Bill Text: IL SB3268 | 2023-2024 | 103rd General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: 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.

Spectrum: Moderate Partisan Bill (Democrat 13-3)

Status: (Enrolled) 2024-05-26 - Passed Both Houses [SB3268 Detail]

Download: Illinois-2023-SB3268-Engrossed.html

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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Article 1.
(305 ILCS 5/15-6 rep.)
Section 1-5. The Illinois Public Aid Code is amended by
repealing Section 15-6.
Article 5.
Section 5-5. The State Finance Act is amended by changing
Section 5.797 as follows:
(30 ILCS 105/5.797)
Sec. 5.797. The Electronic Health Record Incentive Fund.
This Section is repealed on January 1, 2025.
(Source: P.A. 97-169, eff. 7-22-11; 97-813, eff. 7-13-12.)
Section 5-10. The Illinois Public Aid Code is amended by
changing Section 12-10.6a as follows:
(305 ILCS 5/12-10.6a)
Sec. 12-10.6a. The Electronic Health Record Incentive

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Fund.
(a) The Electronic Health Record Incentive Fund is a
special fund created in the State treasury. All federal moneys
received by the Department of Healthcare and Family Services
for payments to qualifying health care providers to encourage
the adoption and use of certified electronic health records
technology pursuant to paragraph 1903(t)(1) of the Social
Security Act, shall be deposited into the Fund.
(b) Disbursements from the Fund shall be made at the
direction of the Director of Healthcare and Family Services to
qualifying health care providers, in amounts established under
applicable federal regulation (42 CFR 495 et seq.), in order
to encourage the adoption and use of certified electronic
health records technology.
(c) 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. 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.
(Source: P.A. 97-169, eff. 7-22-11.)
Article 10.

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(30 ILCS 105/5.836 rep.)
Section 10-5. The State Finance Act is amended by
repealing Section 5.836.
(305 ILCS 5/5-31 rep.)
(305 ILCS 5/5-32 rep.)
Section 10-15. The Illinois Public Aid Code is amended by
repealing Sections 5-31 and 5-32.
Article 15.
Section 15-5. The State Finance Act is amended by changing
Section 5.481 as follows:
(30 ILCS 105/5.481)
Sec. 5.481. The Juvenile Rehabilitation Services Medicaid
Matching Fund. This Section is repealed on January 1, 2026.
(Source: P.A. 90-587, eff. 7-1-98.)
Section 15-10. The Illinois Public Aid Code is amended by
changing Sections 12-9 and 12-10.4 as follows:
(305 ILCS 5/12-9) (from Ch. 23, par. 12-9)
Sec. 12-9. Public Aid Recoveries Trust Fund; uses. The
Public Aid Recoveries Trust Fund shall consist of (1)

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recoveries by the Department of Healthcare and Family Services
(formerly Illinois Department of Public Aid) authorized by
this Code in respect to applicants or recipients under
Articles III, IV, V, and VI, including recoveries made by the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) from the estates of
deceased recipients, (2) recoveries made by the Department of
Healthcare and Family Services (formerly Illinois Department
of Public Aid) in respect to applicants and recipients under
the Children's Health Insurance Program Act, and the Covering
ALL KIDS Health Insurance Act, (2.5) recoveries made by the
Department of Healthcare and Family Services in connection
with the imposition of an administrative penalty as provided
under Section 12-4.45, (3) federal funds received on behalf of
and earned by State universities, other State agencies or
departments, and local governmental entities for services
provided to applicants or recipients covered under this Code,
the Children's Health Insurance Program Act, and the Covering
ALL KIDS Health Insurance Act, (3.5) federal financial
participation revenue related to eligible disbursements made
by the Department of Healthcare and Family Services from
appropriations required by this Section, and (4) all other
moneys received to the Fund, including interest thereon. The
Fund shall be held as a special fund in the State Treasury.
Disbursements from this Fund shall be only (1) for the
reimbursement of claims collected by the Department of

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Healthcare and Family Services (formerly Illinois Department
of Public Aid) through error or mistake, (2) for payment to
persons or agencies designated as payees or co-payees on any
instrument, whether or not negotiable, delivered to the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) as a recovery under this
Section, such payment to be in proportion to the respective
interests of the payees in the amount so collected, (3) for
payments to the Department of Human Services for collections
made by the Department of Healthcare and Family Services
(formerly Illinois Department of Public Aid) on behalf of the
Department of Human Services under this Code, the Children's
Health Insurance Program Act, and the Covering ALL KIDS Health
Insurance Act, (4) for payment of administrative expenses
incurred in performing the activities authorized under this
Code, the Children's Health Insurance Program Act, and the
Covering ALL KIDS Health Insurance Act, (5) for payment of
fees to persons or agencies in the performance of activities
pursuant to the collection of monies owed the State that are
collected under this Code, the Children's Health Insurance
Program Act, and the Covering ALL KIDS Health Insurance Act,
(6) for payments of any amounts which are reimbursable to the
federal government which are required to be paid by State
warrant by either the State or federal government, and (7) for
payments to State universities, other State agencies or
departments, and local governmental entities of federal funds

