Illinois Compiled Statutes 210 ILCS 42/40 – Reimbursement rules
Current as of: 2024 | Check for updates
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The Secretary of Human Services and the Director of Healthcare and Family Services shall:
(1) ensure that reimbursement utilizing federal
(1) ensure that reimbursement utilizing federal
and State resources for services provided to eligible beneficiaries through a continuum of care facility comports with the following requirements:
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(A) such services shall be reimbursed in a
budget-neutral manner such that reimbursement for services provided by the facility constituent elements of a continuum of care licensee shall be neither greater nor lesser than the reimbursement received for such services provided by that facility constituent element prior to the licensing of the continuum of care facility, adjusted to take into account any subsequent changes in reimbursement for such similar services, or, if the facility constituent element is a new facility reimbursement for the services provided by the new facility shall be no less than the reimbursement received for such services by a comparable facility constituent element of that continuum of care facility; and
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(B) a continuum of care licensee shall enter
into a single provider agreement with the Director of Healthcare and Family Services or the Secretary of Human Services; changes that may occur from time to time in the facility constituent elements under the continuum of care license shall be addressed as may be required by applicable requirements of law through amendments to the provider agreement; the Director of Healthcare and Family Services shall make all reasonable efforts to ensure that all facility constituent elements that are approved parts of a continuum of care license remain qualified for reimbursement under relevant State and federal programs including Title XIX of the federal Social Security Act; and
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(2) in cooperation with interested
stakeholders, develop an alternative payment methodology for a continuum of care facility; the initial methodology shall produce payments that are budget neutral as compared to the services provided by the licensee prior to the implementation of the continuum of care license; the effectiveness of the methodology and corresponding rate levels shall be evaluated 18 months following the implementation of the methodology and every 12 months thereafter and shall be adjusted as necessary, subject to appropriation.
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Terms Used In Illinois Compiled Statutes 210 ILCS 42/40
- Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
- State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14