Sen. Jacqueline Y. Collins
Filed: 5/8/2013
 
 


 




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1
AMENDMENT TO HOUSE BILL 11




2 AMENDMENT NO. ______. Amend House Bill 11 by replacing 
3everything after the enacting clause with the following:


4 "Section 5. The Nursing Home Care Act is amended by 
5changing Section 3-202.05 as follows:

6 (210 ILCS 45/3-202.05)
7 Sec. 3-202.05. Staffing ratios effective July 1, 2010 and 
8thereafter.
9 (a) For the purpose of computing staff to resident ratios, 
10direct care staff shall include:
11  (1) registered nurses;
12  (2) licensed practical nurses;
13  (3) certified nurse assistants;
14  (4) psychiatric services rehabilitation aides;
15  (5) rehabilitation and therapy aides;
16  (6) psychiatric services rehabilitation coordinators;
 
 
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1  (7) assistant directors of nursing;
2  (8) 50% of the Director of Nurses' time; and
3  (9) 30% of the Social Services Directors' time.
4 The Department shall, by rule, allow certain facilities 
5subject to 77 Ill. Admin. Code 300.4000 and following (Subpart 
6S) to utilize specialized clinical staff, as defined in rules, 
7to count towards the staffing ratios. 
8 Within 120 days of the effective date of this amendatory 
9Act of the 97th General Assembly, the Department shall 
10promulgate rules specific to the staffing requirements for 
11facilities federally defined as Institutions for Mental 
12Disease. These rules shall recognize the unique nature of 
13individuals with chronic mental health conditions, shall 
14include minimum requirements for specialized clinical staff, 
15including clinical social workers, psychiatrists, 
16psychologists, and direct care staff set forth in paragraphs 
17(4) through (6) and any other specialized staff which may be 
18utilized and deemed necessary to count toward staffing ratios. 
19 Within 120 days of the effective date of this amendatory 
20Act of the 97th General Assembly, the Department shall 
21promulgate rules specific to the staffing requirements for 
22facilities licensed under the Specialized Mental Health 
23Rehabilitation Act. These rules shall recognize the unique 
24nature of individuals with chronic mental health conditions, 
25shall include minimum requirements for specialized clinical 
26staff, including clinical social workers, psychiatrists, 
 
 
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1psychologists, and direct care staff set forth in paragraphs 
2(4) through (6) and any other specialized staff which may be 
3utilized and deemed necessary to count toward staffing ratios. 
4 (b) Beginning January 1, 2011, and thereafter, light 
5intermediate care shall be staffed at the same staffing ratio 
6as intermediate care.
7 (c) Facilities shall notify the Department within 60 days 
8after the effective date of this amendatory Act of the 96th 
9General Assembly, in a form and manner prescribed by the 
10Department, of the staffing ratios in effect on the effective 
11date of this amendatory Act of the 96th General Assembly for 
12both intermediate and skilled care and the number of residents 
13receiving each level of care. 
14 (d)(1) Effective July 1, 2010, for each resident needing 
15skilled care, a minimum staffing ratio of 2.5 hours of nursing 
16and personal care each day must be provided; for each resident 
17needing intermediate care, 1.7 hours of nursing and personal 
18care each day must be provided.
19 (2) Effective January 1, 2011, the minimum staffing ratios 
20shall be increased to 2.7 hours of nursing and personal care 
21each day for a resident needing skilled care and 1.9 hours of 
22nursing and personal care each day for a resident needing 
23intermediate care.
24 (3) Effective January 1, 2012, the minimum staffing ratios 
25shall be increased to 3.0 hours of nursing and personal care 
26each day for a resident needing skilled care and 2.1 hours of 
 
 
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1nursing and personal care each day for a resident needing 
2intermediate care.
3 (4) Effective January 1, 2013, the minimum staffing ratios 
4shall be increased to 3.4 hours of nursing and personal care 
5each day for a resident needing skilled care and 2.3 hours of 
6nursing and personal care each day for a resident needing 
7intermediate care.
8 (5) Effective January 1, 2014, the minimum staffing ratios 
9shall be increased to 3.8 hours of nursing and personal care 
10each day for a resident needing skilled care and 2.5 hours of 
11nursing and personal care each day for a resident needing 
12intermediate care. 

