Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1391 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1391 Introduced 1/29/2025, by Sen. Kimberly A. Lightford SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5e.1305 ILCS 5/14-12.6 new Amends the Illinois Public Aid Code. In a provision in the Medical Assistance Article concerning safety-net hospitals, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10% for safety-net hospitals; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10% for safety-net hospitals. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases for safety-net hospitals are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. In the Hospital Services Trust Fund Article, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10%; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10%. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. Effective immediately. LRB104 09551 KTG 19614 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1391 Introduced 1/29/2025, by Sen. Kimberly A. Lightford SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5e.1305 ILCS 5/14-12.6 new 305 ILCS 5/5-5e.1 305 ILCS 5/14-12.6 new Amends the Illinois Public Aid Code. In a provision in the Medical Assistance Article concerning safety-net hospitals, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10% for safety-net hospitals; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10% for safety-net hospitals. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases for safety-net hospitals are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. In the Hospital Services Trust Fund Article, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10%; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10%. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. Effective immediately. LRB104 09551 KTG 19614 b LRB104 09551 KTG 19614 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1391 Introduced 1/29/2025, by Sen. Kimberly A. Lightford SYNOPSIS AS INTRODUCED:
3	3	305 ILCS 5/5-5e.1305 ILCS 5/14-12.6 new 305 ILCS 5/5-5e.1 305 ILCS 5/14-12.6 new
4	4	305 ILCS 5/5-5e.1
5	5	305 ILCS 5/14-12.6 new
6	6	Amends the Illinois Public Aid Code. In a provision in the Medical Assistance Article concerning safety-net hospitals, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10% for safety-net hospitals; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10% for safety-net hospitals. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases for safety-net hospitals are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. In the Hospital Services Trust Fund Article, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10%; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10%. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. Effective immediately.
7	7	LRB104 09551 KTG 19614 b LRB104 09551 KTG 19614 b
8	8	LRB104 09551 KTG 19614 b
9	9	A BILL FOR
10	10	SB1391LRB104 09551 KTG 19614 b SB1391 LRB104 09551 KTG 19614 b
11	11	SB1391 LRB104 09551 KTG 19614 b
12	12	1 AN ACT concerning public aid.
13	13	2 Be it enacted by the People of the State of Illinois,
14	14	3 represented in the General Assembly:
15	15	4 Section 5. The Illinois Public Aid Code is amended by
16	16	5 adding Sections 5-5e.1 and 14-12.6 as follows:
17	17	6 (305 ILCS 5/5-5e.1)
18	18	7 Sec. 5-5e.1. Safety-Net Hospitals.
19	19	8 (a) A Safety-Net Hospital is an Illinois hospital that:
20	20	9 (1) is licensed by the Department of Public Health as
21	21	10 a general acute care or pediatric hospital; and
22	22	11 (2) is a disproportionate share hospital, as described
23	23	12 in Section 1923 of the federal Social Security Act, as
24	24	13 determined by the Department; and
25	25	14 (3) meets one of the following:
26	26	15 (A) has a MIUR of at least 40% and a charity
27	27	16 percent of at least 4%; or
28	28	17 (B) has a MIUR of at least 50%.
29	29	18 (b) Definitions. As used in this Section:
30	30	19 (1) "Charity percent" means the ratio of (i) the
31	31	20 hospital's charity charges for services provided to
32	32	21 individuals without health insurance or another source of
33	33	22 third party coverage to (ii) the Illinois total hospital
34	34	23 charges, each as reported on the hospital's OBRA form.
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38	38	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1391 Introduced 1/29/2025, by Sen. Kimberly A. Lightford SYNOPSIS AS INTRODUCED:
39	39	305 ILCS 5/5-5e.1305 ILCS 5/14-12.6 new 305 ILCS 5/5-5e.1 305 ILCS 5/14-12.6 new
40	40	305 ILCS 5/5-5e.1
41	41	305 ILCS 5/14-12.6 new
42	42	Amends the Illinois Public Aid Code. In a provision in the Medical Assistance Article concerning safety-net hospitals, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10% for safety-net hospitals; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10% for safety-net hospitals. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases for safety-net hospitals are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. In the Hospital Services Trust Fund Article, provides that, subject to federal approval, reimbursement rates for inpatient hospital services in effect January 1, 2025 under the All Patient Refined-Diagnosis Related Groups system shall be increased by 10%; and reimbursement rates for outpatient hospital services in effect January 1, 2025 under the Enhanced Ambulatory Procedure Grouping system shall be increased by 10%. Requires the Department of Healthcare and Family Services to take all actions necessary to ensure the rate increases are in effect for dates of service on and after January 1, 2026, including publishing all appropriate public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if necessary. Effective immediately.
