This bill will significantly affect the reimbursement process for nursing services under Medicaid, thereby impacting state laws that govern financial assistance in healthcare. Under the new system, facilities that meet certain staffing thresholds will receive per diem add-on payments that scale based on the percentage of the staffing levels achieved. This incentivizes higher staffing levels among nursing facilities and aims to improve the quality of care provided to residents.
Summary
SB3380 amends the Medical Assistance Article of the Illinois Public Aid Code to adjust per diem add-on payments for nursing facilities based on specified staffing levels indicated by the STRIVE study. This legislation establishes that when the Centers for Medicare and Medicaid Services (CMS) ceases to update the STRIVE study, the Illinois Department of Healthcare and Family Services (DHFS) will revert to the most recent data available, ensuring payment amounts are not decreased until a new measurement study is legislated. This aims to create stability in funding for nursing facilities during transitions in federal study protocols.
Contention
Notable points of contention arise from the implementation timelines and financial implications. There have been concerns from various stakeholders regarding the adequacy of funding to support the increase in staffing levels and the overall impact on care quality. Additionally, as the reimbursement methodologies shift to adapt to the Patient Driven Payment Model (PDPM), some industry representatives argue that such changes may favor larger facilities disproportionately, leaving smaller establishments at a disadvantage.