13 (e) Ninety days after the effective date of this amendatory 
14Act of the 97th General Assembly, a minimum of 25% of nursing 
15and personal care time shall be provided by licensed nurses, 
16with at least 10% of nursing and personal care time provided by 
17registered nurses. These minimum requirements shall remain in 
18effect until an acuity based registered nurse requirement is 
19promulgated by rule concurrent with the adoption of the 
20Resource Utilization Group classification-based payment 
21methodology, as provided in Section 5-5.2 of the Illinois 
22Public Aid Code. Registered nurses and licensed practical 
23nurses employed by a facility in excess of these requirements 
24may be used to satisfy the remaining 75% of the nursing and 
25personal care time requirements. Notwithstanding this 
26subsection, no staffing requirement in statute in effect on the 
 
 
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1effective date of this amendatory Act of the 97th General 
2Assembly shall be reduced on account of this subsection. Both 
3the 25% licensed nurse requirement and 10% registered nurse 
4requirement shall remain in effect until an acuity based 
5licensed nurse requirement and registered nurse requirement 
6are adopted in administrative rules subsequent to the 
7implementation of the Resource Utilization Group 
8classification-based payment methodology, as provided in 
9Section 5-5.2 of the Illinois Public Aid Code. An acuity based 
10licensed nurse requirement and registered nurse requirement 
11shall not be made effective before January 1, 2014.
12(Source: P.A. 96-1372, eff. 7-29-10; 96-1504, eff. 1-27-11; 
1397-689, eff. 6-14-12.)

14 Section 10. The Illinois Public Aid Code is amended by 
15changing Sections 5-5.2 and 5-5.4 as follows:




16 (305 ILCS 5/5-5.2) (from Ch. 23, par. 5-5.2)



17 Sec. 5-5.2. Payment. 

18 (a) All nursing facilities that are grouped pursuant to 
19Section
5-5.1 of this Act shall receive the same rate of 
20payment for similar
services.

21 (b) It shall be a matter of State policy that the Illinois 
22Department
shall utilize a uniform billing cycle throughout the 
23State for the
long-term care providers.

24 (c) Notwithstanding any other provisions of this Code, the 
 
 
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1methodologies for reimbursement of nursing services as 
2provided under this Article shall no longer be applicable for 
3bills payable for nursing services rendered on or after a new 
4reimbursement system based on the Resource Utilization Groups 
5(RUGs) has been fully operationalized, which shall take effect 
6for services provided on or after July 1, 2013 January 1, 2014. 
7 (d) A new nursing services reimbursement methodology 
8utilizing RUGs IV 48 grouper model shall be established and may 
9include an Illinois-specific default group, as needed. The new 
10RUGs-based nursing services reimbursement methodology shall be 
11resident-driven, facility-specific, and cost-based. Costs 
12shall be annually rebased and case mix index quarterly updated. 
13The methodology shall include regional wage adjustors based on 
14the Health Service Areas (HSA) groupings in effect on April 30, 
152012. The Department shall assign a case mix index to each 
16resident class based on the Centers for Medicare and Medicaid 
17Services staff time measurement study utilizing an index 
18maximization approach.
19 (e) Notwithstanding any other provision of this Code, the 
20Department shall by rule develop a reimbursement methodology 
21reflective of the intensity of care and services requirements 
22of low need residents in the lowest RUG IV groupers and 
23corresponding regulations.
24 (f) Notwithstanding any other provision of this Code, on 
25and after July 1, 2012, reimbursement rates associated with the 
26nursing or support components of the current nursing facility 
 
