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

3 everything after the enacting clause with the following:

4 "Section 5. The Nursing Home Care Act is amended by

5 changing 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

8 thereafter.

9 (a) For the purpose of computing staff to resident ratios,

10 direct 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

5 subject to 77 Ill. Admin. Code 300.4000 and following (Subpart

6 S) to utilize specialized clinical staff, as defined in rules,

7 to count towards the staffing ratios.

8 Within 120 days of the effective date of this amendatory

9 Act of the 97th General Assembly, the Department shall

10 promulgate rules specific to the staffing requirements for

11 facilities federally defined as Institutions for Mental

12 Disease. These rules shall recognize the unique nature of

13 individuals with chronic mental health conditions, shall

14 include minimum requirements for specialized clinical staff,

15 including clinical social workers, psychiatrists,

16 psychologists, and direct care staff set forth in paragraphs

17 (4) through (6) and any other specialized staff which may be

18 utilized and deemed necessary to count toward staffing ratios.

19 Within 120 days of the effective date of this amendatory

20 Act of the 97th General Assembly, the Department shall

21 promulgate rules specific to the staffing requirements for

22 facilities licensed under the Specialized Mental Health

23 Rehabilitation Act. These rules shall recognize the unique

24 nature of individuals with chronic mental health conditions,

25 shall include minimum requirements for specialized clinical

26 staff, including clinical social workers, psychiatrists,

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1 psychologists, and direct care staff set forth in paragraphs

2 (4) through (6) and any other specialized staff which may be

3 utilized and deemed necessary to count toward staffing ratios.

4 (b) Beginning January 1, 2011, and thereafter, light

5 intermediate care shall be staffed at the same staffing ratio

6 as intermediate care.

7 (c) Facilities shall notify the Department within 60 days

8 after the effective date of this amendatory Act of the 96th

9 General Assembly, in a form and manner prescribed by the

10 Department, of the staffing ratios in effect on the effective

11 date of this amendatory Act of the 96th General Assembly for

12 both intermediate and skilled care and the number of residents

13 receiving each level of care.

14 (d)(1) Effective July 1, 2010, for each resident needing

15 skilled care, a minimum staffing ratio of 2.5 hours of nursing

16 and personal care each day must be provided; for each resident

17 needing intermediate care, 1.7 hours of nursing and personal

18 care each day must be provided.

19 (2) Effective January 1, 2011, the minimum staffing ratios

20 shall be increased to 2.7 hours of nursing and personal care

21 each day for a resident needing skilled care and 1.9 hours of

22 nursing and personal care each day for a resident needing

23 intermediate care.

24 (3) Effective January 1, 2012, the minimum staffing ratios

25 shall be increased to 3.0 hours of nursing and personal care

26 each day for a resident needing skilled care and 2.1 hours of

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1 nursing and personal care each day for a resident needing

2 intermediate care.

3 (4) Effective January 1, 2013, the minimum staffing ratios

4 shall be increased to 3.4 hours of nursing and personal care

5 each day for a resident needing skilled care and 2.3 hours of

6 nursing and personal care each day for a resident needing

7 intermediate care.

8 (5) Effective January 1, 2014, the minimum staffing ratios

9 shall be increased to 3.8 hours of nursing and personal care

10 each day for a resident needing skilled care and 2.5 hours of

11 nursing and personal care each day for a resident needing

12 intermediate care.