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for services provided to applicants or recipients covered
under this Code, the Children's Health Insurance Program Act,
and the Covering ALL KIDS Health Insurance Act. Disbursements
from this Fund for purposes of items (4) and (5) of this
paragraph shall be subject to appropriations from the Fund to
the Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid).
The balance in this Fund after payment therefrom of any
amounts reimbursable to the federal government, and minus the
amount reasonably anticipated to be needed to make the
disbursements authorized by this Section during the current
and following 3 calendar months, shall be certified by the
Director of Healthcare and Family Services and transferred by
the State Comptroller to the Drug Rebate Fund or the
Healthcare Provider Relief Fund in the State Treasury, as
appropriate, on at least an annual basis by June 30th of each
fiscal year. The Director of Healthcare and Family Services
may certify and the State Comptroller shall transfer to the
Drug Rebate Fund or the Healthcare Provider Relief Fund
amounts on a more frequent basis.
On July 1, 1999, the State Comptroller shall transfer the
sum of $5,000,000 from the Public Aid Recoveries Trust Fund
(formerly the Public Assistance Recoveries Trust Fund) into
the DHS Recoveries Trust Fund.
(Source: P.A. 97-647, eff. 1-1-12; 97-689, eff. 6-14-12;
98-130, eff. 8-2-13; 98-651, eff. 6-16-14.)

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(305 ILCS 5/12-10.4)
Sec. 12-10.4. Juvenile Rehabilitation Services Medicaid
Matching Fund. There is created in the State Treasury the
Juvenile Rehabilitation Services Medicaid Matching Fund.
Deposits to this Fund shall consist of all moneys received
from the federal government for behavioral health services
secured by counties pursuant to an agreement with the
Department of Healthcare and Family Services with respect to
Title XIX of the Social Security Act or under the Children's
Health Insurance Program pursuant to the Children's Health
Insurance Program Act and Title XXI of the Social Security Act
for minors who are committed to mental health facilities by
the Illinois court system and for residential placements
secured by the Department of Juvenile Justice for minors as a
condition of their aftercare release.
Disbursements from the Fund shall be made, subject to
appropriation, by the Department of Healthcare and Family
Services for grants to the Department of Juvenile Justice and
those counties which secure behavioral health services ordered
by the courts and which have an interagency agreement with the
Department and submit detailed bills according to standards
determined by the Department.
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

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Rehabilitation Services Medicaid Matching Fund into the Public
Aid Recoveries Trust Fund. 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.
(Source: P.A. 98-558, eff. 1-1-14.)
Article 20.
(30 ILCS 105/5.856 rep.)
Section 20-5. The State Finance Act is amended by
repealing Section 5.856.
(305 ILCS 5/Art. V-G rep.)
Section 20-10. The Illinois Public Aid Code is amended by
repealing Article V-G.
Article 25.
Section 25-5. The State Finance Act is amended by changing
Sections 5.409 and 6z-40 as follows:
(30 ILCS 105/5.409)
Sec. 5.409. The Provider Inquiry Trust Fund. This Section
is repealed on January 1, 2025.

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(Source: P.A. 89-21, eff. 7-1-95.)
(30 ILCS 105/6z-40)
Sec. 6z-40. Provider Inquiry Trust Fund. The Provider
Inquiry Trust Fund is created as a special fund in the State
treasury. Payments into the fund shall consist of fees or
other moneys owed by providers of services or their agents,
including other State agencies, for access to and utilization
of Illinois Department of Healthcare and Family Services
Public Aid eligibility files to verify eligibility of clients,
bills for services, or other similar, related uses.
Disbursements from the fund shall consist of payments to the
Department of Innovation and Technology Central Management
Services for communication and statistical services and for
payments for administrative expenses incurred by the Illinois
Department of Healthcare and Family Services Public Aid in the
operation of the fund.
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. 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.
(Source: P.A. 94-91, eff. 7-1-05.)

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Article 999.
Section 999-99. Effective date. This Act takes effect upon
becoming law.
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INDEX
Statutes amended in order of appearance