 
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1rate methodology shall not increase beyond the level effective 
2May 1, 2011 until a new reimbursement system based on the RUGs 
3IV 48 grouper model has been fully operationalized.
4 (g) Notwithstanding any other provision of this Code, on 
5and after July 1, 2012, for facilities not designated by the 
6Department of Healthcare and Family Services as "Institutions 
7for Mental Disease", rates effective May 1, 2011 shall be 
8adjusted as follows:
9  (1) Individual nursing rates for residents classified 
10 in RUG IV groups PA1, PA2, BA1, and BA2 during the quarter 
11 ending March 31, 2012 shall be reduced by 10%;
12  (2) Individual nursing rates for residents classified 
13 in all other RUG IV groups shall be reduced by 1.0%;
14  (3) Facility rates for the capital and support 
15 components shall be reduced by 1.7%.
16 (h) Notwithstanding any other provision of this Code, on 
17and after July 1, 2012, nursing facilities designated by the 
18Department of Healthcare and Family Services as "Institutions 
19for Mental Disease" and "Institutions for Mental Disease" that 
20are facilities licensed under the Specialized Mental Health 
21Rehabilitation Act shall have the nursing, 
22socio-developmental, capital, and support components of their 
23reimbursement rate effective May 1, 2011 reduced in total by 
242.7%.
25(Source: P.A. 96-1530, eff. 2-16-11; 97-689, eff. 6-14-12.)


 
 
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1 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
2 Sec. 5-5.4. Standards of Payment - Department of Healthcare 
3and Family Services.
The Department of Healthcare and Family 
4Services shall develop standards of payment of
nursing facility 
5and ICF/DD services in facilities providing such services
under 
6this Article which:

7 (1) Provide for the determination of a facility's payment

8for nursing facility or ICF/DD services on a prospective basis.

9The amount of the payment rate for all nursing facilities 
10certified by the
Department of Public Health under the ID/DD 
11Community Care Act or the Nursing Home Care Act as Intermediate

12Care for the Developmentally Disabled facilities, Long Term 
13Care for Under Age
22 facilities, Skilled Nursing facilities, 
14or Intermediate Care facilities
under the
medical assistance 
15program shall be prospectively established annually on the

16basis of historical, financial, and statistical data 
17reflecting actual costs
from prior years, which shall be 
18applied to the current rate year and updated
for inflation, 
19except that the capital cost element for newly constructed

20facilities shall be based upon projected budgets. The annually 
21established
payment rate shall take effect on July 1 in 1984 
22and subsequent years. No rate
increase and no
update for 
23inflation shall be provided on or after July 1, 1994 and before

24January 1, 2014, unless specifically provided for in this

25Section.
The changes made by Public Act 93-841
extending the 
26duration of the prohibition against a rate increase or update 
 
 
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1for inflation are effective retroactive to July 1, 2004.

2 For facilities licensed by the Department of Public Health 
3under the Nursing
Home Care Act as Intermediate Care for the 
4Developmentally Disabled facilities
or Long Term Care for Under 
5Age 22 facilities, the rates taking effect on July
1, 1998 
6shall include an increase of 3%. For facilities licensed by the

7Department of Public Health under the Nursing Home Care Act as 
8Skilled Nursing
facilities or Intermediate Care facilities, 
9the rates taking effect on July 1,
1998 shall include an 
10increase of 3% plus $1.10 per resident-day, as defined by
the 
11Department. For facilities licensed by the Department of Public 
12Health under the Nursing Home Care Act as Intermediate Care 
13Facilities for the Developmentally Disabled or Long Term Care 
14for Under Age 22 facilities, the rates taking effect on January 
151, 2006 shall include an increase of 3%.
For facilities 
16licensed by the Department of Public Health under the Nursing 
17Home Care Act as Intermediate Care Facilities for the 
18Developmentally Disabled or Long Term Care for Under Age 22 
19facilities, the rates taking effect on January 1, 2009 shall 
20include an increase sufficient to provide a $0.50 per hour wage 
21increase for non-executive staff. 
22 For facilities licensed by the Department of Public Health 
23under the
Nursing Home Care Act as Intermediate Care for the 
24Developmentally Disabled
facilities or Long Term Care for Under 
25Age 22 facilities, the rates taking
effect on July 1, 1999 
26shall include an increase of 1.6% plus $3.00 per
resident-day, 
 
 
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1as defined by the Department. For facilities licensed by the

2Department of Public Health under the Nursing Home Care Act as 
3Skilled Nursing
facilities or Intermediate Care facilities, 
4the rates taking effect on July 1,
1999 shall include an 
5increase of 1.6% and, for services provided on or after
October 
61, 1999, shall be increased by $4.00 per resident-day, as 
7defined by
the Department.