13 (e) Ninety days after the effective date of this amendatory

14 Act of the 97th General Assembly, a minimum of 25% of nursing

15 and personal care time shall be provided by licensed nurses,

16 with at least 10% of nursing and personal care time provided by

17 registered nurses. ~~These minimum requirements shall remain in~~

18 ~~effect until an acuity based registered nurse requirement is~~

19 ~~promulgated by rule concurrent with the adoption of the~~

20 ~~Resource Utilization Group classification-based payment~~

21 ~~methodology, as provided in Section 5-5.2 of the Illinois~~

22 ~~Public Aid Code.~~ Registered nurses and licensed practical

23 nurses employed by a facility in excess of these requirements

24 may be used to satisfy the remaining 75% of the nursing and

25 personal care time requirements. Notwithstanding this

26 subsection, no staffing requirement in statute in effect on the

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1 effective date of this amendatory Act of the 97th General

2 Assembly shall be reduced on account of this subsection. Both

3 the 25% licensed nurse requirement and 10% registered nurse

4 requirement shall remain in effect until an acuity based

5 licensed nurse requirement and registered nurse requirement

6 are adopted in administrative rules subsequent to the

7 implementation of the Resource Utilization Group

8 classification-based payment methodology, as provided in

9 Section 5-5.2 of the Illinois Public Aid Code. An acuity based

10 licensed nurse requirement and registered nurse requirement

11 shall not be made effective before January 1, 2014.

12 (Source: P.A. 96-1372, eff. 7-29-10; 96-1504, eff. 1-27-11;

13 97-689, eff. 6-14-12.)

14 Section 10. The Illinois Public Aid Code is amended by

15 changing 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

19 Section 5-5.1 of this Act shall receive the same rate of

20 payment for similar services.

21 (b) It shall be a matter of State policy that the Illinois

22 Department shall utilize a uniform billing cycle throughout the

23 State for the long-term care providers.

24 (c) Notwithstanding any other provisions of this Code, the

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1 methodologies for reimbursement of nursing services as

2 provided under this Article shall no longer be applicable for

3 bills payable for nursing services rendered on or after a new

4 reimbursement system based on the Resource Utilization Groups

5 (RUGs) has been fully operationalized, which shall take effect

6 for services provided on or after July 1, 2013 ~~January 1, 2014~~.

7 (d) A new nursing services reimbursement methodology

8 utilizing RUGs IV 48 grouper model shall be established and may

9 include an Illinois-specific default group, as needed. The new

10 RUGs-based nursing services reimbursement methodology shall be

11 resident-driven, facility-specific, and cost-based. Costs

12 shall be annually rebased and case mix index quarterly updated.

13 The methodology shall include regional wage adjustors based on

14 the Health Service Areas (HSA) groupings in effect on April 30,

15 2012. The Department shall assign a case mix index to each

16 resident class based on the Centers for Medicare and Medicaid

17 Services staff time measurement study utilizing an index

18 maximization approach.

19 (e) Notwithstanding any other provision of this Code, the

20 Department shall by rule develop a reimbursement methodology

21 reflective of the intensity of care and services requirements

22 of low need residents in the lowest RUG IV groupers and

23 corresponding regulations.

24 (f) Notwithstanding any other provision of this Code, on

25 and after July 1, 2012, reimbursement rates associated with the

26 nursing or support components of the current nursing facility

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1 rate methodology shall not increase beyond the level effective

2 May 1, 2011 until a new reimbursement system based on the RUGs

3 IV 48 grouper model has been fully operationalized.

4 (g) Notwithstanding any other provision of this Code, on

5 and after July 1, 2012, for facilities not designated by the

6 Department of Healthcare and Family Services as "Institutions

7 for Mental Disease", rates effective May 1, 2011 shall be

8 adjusted 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

17 and after July 1, 2012, nursing facilities designated by the

18 Department of Healthcare and Family Services as "Institutions

19 for Mental Disease" and "Institutions for Mental Disease" that

20 are facilities licensed under the Specialized Mental Health

21 Rehabilitation Act shall have the nursing,

22 socio-developmental, capital, and support components of their

23 reimbursement rate effective May 1, 2011 reduced in total by

24 2.7%.

