2012 and ending on December 31, | ||||||
21 | 2026, a hospital that would have qualified for the rate year | ||||||
22 | beginning October 1, 2011 or October 1, 2012 shall be a | ||||||
23 | Safety-Net Hospital. | ||||||
24 | (c-5) Beginning July 1, 2020 and ending on December 31, | ||||||
25 | 2026, a hospital that would have qualified for the rate year | ||||||
26 | beginning October 1, 2020 and was designated a federal rural |
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1 | referral center under 42 CFR 412.96 as of October 1, 2020 shall | ||||||
2 | be a Safety-Net Hospital. | ||||||
3 | (c-6) The rate of reimbursement for inpatient psychiatric | ||||||
4 | services for safety-net hospitals shall be no less than $800 | ||||||
5 | per day. | ||||||
6 | (d) No later than August 15 preceding the rate year, each | ||||||
7 | hospital shall submit the OBRA form to the Department. Prior | ||||||
8 | to October 1, the Department shall notify each hospital | ||||||
9 | whether it has qualified as a Safety-Net Hospital. | ||||||
10 | (e) The Department may promulgate rules in order to | ||||||
11 | implement this Section.
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12 | (f) Nothing in this Section shall be construed as limiting | ||||||
13 | the ability of the Department to include the Safety-Net | ||||||
14 | Hospitals in the hospital rate reform mandated by Section | ||||||
15 | 14-11 of this Code and implemented under Section 14-12 of this | ||||||
16 | Code and by administrative rulemaking. | ||||||
17 | (Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21; | ||||||
18 | 102-886, eff. 5-17-22.)
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