8 For facilities licensed by the Department of Public Health 
9under the
Nursing Home Care Act as Intermediate Care for the 
10Developmentally Disabled
facilities or Long Term Care for Under 
11Age 22 facilities, the rates taking
effect on July 1, 2000 
12shall include an increase of 2.5% per resident-day,
as defined 
13by the Department. For facilities licensed by the Department of

14Public Health under the Nursing Home Care Act as Skilled 
15Nursing facilities or
Intermediate Care facilities, the rates 
16taking effect on July 1, 2000 shall
include an increase of 2.5% 
17per resident-day, as defined by the Department.

18 For facilities licensed by the Department of Public Health 
19under the
Nursing Home Care Act as skilled nursing facilities 
20or intermediate care
facilities, a new payment methodology must 
21be implemented for the nursing
component of the rate effective 
22July 1, 2003. The Department of Public Aid
(now Healthcare and 
23Family Services) shall develop the new payment methodology 
24using the Minimum Data Set
(MDS) as the instrument to collect 
25information concerning nursing home
resident condition 
26necessary to compute the rate. The Department
shall develop the 
 
 
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1new payment methodology to meet the unique needs of
Illinois 
2nursing home residents while remaining subject to the 
3appropriations
provided by the General Assembly.
A transition 
4period from the payment methodology in effect on June 30, 2003

5to the payment methodology in effect on July 1, 2003 shall be 
6provided for a
period not exceeding 3 years and 184 days after 
7implementation of the new payment
methodology as follows:

8  (A) For a facility that would receive a lower
nursing 
9 component rate per patient day under the new system than 
10 the facility
received
effective on the date immediately 
11 preceding the date that the Department
implements the new 
12 payment methodology, the nursing component rate per 
13 patient
day for the facility
shall be held at
the level in 
14 effect on the date immediately preceding the date that the

15 Department implements the new payment methodology until a 
16 higher nursing
component rate of
reimbursement is achieved 
17 by that
facility.

18  (B) For a facility that would receive a higher nursing 
19 component rate per
patient day under the payment 
20 methodology in effect on July 1, 2003 than the
facility 
21 received effective on the date immediately preceding the 
22 date that the
Department implements the new payment 
23 methodology, the nursing component rate
per patient day for 
24 the facility shall be adjusted.

25  (C) Notwithstanding paragraphs (A) and (B), the 
26 nursing component rate per
patient day for the facility 
 
 
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1 shall be adjusted subject to appropriations
provided by the 
2 General Assembly.

3 For facilities licensed by the Department of Public Health 
4under the
Nursing Home Care Act as Intermediate Care for the 
5Developmentally Disabled
facilities or Long Term Care for Under 
6Age 22 facilities, the rates taking
effect on March 1, 2001 
7shall include a statewide increase of 7.85%, as
defined by the 
8Department.

9 Notwithstanding any other provision of this Section, for 
10facilities licensed by the Department of Public Health under 
11the
Nursing Home Care Act as skilled nursing facilities or 
12intermediate care
facilities, except facilities participating 
13in the Department's demonstration program pursuant to the 
14provisions of Title 77, Part 300, Subpart T of the Illinois 
15Administrative Code, the numerator of the ratio used by the 
16Department of Healthcare and Family Services to compute the 
17rate payable under this Section using the Minimum Data Set 
18(MDS) methodology shall incorporate the following annual 
19amounts as the additional funds appropriated to the Department 
20specifically to pay for rates based on the MDS nursing 
21component methodology in excess of the funding in effect on 
22December 31, 2006:
23  (i) For rates taking effect January 1, 2007, 
24 $60,000,000.
25  (ii) For rates taking effect January 1, 2008, 
26 $110,000,000.
 