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

3 and Family Services.The Department of Healthcare and Family

4 Services shall develop standards of payment of nursing facility

5 and ICF/DD services in facilities providing such services under

6 this Article which:

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

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

9 The amount of the payment rate for all nursing facilities

10 certified by the Department of Public Health under the ID/DD

11 Community Care Act or the Nursing Home Care Act as Intermediate

12 Care for the Developmentally Disabled facilities, Long Term

13 Care for Under Age 22 facilities, Skilled Nursing facilities,

14 or Intermediate Care facilities under the medical assistance

15 program shall be prospectively established annually on the

16 basis of historical, financial, and statistical data

17 reflecting actual costs from prior years, which shall be

18 applied to the current rate year and updated for inflation,

19 except that the capital cost element for newly constructed

20 facilities shall be based upon projected budgets. The annually

21 established payment rate shall take effect on July 1 in 1984

22 and subsequent years. No rate increase and no update for

23 inflation shall be provided on or after July 1, 1994 and before

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

25 Section. The changes made by Public Act 93-841 extending the

26 duration of the prohibition against a rate increase or update

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1 for inflation are effective retroactive to July 1, 2004.

2 For facilities licensed by the Department of Public Health

3 under the Nursing Home Care Act as Intermediate Care for the

4 Developmentally Disabled facilities or Long Term Care for Under

5 Age 22 facilities, the rates taking effect on July 1, 1998

6 shall include an increase of 3%. For facilities licensed by the

7 Department of Public Health under the Nursing Home Care Act as

8 Skilled Nursing facilities or Intermediate Care facilities,

9 the rates taking effect on July 1, 1998 shall include an

10 increase of 3% plus $1.10 per resident-day, as defined by the

11 Department. For facilities licensed by the Department of Public

12 Health under the Nursing Home Care Act as Intermediate Care

13 Facilities for the Developmentally Disabled or Long Term Care

14 for Under Age 22 facilities, the rates taking effect on January

15 1, 2006 shall include an increase of 3%. For facilities

16 licensed by the Department of Public Health under the Nursing

17 Home Care Act as Intermediate Care Facilities for the

18 Developmentally Disabled or Long Term Care for Under Age 22

19 facilities, the rates taking effect on January 1, 2009 shall

20 include an increase sufficient to provide a $0.50 per hour wage

21 increase for non-executive staff.

22 For facilities licensed by the Department of Public Health

23 under the Nursing Home Care Act as Intermediate Care for the

24 Developmentally Disabled facilities or Long Term Care for Under

25 Age 22 facilities, the rates taking effect on July 1, 1999

26 shall include an increase of 1.6% plus $3.00 per resident-day,

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1 as defined by the Department. For facilities licensed by the

2 Department of Public Health under the Nursing Home Care Act as

3 Skilled Nursing facilities or Intermediate Care facilities,

4 the rates taking effect on July 1, 1999 shall include an

5 increase of 1.6% and, for services provided on or after October

6 1, 1999, shall be increased by $4.00 per resident-day, as

7 defined by the Department.

8 For facilities licensed by the Department of Public Health

9 under the Nursing Home Care Act as Intermediate Care for the

10 Developmentally Disabled facilities or Long Term Care for Under

11 Age 22 facilities, the rates taking effect on July 1, 2000

12 shall include an increase of 2.5% per resident-day, as defined

13 by the Department. For facilities licensed by the Department of

14 Public Health under the Nursing Home Care Act as Skilled

15 Nursing facilities or Intermediate Care facilities, the rates

16 taking effect on July 1, 2000 shall include an increase of 2.5%

17 per resident-day, as defined by the Department.

18 For facilities licensed by the Department of Public Health

19 under the Nursing Home Care Act as skilled nursing facilities

20 or intermediate care facilities, a new payment methodology must

21 be implemented for the nursing component of the rate effective

22 July 1, 2003. The Department of Public Aid (now Healthcare and

23 Family Services) shall develop the new payment methodology

24 using the Minimum Data Set (MDS) as the instrument to collect

25 information concerning nursing home resident condition

26 necessary to compute the rate. The Department shall develop the

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1 new payment methodology to meet the unique needs of Illinois