43	43	LRB104 09551 KTG 19614 b LRB104 09551 KTG 19614 b
44	44	LRB104 09551 KTG 19614 b
45	45	A BILL FOR
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51	51	305 ILCS 5/5-5e.1
52	52	305 ILCS 5/14-12.6 new
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71	71	1 (2) "MIUR" means Medicaid Inpatient Utilization Rate
72	72	2 and is defined as a fraction, the numerator of which is the
73	73	3 number of a hospital's inpatient days provided in the
74	74	4 hospital's fiscal year ending 3 years prior to the rate
75	75	5 year, to patients who, for such days, were eligible for
76	76	6 Medicaid under Title XIX of the federal Social Security
77	77	7 Act, 42 USC 1396a et seq., excluding those persons
78	78	8 eligible for medical assistance pursuant to 42 U.S.C.
79	79	9 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
80	80	10 Section 5-2 of this Article, and the denominator of which
81	81	11 is the total number of the hospital's inpatient days in
82	82	12 that same period, excluding those persons eligible for
83	83	13 medical assistance pursuant to 42 U.S.C.
84	84	14 1396a(a)(10)(A)(i)(VIII) as set forth in paragraph 18 of
85	85	15 Section 5-2 of this Article.
86	86	16 (3) "OBRA form" means form HFS-3834, OBRA '93 data
87	87	17 collection form, for the rate year.
88	88	18 (4) "Rate year" means the 12-month period beginning on
89	89	19 October 1.
90	90	20 (c) Beginning July 1, 2012 and ending on December 31,
91	91	21 2026, a hospital that would have qualified for the rate year
92	92	22 beginning October 1, 2011 or October 1, 2012 shall be a
93	93	23 Safety-Net Hospital.
94	94	24 (c-5) Beginning July 1, 2020 and ending on December 31,
95	95	25 2026, a hospital that would have qualified for the rate year
96	96	26 beginning October 1, 2020 and was designated a federal rural
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107	107	1 referral center under 42 CFR 412.96 as of October 1, 2020 shall
108	108	2 be a Safety-Net Hospital.
109	109	3 (d) No later than August 15 preceding the rate year, each
110	110	4 hospital shall submit the OBRA form to the Department. Prior
111	111	5 to October 1, the Department shall notify each hospital
112	112	6 whether it has qualified as a Safety-Net Hospital.
113	113	7 (e) The Department may promulgate rules in order to
114	114	8 implement this Section.
115	115	9 (f) Nothing in this Section shall be construed as limiting
116	116	10 the ability of the Department to include the Safety-Net
117	117	11 Hospitals in the hospital rate reform mandated by Section
118	118	12 14-11 of this Code and implemented under Section 14-12 of this
119	119	13 Code and by administrative rulemaking.
120	120	14 (g) Notwithstanding any other provision of this Code,
121	121	15 effective for dates of service on and after January 1, 2026,
122	122	16 subject to federal approval, reimbursement rates for
123	123	17 safety-net hospitals shall be revised as follows:
124	124	18 (1) For inpatient hospital services, reimbursement
125	125	19 rates in effect January 1, 2025 under the All Patient
126	126	20 Refined-Diagnosis Related Groups system shall be increased
127	127	21 by 10% for safety-net hospitals.
128	128	22 (2) For outpatient hospital services, reimbursement
129	129	23 rates in effect January 1, 2025 under the Enhanced
130	130	24 Ambulatory Procedure Grouping system shall be increased by
131	131	25 10% for safety-net hospitals.
132	132	26 The Department shall take all actions necessary to ensure
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143	143	1 the rate increases for safety-net hospitals authorized by this
144	144	2 amendatory Act of the 104th General Assembly are in effect for
145	145	3 dates of service on and after January 1, 2026, including
146	146	4 publishing all appropriate public notices, applying for
147	147	5 federal approval of amendments to the Illinois Title XIX State
148	148	6 Plan, and adopting administrative rules if necessary.
149	149	7 (Source: P.A. 101-650, eff. 7-7-20; 101-669, eff. 4-2-21;
150	150	8 102-886, eff. 5-17-22.)
151	151	9 (305 ILCS 5/14-12.6 new)
152	152	10 Sec. 14-12.6. Hospital services; rate increases.
153	153	11 (a) Notwithstanding any other provision of this Code,
154	154	12 effective for dates of service on and after January 1, 2026,
155	155	13 subject to federal approval, hospital reimbursement rates
156	156	14 shall be revised as follows:
157	157	15 (1) For inpatient hospital services, reimbursement
158	158	16 rates in effect January 1, 2025 under the All Patient
159	159	17 Refined-Diagnosis Related Groups system shall be increased
160	160	18 by 10%.
161	161	19 (2) For outpatient hospital services, reimbursement
162	162	20 rates in effect January 1, 2025 under the Enhanced
163	163	21 Ambulatory Procedure Grouping system shall be increased by
164	164	22 10%.
165	165	23 (b) The Department shall take all actions necessary to
166	166	24 ensure the rate increases authorized in this amendatory Act of
167	167	25 the 104th General Assembly are in effect for dates of service
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178	178	1 on and after January 1, 2026, including publishing all
179	179	2 appropriate public notices, applying for federal approval of
180	180	3 amendments to the Illinois Title XIX State Plan, and adopting
181	181	4 administrative rules if necessary.
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