 
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1  (iii) For rates taking effect January 1, 2009, 
2 $194,000,000. 
3  (iv) For rates taking effect April 1, 2011, or the 
4 first day of the month that begins at least 45 days after 
5 the effective date of this amendatory Act of the 96th 
6 General Assembly, $416,500,000 or an amount as may be 
7 necessary to complete the transition to the MDS methodology 
8 for the nursing component of the rate. Increased payments 
9 under this item (iv) are not due and payable, however, 
10 until (i) the methodologies described in this paragraph are 
11 approved by the federal government in an appropriate State 
12 Plan amendment and (ii) the assessment imposed by Section 
13 5B-2 of this Code is determined to be a permissible tax 
14 under Title XIX of the Social Security Act.
15 Notwithstanding any other provision of this Section, for 
16facilities licensed by the Department of Public Health under 
17the Nursing Home Care Act as skilled nursing facilities or 
18intermediate care facilities, the support component of the 
19rates taking effect on January 1, 2008 shall be computed using 
20the most recent cost reports on file with the Department of 
21Healthcare and Family Services no later than April 1, 2005, 
22updated for inflation to January 1, 2006. 
23 For facilities licensed by the Department of Public Health 
24under the
Nursing Home Care Act as Intermediate Care for the 
25Developmentally Disabled
facilities or Long Term Care for Under 
26Age 22 facilities, the rates taking
effect on April 1, 2002 
 
 
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1shall include a statewide increase of 2.0%, as
defined by the 
2Department.
This increase terminates on July 1, 2002;
beginning 
3July 1, 2002 these rates are reduced to the level of the rates

4in effect on March 31, 2002, as defined by the Department.

5 For facilities licensed by the Department of Public Health 
6under the
Nursing Home Care Act as skilled nursing facilities 
7or intermediate care
facilities, the rates taking effect on 
8July 1, 2001 shall be computed using the most recent cost 
9reports
on file with the Department of Public Aid no later than 
10April 1, 2000,
updated for inflation to January 1, 2001. For 
11rates effective July 1, 2001
only, rates shall be the greater 
12of the rate computed for July 1, 2001
or the rate effective on 
13June 30, 2001.

14 Notwithstanding any other provision of this Section, for 
15facilities
licensed by the Department of Public Health under 
16the Nursing Home Care Act
as skilled nursing facilities or 
17intermediate care facilities, the Illinois
Department shall 
18determine by rule the rates taking effect on July 1, 2002,

19which shall be 5.9% less than the rates in effect on June 30, 
202002.

21 Notwithstanding any other provision of this Section, for 
22facilities
licensed by the Department of Public Health under 
23the Nursing Home Care Act as
skilled nursing
facilities or 
24intermediate care facilities, if the payment methodologies 
25required under Section 5A-12 and the waiver granted under 42 
26CFR 433.68 are approved by the United States Centers for 
 
 
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1Medicare and Medicaid Services, the rates taking effect on July 
21, 2004 shall be 3.0% greater than the rates in effect on June 
330, 2004. These rates shall take
effect only upon approval and

4implementation of the payment methodologies required under 
5Section 5A-12.

6 Notwithstanding any other provisions of this Section, for 
7facilities licensed by the Department of Public Health under 
8the Nursing Home Care Act as skilled nursing facilities or 
9intermediate care facilities, the rates taking effect on 
10January 1, 2005 shall be 3% more than the rates in effect on 
11December 31, 2004.