2 nursing home residents while remaining subject to the

3 appropriations provided by the General Assembly. A transition

4 period from the payment methodology in effect on June 30, 2003

5 to the payment methodology in effect on July 1, 2003 shall be

6 provided for a period not exceeding 3 years and 184 days after

7 implementation 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

4 under the Nursing Home Care Act as Intermediate Care for the

5 Developmentally Disabled facilities or Long Term Care for Under

6 Age 22 facilities, the rates taking effect on March 1, 2001

7 shall include a statewide increase of 7.85%, as defined by the

8 Department.

9 Notwithstanding any other provision of this Section, for

10 facilities licensed by the Department of Public Health under

11 the Nursing Home Care Act as skilled nursing facilities or

12 intermediate care facilities, except facilities participating

13 in the Department's demonstration program pursuant to the

14 provisions of Title 77, Part 300, Subpart T of the Illinois

15 Administrative Code, the numerator of the ratio used by the

16 Department of Healthcare and Family Services to compute the

17 rate payable under this Section using the Minimum Data Set

18 (MDS) methodology shall incorporate the following annual

19 amounts as the additional funds appropriated to the Department

20 specifically to pay for rates based on the MDS nursing

21 component methodology in excess of the funding in effect on

22 December 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

16 facilities licensed by the Department of Public Health under

17 the Nursing Home Care Act as skilled nursing facilities or

18 intermediate care facilities, the support component of the

19 rates taking effect on January 1, 2008 shall be computed using

20 the most recent cost reports on file with the Department of

21 Healthcare and Family Services no later than April 1, 2005,

22 updated for inflation to January 1, 2006.

23 For facilities licensed by the Department of Public Health

24 under the Nursing Home Care Act as Intermediate Care for the

25 Developmentally Disabled facilities or Long Term Care for Under

26 Age 22 facilities, the rates taking effect on April 1, 2002

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1 shall include a statewide increase of 2.0%, as defined by the

2 Department. This increase terminates on July 1, 2002; beginning

3 July 1, 2002 these rates are reduced to the level of the rates

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

5 For facilities licensed by the Department of Public Health

6 under the Nursing Home Care Act as skilled nursing facilities

7 or intermediate care facilities, the rates taking effect on

8 July 1, 2001 shall be computed using the most recent cost

9 reports on file with the Department of Public Aid no later than

10 April 1, 2000, updated for inflation to January 1, 2001. For

11 rates effective July 1, 2001 only, rates shall be the greater

12 of the rate computed for July 1, 2001 or the rate effective on

13 June 30, 2001.

14 Notwithstanding any other provision of this Section, for

15 facilities licensed by the Department of Public Health under

16 the Nursing Home Care Act as skilled nursing facilities or

17 intermediate care facilities, the Illinois Department shall

18 determine by rule the rates taking effect on July 1, 2002,

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

20 2002.

21 Notwithstanding any other provision of this Section, for

22 facilities licensed by the Department of Public Health under

23 the Nursing Home Care Act as skilled nursing facilities or

24 intermediate care facilities, if the payment methodologies

25 required under Section 5A-12 and the waiver granted under 42

26 CFR 433.68 are approved by the United States Centers for

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1 Medicare and Medicaid Services, the rates taking effect on July

2 1, 2004 shall be 3.0% greater than the rates in effect on June

3 30, 2004. These rates shall take effect only upon approval and

4 implementation of the payment methodologies required under

5 Section 5A-12.

6 Notwithstanding any other provisions of this Section, for

7 facilities licensed by the Department of Public Health under

8 the Nursing Home Care Act as skilled nursing facilities or

9 intermediate care facilities, the rates taking effect on

10 January 1, 2005 shall be 3% more than the rates in effect on

11 December 31, 2004.

12 Notwithstanding any other provision of this Section, for

13 facilities licensed by the Department of Public Health under

14 the Nursing Home Care Act as skilled nursing facilities or

15 intermediate care facilities, effective January 1, 2009, the

16 per diem support component of the rates effective on January 1,

17 2008, computed using the most recent cost reports on file with

18 the Department of Healthcare and Family Services no later than

19 April 1, 2005, updated for inflation to January 1, 2006, shall

20 be increased to the amount that would have been derived using

21 standard Department of Healthcare and Family Services methods,

22 procedures, and inflators.

