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Bill > SB1391


IL SB1391

IL SB1391
MEDICAID-HOSPITAL RATES


summary

Introduced
01/29/2025
In Committee
06/02/2025
Crossed Over
Passed
Dead

Introduced Session

Potential new amendment
104th General Assembly

Bill Summary

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.

AI Summary

This bill amends the Illinois Public Aid Code to increase reimbursement rates for hospitals, with a specific focus on safety-net hospitals. A safety-net hospital is defined as an Illinois hospital licensed as a general acute care or pediatric hospital, designated as a disproportionate share hospital, and meeting specific criteria related to Medicaid Inpatient Utilization Rate (MIUR) and charity care. Effective January 1, 2026, and subject to federal approval, the bill mandates a 10% increase in reimbursement rates for both inpatient and outpatient hospital services. For safety-net hospitals, this increase will apply to rates under the All Patient Refined-Diagnosis Related Groups system for inpatient services and the Enhanced Ambulatory Procedure Grouping system for outpatient services. The Department of Healthcare and Family Services is required to take all necessary actions to implement these rate increases, including publishing public notices, applying for federal approval of amendments to the Illinois Title XIX State Plan, and adopting administrative rules if needed. The bill aims to provide financial support to hospitals that serve a significant number of Medicaid and uninsured patients, potentially improving access to healthcare for vulnerable populations.

Committee Categories

Budget and Finance

Sponsors (1)

Last Action

Senate Committee Amendment No. 1 Rule 3-9(a) / Re-referred to Assignments (on 06/02/2025)

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