12 Notwithstanding any other provision of this Section, for 
13facilities licensed by the Department of Public Health under 
14the Nursing Home Care Act as skilled nursing facilities or 
15intermediate care facilities, effective January 1, 2009, the 
16per diem support component of the rates effective on January 1, 
172008, computed using the most recent cost reports on file with 
18the Department of Healthcare and Family Services no later than 
19April 1, 2005, updated for inflation to January 1, 2006, shall 
20be increased to the amount that would have been derived using 
21standard Department of Healthcare and Family Services methods, 
22procedures, and inflators. 
23 Notwithstanding any other provisions of this Section, for 
24facilities licensed by the Department of Public Health under 
25the Nursing Home Care Act as intermediate care facilities that 
26are federally defined as Institutions for Mental Disease, or 
 
 
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1facilities licensed by the Department of Public Health under 
2the Specialized Mental Health Rehabilitation Act, a 
3socio-development component rate equal to 6.6% of the 
4facility's nursing component rate as of January 1, 2006 shall 
5be established and paid effective July 1, 2006. The 
6socio-development component of the rate shall be increased by a 
7factor of 2.53 on the first day of the month that begins at 
8least 45 days after January 11, 2008 (the effective date of 
9Public Act 95-707). As of August 1, 2008, the socio-development 
10component rate shall be equal to 6.6% of the facility's nursing 
11component rate as of January 1, 2006, multiplied by a factor of 
123.53. For services provided on or after April 1, 2011, or the 
13first day of the month that begins at least 45 days after the 
14effective date of this amendatory Act of the 96th General 
15Assembly, whichever is later, the Illinois Department may by 
16rule adjust these socio-development component rates, and may 
17use different adjustment methodologies for those facilities 
18participating, and those not participating, in the Illinois 
19Department's demonstration program pursuant to the provisions 
20of Title 77, Part 300, Subpart T of the Illinois Administrative 
21Code, but in no case may such rates be diminished below those 
22in effect on August 1, 2008.

23 For facilities
licensed
by the
Department of Public Health 
24under the Nursing Home Care Act as Intermediate
Care for
the 
25Developmentally Disabled facilities or as long-term care 
26facilities for
residents under 22 years of age, the rates 
 
 
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1taking effect on July 1,
2003 shall
include a statewide 
2increase of 4%, as defined by the Department.

3 For facilities licensed by the Department of Public Health 
4under the
Nursing Home Care Act as Intermediate Care for the 
5Developmentally Disabled
facilities or Long Term Care for Under 
6Age 22 facilities, the rates taking
effect on the first day of 
7the month that begins at least 45 days after the effective date 
8of this amendatory Act of the 95th General Assembly shall 
9include a statewide increase of 2.5%, as
defined by the 
10Department. 
11 Notwithstanding any other provision of this Section, for 
12facilities licensed by the Department of Public Health under 
13the Nursing Home Care Act as skilled nursing facilities or 
14intermediate care facilities, effective January 1, 2005, 
15facility rates shall be increased by the difference between (i) 
16a facility's per diem property, liability, and malpractice 
17insurance costs as reported in the cost report filed with the 
18Department of Public Aid and used to establish rates effective 
19July 1, 2001 and (ii) those same costs as reported in the 
20facility's 2002 cost report. These costs shall be passed 
21through to the facility without caps or limitations, except for 
22adjustments required under normal auditing procedures.

23 Rates established effective each July 1 shall govern 
24payment
for services rendered throughout that fiscal year, 
25except that rates
established on July 1, 1996 shall be 
26increased by 6.8% for services
provided on or after January 1, 
 
 
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11997. Such rates will be based
upon the rates calculated for 
2the year beginning July 1, 1990, and for
subsequent years 
3thereafter until June 30, 2001 shall be based on the
facility 
4cost reports
for the facility fiscal year ending at any point 
5in time during the previous
calendar year, updated to the 
6midpoint of the rate year. The cost report
shall be on file 
7with the Department no later than April 1 of the current
rate 
8year. Should the cost report not be on file by April 1, the 
9Department
shall base the rate on the latest cost report filed 
10by each skilled care
facility and intermediate care facility, 
11updated to the midpoint of the
current rate year. In 
12determining rates for services rendered on and after
July 1, 
131985, fixed time shall not be computed at less than zero. The

14Department shall not make any alterations of regulations which 
15would reduce
any component of the Medicaid rate to a level 
16below what that component would
have been utilizing in the rate 
17effective on July 1, 1984.