23 Notwithstanding any other provisions of this Section, for

24 facilities licensed by the Department of Public Health under

25 the Nursing Home Care Act as intermediate care facilities that

26 are federally defined as Institutions for Mental Disease, or

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1 facilities licensed by the Department of Public Health under

2 the Specialized Mental Health Rehabilitation Act, a

3 socio-development component rate equal to 6.6% of the

4 facility's nursing component rate as of January 1, 2006 shall

5 be established and paid effective July 1, 2006. The

6 socio-development component of the rate shall be increased by a

7 factor of 2.53 on the first day of the month that begins at

8 least 45 days after January 11, 2008 (the effective date of

9 Public Act 95-707). As of August 1, 2008, the socio-development

10 component rate shall be equal to 6.6% of the facility's nursing

11 component rate as of January 1, 2006, multiplied by a factor of

12 3.53. For services provided on or after April 1, 2011, or the

13 first day of the month that begins at least 45 days after the

14 effective date of this amendatory Act of the 96th General

15 Assembly, whichever is later, the Illinois Department may by

16 rule adjust these socio-development component rates, and may

17 use different adjustment methodologies for those facilities

18 participating, and those not participating, in the Illinois

19 Department's demonstration program pursuant to the provisions

20 of Title 77, Part 300, Subpart T of the Illinois Administrative

21 Code, but in no case may such rates be diminished below those

22 in effect on August 1, 2008.

23 For facilities licensed by the Department of Public Health

24 under the Nursing Home Care Act as Intermediate Care for the

25 Developmentally Disabled facilities or as long-term care

26 facilities for residents under 22 years of age, the rates

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1 taking effect on July 1, 2003 shall include a statewide

2 increase of 4%, as defined by the Department.

3 For facilities licensed by the Department of Public Health

4 under the Nursing Home Care Act as Intermediate Care for the

5 Developmentally Disabled facilities or Long Term Care for Under

6 Age 22 facilities, the rates taking effect on the first day of

7 the month that begins at least 45 days after the effective date

8 of this amendatory Act of the 95th General Assembly shall

9 include a statewide increase of 2.5%, as defined by the

10 Department.

11 Notwithstanding any other provision of this Section, for

12 facilities licensed by the Department of Public Health under

13 the Nursing Home Care Act as skilled nursing facilities or

14 intermediate care facilities, effective January 1, 2005,

15 facility rates shall be increased by the difference between (i)

16 a facility's per diem property, liability, and malpractice

17 insurance costs as reported in the cost report filed with the

18 Department of Public Aid and used to establish rates effective

19 July 1, 2001 and (ii) those same costs as reported in the

20 facility's 2002 cost report. These costs shall be passed

21 through to the facility without caps or limitations, except for

22 adjustments required under normal auditing procedures.

23 Rates established effective each July 1 shall govern

24 payment for services rendered throughout that fiscal year,

25 except that rates established on July 1, 1996 shall be

26 increased by 6.8% for services provided on or after January 1,

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1 1997. Such rates will be based upon the rates calculated for

2 the year beginning July 1, 1990, and for subsequent years

3 thereafter until June 30, 2001 shall be based on the facility

4 cost reports for the facility fiscal year ending at any point

5 in time during the previous calendar year, updated to the

6 midpoint of the rate year. The cost report shall be on file

7 with the Department no later than April 1 of the current rate

8 year. Should the cost report not be on file by April 1, the

9 Department shall base the rate on the latest cost report filed

10 by each skilled care facility and intermediate care facility,

11 updated to the midpoint of the current rate year. In

12 determining rates for services rendered on and after July 1,

13 1985, fixed time shall not be computed at less than zero. The

14 Department shall not make any alterations of regulations which

15 would reduce any component of the Medicaid rate to a level

16 below what that component would have been utilizing in the rate

17 effective on July 1, 1984.

18 (2) Shall take into account the actual costs incurred by

19 facilities in providing services for recipients of skilled

20 nursing and intermediate care services under the medical

21 assistance program.

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

23 characteristics and needs of the patients.

24 (4) Shall take into account the actual costs incurred by

25 facilities in meeting licensing and certification standards

26 imposed and prescribed by the State of Illinois, any of its

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1 political subdivisions or municipalities and by the U.S.

2 Department of Health and Human Services pursuant to Title XIX

3 of the Social Security Act.

4 The Department of Healthcare and Family Services shall

5 develop precise standards for payments to reimburse nursing

6 facilities for any utilization of appropriate rehabilitative

7 personnel for the provision of rehabilitative services which is

8 authorized by federal regulations, including reimbursement for

9 services provided by qualified therapists or qualified

10 assistants, and which is in accordance with accepted

11 professional practices. Reimbursement also may be made for

12 utilization of other supportive personnel under appropriate

13 supervision.

14 The Department shall develop enhanced payments to offset

15 the additional costs incurred by a facility serving exceptional

16 need residents and shall allocate at least $8,000,000 of the

17 funds collected from the assessment established by Section 5B-2

18 of this Code for such payments. For the purpose of this

19 Section, "exceptional needs" means, but need not be limited to,

20 ventilator care, tracheotomy care, bariatric care, complex

21 wound care, and traumatic brain injury care. The enhanced

22 payments for exceptional need residents under this paragraph

23 are not due and payable, however, until (i) the methodologies

24 described in this paragraph are approved by the federal

25 government in an appropriate State Plan amendment and (ii) the

26 assessment imposed by Section 5B-2 of this Code is determined

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1 to be a permissible tax under Title XIX of the Social Security

2 Act.

3 Beginning July 1, 2013, ~~January 1, 2014~~ the methodologies

4 for reimbursement of nursing facility services as provided

5 under this Section 5-5.4 shall no longer be applicable for

6 services provided on or after July 1, 2013 ~~January 1, 2014~~.

7 No payment increase under this Section for the MDS

8 methodology, exceptional care residents, or the

9 socio-development component rate established by Public Act

10 96-1530 of the 96th General Assembly and funded by the

11 assessment imposed under Section 5B-2 of this Code shall be due

12 and payable until after the Department notifies the long-term

13 care providers, in writing, that the payment methodologies to

14 long-term care providers required under this Section have been

15 approved by the Centers for Medicare and Medicaid Services of

16 the U.S. Department of Health and Human Services and the

17 waivers under 42 CFR 433.68 for the assessment imposed by this

18 Section, if necessary, have been granted by the Centers for

19 Medicare and Medicaid Services of the U.S. Department of Health

20 and Human Services. Upon notification to the Department of

21 approval of the payment methodologies required under this

22 Section and the waivers granted under 42 CFR 433.68, all

23 increased payments otherwise due under this Section prior to

24 the date of notification shall be due and payable within 90

25 days of the date federal approval is received.

26 On and after July 1, 2012, the Department shall reduce any

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1 rate of reimbursement for services or other payments or alter

2 any methodologies authorized by this Code to reduce any rate of

3 reimbursement for services or other payments in accordance with

4 Section 5-5e.

5 (Source: P.A. 96-45, eff. 7-15-09; 96-339, eff. 7-1-10; 96-959,

6 eff. 7-1-10; 96-1000, eff. 7-2-10; 96-1530, eff. 2-16-11;

7 97-10, eff. 6-14-11; 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;

8 97-584, eff. 8-26-11; 97-689, eff. 6-14-12; 97-813, eff.

9 7-13-12.)

10 Section 99. Effective date. This Act takes effect upon

11 becoming law.".