18 (2) Shall take into account the actual costs incurred by 
19facilities
in providing services for recipients of skilled 
20nursing and intermediate
care services under the medical 
21assistance program.

22 (3) Shall take into account the medical and psycho-social

23characteristics and needs of the patients.

24 (4) Shall take into account the actual costs incurred by 
25facilities in
meeting licensing and certification standards 
26imposed and prescribed by the
State of Illinois, any of its 
 
 
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1political subdivisions or municipalities and by
the U.S. 
2Department of Health and Human Services pursuant to Title XIX 
3of the
Social Security Act.

4 The Department of Healthcare and Family Services
shall 
5develop precise standards for
payments to reimburse nursing 
6facilities for any utilization of
appropriate rehabilitative 
7personnel for the provision of rehabilitative
services which is 
8authorized by federal regulations, including
reimbursement for 
9services provided by qualified therapists or qualified

10assistants, and which is in accordance with accepted 
11professional
practices. Reimbursement also may be made for 
12utilization of other
supportive personnel under appropriate 
13supervision.

14 The Department shall develop enhanced payments to offset 
15the additional costs incurred by a
facility serving exceptional 
16need residents and shall allocate at least $8,000,000 of the 
17funds
collected from the assessment established by Section 5B-2 
18of this Code for such payments. For
the purpose of this 
19Section, "exceptional needs" means, but need not be limited to, 
20ventilator care, tracheotomy care,
bariatric care, complex 
21wound care, and traumatic brain injury care. The enhanced 
22payments for exceptional need residents under this paragraph 
23are not due and payable, however, until (i) the methodologies 
24described in this paragraph are approved by the federal 
25government in an appropriate State Plan amendment and (ii) the 
26assessment imposed by Section 5B-2 of this Code is determined 
 
 
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1to be a permissible tax under Title XIX of the Social Security 
2Act.
3 Beginning July 1, 2013, January 1, 2014 the methodologies 
4for reimbursement of nursing facility services as provided 
5under this Section 5-5.4 shall no longer be applicable for 
6services provided on or after July 1, 2013 January 1, 2014. 
7 No payment increase under this Section for the MDS 
8methodology, exceptional care residents, or the 
9socio-development component rate established by Public Act 
1096-1530 of the 96th General Assembly and funded by the 
11assessment imposed under Section 5B-2 of this Code shall be due 
12and payable until after the Department notifies the long-term 
13care providers, in writing, that the payment methodologies to 
14long-term care providers required under this Section have been 
15approved by the Centers for Medicare and Medicaid Services of 
16the U.S. Department of Health and Human Services and the 
17waivers under 42 CFR 433.68 for the assessment imposed by this 
18Section, if necessary, have been granted by the Centers for 
19Medicare and Medicaid Services of the U.S. Department of Health 
20and Human Services. Upon notification to the Department of 
21approval of the payment methodologies required under this 
22Section and the waivers granted under 42 CFR 433.68, all 
23increased payments otherwise due under this Section prior to 
24the date of notification shall be due and payable within 90 
25days of the date federal approval is received. 
26 On and after July 1, 2012, the Department shall reduce any 
 
 
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1rate of reimbursement for services or other payments or alter 
2any methodologies authorized by this Code to reduce any rate of 
3reimbursement for services or other payments in accordance with 
4Section 5-5e. 
5(Source: P.A. 96-45, eff. 7-15-09; 96-339, eff. 7-1-10; 96-959, 
6eff. 7-1-10; 96-1000, eff. 7-2-10; 96-1530, eff. 2-16-11; 
797-10, eff. 6-14-11; 97-38, eff. 6-28-11; 97-227, eff. 1-1-12; 
897-584, eff. 8-26-11; 97-689, eff. 6-14-12; 97-813, eff. 
97-13-12.)


10 Section 99. Effective date. This Act takes effect upon 
11becoming law.".